Substantia nigra echogenicity and imaging of striatal dopamine transporters in Parkinson's disease: A cross-sectional study

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2014-05-01
Autores
Bor-Seng-Shu, Edson
Pedroso, Jose Luiz [UNIFESP]
Felicio, Andre C. [UNIFESP]
Andrade, Daniel Ciampi de
Teixeira, Manoel Jacobsen
Braga-Neto, Pedro [UNIFESP]
Batista, Ilza Rosa [UNIFESP]
Barsottini, Orlando Graziani Povoas [UNIFESP]
Borges, Vanderci [UNIFESP]
Ferraz, Henrique Ballalai [UNIFESP]
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Approximately 10% of patients with a presumed diagnosis of Parkinson's disease (PD) remain misdiagnosed despite recent advances in neuroimaging. the current study addresses the use of transcranial sonography and single-photon emission computed tomography (SPECT) using Tc-99m-TRODAT-1 to evaluate the echogenicity of the substantia nigra (SN) and the density of striatal presynaptic dopamine transporters, respectively, in a sample of 20 PD patients (13 males and 7 females) and 9 healthy subjects. the median age of the PD patients was 62 years. the median age at disease onset was 56 years, and the median disease duration was 5 years. the SN echogenic area was larger in PD patients than healthy subjects. the cut-off value of 0.22 cm(2) for the SN echogenic area was associated with 100% sensitivity and 78% specificity for the diagnosis of PD. Striatal and putaminal Tc-99m-TRODAT-1 binding was lower in PD patients than healthy subjects. the cut-off value of 0.90 for the striatal Tc-99m-TRODAT-1 binding was associated with 100% sensitivity and an 89% specificity for the diagnosis of PD, and the cut-off value of 0.76 for putaminal Tc-99m-TRODAT-1 binding was associated with an 85% sensitivity and an 89% specificity. the size of the SN echogenic area did not correlate with the degree of striatal Tc-99m-TRODAT-1 binding in PD patients. in conclusion, both SN hyperechogenicity and decreased striatal or putaminal Tc-99m-TRODAT-1 binding constitute surrogate markers for differentiating PD patients from healthy individuals with a slightly higher diagnostic specificity of Tc-99m-TRODAT-1 SPECT. (C) 2014 Elsevier B.V. All rights reserved.
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Parkinsonism & Related Disorders. Oxford: Elsevier B.V., v. 20, n. 5, p. 477-481, 2014.
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