Application of Transcranial Sonography in Extrapyramidal Disorders: Updated Recommendations

Zusammenfassung

Eine stetig wachsende Anzahl von Untersuchungen belegt, dass die Transkranielle Sonographie (TCS) als hilfreiches Instrument in der Diagnose und Differenzialdiagnose von extrapyramidalen Erkrankungen eingesetzt werden kann. Durch diese Methode werden klinische und pathophysiologische Daten, die durch andere bildgebende Untersuchungen erhoben werden, ergänzt. Aufgrund des wachsenden Interesses an der Methode und einer zunehmende Verbreitung der Anwendung bei extrapyramidalen Erkrankungen sind standardisierte Prinzipien bezüglich des Untersuchungsablaufs und der Parametereinstellung der verwendeten Ultraschallgeräte essentiell, um vergleichbare Ergebnisse zu gewährleisten. Dieser Artikel gibt einen Überblick über diese Prinzipien und typische Befunde bei häufigen extrapyramidalen Erkrankungen.

Abstract

Transcranial sonography (TCS) has been proven to be a valuable tool in the diagnosis and differential diagnosis of extrapyramidal disorders, supplementing clinical and pathophysiological information that may be obtained by other neuroimaging techniques. Growing interest and increased application of TCS in extrapyramidal disorders require adherence to standardised principles concerning examination procedure and parameter settings of the ultrasound machine in order to ensure comparable results. This article provides an overview of these principles and typical findings in distinct extrapyramidal disorders.

Transkranielle Sonographie (TCS) - Extrapyramidale Störungen - Standardisierte Schnittebenen - Hyperechogenität der Substantia nigra - Hyperechogenität des Nucleus lentiformis

Transcranial sonography (TCS) - extrapyramdial disorders - standardised scanning planes - substantia nigra hyperechogenicity - lentiform nucleus hyperechogenicity

References

• 1 Walter U, Behnke S, Eyding J. et al . Transcranial sonography of the brain parenchyma in movement disorders: state of the art.  Mov Disord. 2005, in press; 
• 2 Becker G, Berg D. Neuroimaging in basal ganglia disorders: perspectives for transcranial ultrasound.  Mov Disord. 2001;  27 23-32
• 3 Puls I, Berg D, Maurer M. et al . Transcranial sonography of the brain parenchyma: comparison of B-mode imaging and tissue harmonic imaging.  Ultrasound Med Biol. 2000;  27 189-194
• 4 Bogdahn U, Becker G, Schlachetzki F. Echoenhancers and transcranial color duplex sonography. Berlin, Vienna; Blackwell Science 1998
• 5 Berg D, Becker G, Zeiler B. et al . Vulnerability of the nigrostriatal system as detected by transcranial ultrasound.  Neurology. 1999;  27 1026-1031
• 6 Berg D, Siefker C, Becker G. Echogenicity of the substantia nigra in Parkinson’s disease and its relation to clinical findings.  J Neurol. 2001;  27 684-689
• 7 Walter U, Wittstock M, Benecke R. et al . Substantia nigra echogenicity is normal in non-extrapyramidal cerebral disorders but increased in Parkinson’s disease.  J Neural Transm. 2002;  27 191-196
• 8 Behnke S, Becker G. Sonographic imaging of the brain parenchyma.  Eur J Ultrasound. 2002;  27 73-80
• 9 Becker G, Struck M, Bogdahn U. et al . Echogenicity of the brainstem raphe in patients with major depression.  Psychiatry Res. 1994;  27 75-84
• 10 Becker G, Seufert J, Bogdahn U. et al . Degeneration of substantia nigra in chronic Parkinson’s disease visualized by transcranial color-coded real-time sonography.  Neurology. 1995;  27 182-184
• 11 Berg D, Supprian T, Hofmann E. et al . Depression in Parkinson‘s disease: brainstem midline alteration on transcranial sonography and magnetic resonance imaging.  J Neurol. 1999; 
• 12 Walter U, Dressler D, Wolters A. et al . Overactive bladder in Parkinson’s disease: alteration of brainstem raphe detected by transcranial sonography.  Eur J Neurol. 2005; in press; 
• 13 Becker G, Naumann M, Scheubeck M. et al . Comparison of transcranial sonography, magnetic resonance imaging, and single photon emission computed tomography findings in idiopathic spasmodic torticollis.  Mov Disord. 1997;  27 79-88
• 14 Postert T, Lack B, Kuhn W. et al . Basal ganglia alterations and brain atrophy in Huntington’s disease depicted by transcranial real time sonography.  J Neurol Neurosurg Psychiatry. 1999;  27 457-462
• 15 Postert T, Eyding J, Berg D. et al . Transcranial sonography in spinocerebellar ataxia type 3.  J Neural Transm. 2004;  27 123-133
• 16 Tromp S, Vlaar A, Weber W. et al . Can ultrasonography of the substantia nigra replace FP-CIT-CPECT.  Parkinsonism Rel Dis. 2005;  27 221
• 17 Zedde M, Manca A, Baule G. et al . Brain parenchyma sonography (BPS) of substantia nigra (SN) in Parkinson’s disease.  Parkinsonism Rel Dis. 2005;  27 222
• 18 Walter U, Klein C, Hilker R. et al . Brain parenchyma sonography detects preclinical parkinsonism.  Mov Disord. 2004;  27 1445-1449
• 19 Berg D, Grote C, Rausch W D. et al . Iron accumulation of the substantia nigra in rats visualized by ultrasound.  Ultrasound Med Biol. 1999;  27 901-904
• 20 Berg D, Roggendorf W, Schröder U. et al . Echogenicity of the substantia nigra - association with increased iron content and marker for susceptibility to nigrostriatal injury.  Arch Neurol. 2002;  27 999-1005
• 21 Zecca L, Berg D, Arzberger T. et al . In vivo detection of iron and neuromelanin by transcranial sonography: A new approach for early detection of substantia nigra damage.  Mov Disord. 2005 Jun 28; [Epub ahead of print]; 
• 22 Berg D, Merz B, Reiners K. et al . A five year follow-up study of hyperechogenicity of the substantia nigra in Parkinson’s disease.  Mov Disord,. 2005;  27 383-385
• 23 Niehaus L, Savyer N, Weber U. et al . Brain parenchyma sonography in patients with essential tremor and Parkinson’s disease.  Cerebrovasc Dis. 2004;  27 3
• 24 Fearnley J M, Lees A J. Ageing and Parkinson’s disease: substantia nigra regional selectivity.  Brain. 1991;  27 2283-2301
• 25 Berg D, Siefker C, Ruprecht-Dorfler P. et al . Relationship of substantia nigra echogenicity and motor function in elderly subjects.  Neurology. 2001;  27 13-17
• 26 Berg D, Jabs B, Merschdorf U. et al . Echogenicity of substantia nigra determined by transcranial ultrasound correlates with severity of Parkinsonian symptoms induced by neuroleptic therapy.  Biol Psychiatry. 2001;  27 463-467
• 27 Sommer U, Hummel T, Cormann K. et al . Detection of presymptomatic Parkinson’s disease: combining smell tests, transcranial sonography, and SPECT.  Mov Disord. 2004;  27 1196-1202
• 28 Naumann M, Becker G, Toyka K V. et al . Lenticular nucleus lesion in idiopathic dystonia detected by transcranial sonography.  Neurology. 1996;  27 1284-1290
• 29 Becker G, Berg D, Rausch W D. et al . Increased tissue copper and manganese content of the lentiform nucleus in primary adult-onset dystonia.  Ann Neurol. 1999;  27 260-263
• 30 Berg D, Weishaupt A, Francis M J. et al . Changes of copper transporting proteins and ceruloplasmin in the lentiform nuclei in primary adult-onset dystonia.  Ann Neurol. 2000;  27 827-830
• 31 Walter U, Krolikowski K, Tarnacka B. et al . Sonographic detection of basal ganglia abnormalities in asymptomatic and symptomatic Wilson disease.  Neurology. 2005;  27 1726-1732
• 32 Kruse N, Berg D, Francis M J. et al . Reduction of Menkes mRNA and copper in leukocytes of patients with primary adult-onset dystonia.  Ann Neurol. 2001;  27 405-408
• 33 Berg D, Naumann M, Hoggenmüller U. et al . Differences of echogenicity and T2 relaxation time of the nucleus lentiformis in MSA and PSP as compared to Parkinson‘s disease.  Mov Disord. 2000;  27 206
• 34 Walter U, Niehaus L, Probst T. et al . Brain parenchyma sonography discriminates Parkinson’s disease and atypical parkinsonian syndromes.  Neurology. 2003;  27 74-77
• 35 Walter U, Dressler D, Wolters A. et al . Sonographic discrimination of corticobasal degeneration vs progressive supranuclear palsy.  Neurology. 2004;  27 504-509
• 36 Behnke S, Berg D, Naumann M. et al . Differentiation of Parkinson’s disease and atypical parkinsonian syndromes by transcranial ultrasound.  J Neurol Neurosurg Psychiatry. 2005;  27 423-425
• 37 Dexter D T, Jenner P, Schapira A HV. et al . Alterations in levels of iron, ferritin, and other trace metals in neurodegenerative diseases affecting the basal ganglia.  Ann Neurol. 1992;  27 S94-100
• 38 Walter U, Dressler D, Wolters A. et al . Sonographic discrimination of dementia with Lewy bodies and Parkinson’s disease with dementia.  J Neurol. 2005, in press; 
• 39 Durr A, Stevanin G, Cancel G. et al . Spinocerebellar ataxia 3 and Machado-Joseph disease: clinical, molecular, and neuropathological features.  Ann Neurol. 1996;  27 490-499
• 40 Hochstrasser H, Bauer P, Walter U. et al . Ceruloplasmin gene variations and substantia nigra hyperechogenicity in Parkinson disease.  Neurology. 2004;  27 1912-1917
• 41 Hochstrasser H, Tomiuk J, Walter U. et al . Functional relevance of ceruloplasmin mutations in Parkinson’s Disease.  FASEB J. 2005;  27 1851-1853