Michael Hayes1, Peter Puhl1, Johann Hagenah2,3, Robert Russo4. 1. Department of Neurology Concord Hospital Sydney Australia. 2. Department of Neurology Westküstenklinikum Heide Germany. 3. Department of Neurology University of Lübeck Lübeck Germany. 4. Department of Nuclear Medicine Concord Hospital Sydney Australia.
Abstract
BACKGROUND: The addition of a simple nonmotor symptom (NMS) screen and transcranial sonography (TCS) to standard clinical assessment may improve the diagnostic accuracy of Parkinson's disease (PD). METHODS: Sixty-nine subjects (23 established PD group, 23 healthy controls, and 23 possible PD) were enrolled. All completed 3 "yes-no" NMS questions (score, 0-3) and had a transcranial ultrasound assessing nigral hyperechogenicity (score, 0-1). A combined PD risk score of 0 to 4 was obtained for each subject. A PD risk score of ≥2 was used as the diagnostic cutoff for PD. RESULTS: In the established PD group, there was an average of 2 NMSs per person or a group total of 46 of 69 possible NMSs, but only 4 of 69 NMSs in the healthy control group. Of the technically satisfactory TCS, 16 of 20 (80%) of the established PD group and 2 of 16 (12.5%) of the healthy control group were TCS positive. Using ≥2 NMSs alone as the cutoff identified 17 of 23 (74%) of the established PD and 100% of the healthy controls. The PD risk score of ≥2 identified 21 of 23 (91%) of the established PD as PD and 22 of 23 (96%) of the healthy control group as non-PD. In the possible PD group, the PD risk score identified 9 of 18 (50%) of those with a final clinical diagnosis of PD and 4 of 5 (80%) of non-PD. CONCLUSIONS: The combination of a brief NMS screen and TCS discriminated well between normal healthy controls and established PD. A positive TCS and one NMS, or a negative TCS with two NMSs, indicated a likely diagnosis of PD.
BACKGROUND: The addition of a simple nonmotor symptom (NMS) screen and transcranial sonography (TCS) to standard clinical assessment may improve the diagnostic accuracy of Parkinson's disease (PD). METHODS: Sixty-nine subjects (23 established PD group, 23 healthy controls, and 23 possible PD) were enrolled. All completed 3 "yes-no" NMS questions (score, 0-3) and had a transcranial ultrasound assessing nigral hyperechogenicity (score, 0-1). A combined PD risk score of 0 to 4 was obtained for each subject. A PD risk score of ≥2 was used as the diagnostic cutoff for PD. RESULTS: In the established PD group, there was an average of 2 NMSs per person or a group total of 46 of 69 possible NMSs, but only 4 of 69 NMSs in the healthy control group. Of the technically satisfactory TCS, 16 of 20 (80%) of the established PD group and 2 of 16 (12.5%) of the healthy control group were TCS positive. Using ≥2 NMSs alone as the cutoff identified 17 of 23 (74%) of the established PD and 100% of the healthy controls. The PD risk score of ≥2 identified 21 of 23 (91%) of the established PD as PD and 22 of 23 (96%) of the healthy control group as non-PD. In the possible PD group, the PD risk score identified 9 of 18 (50%) of those with a final clinical diagnosis of PD and 4 of 5 (80%) of non-PD. CONCLUSIONS: The combination of a brief NMS screen and TCS discriminated well between normal healthy controls and established PD. A positive TCS and one NMS, or a negative TCS with two NMSs, indicated a likely diagnosis of PD.
Authors: Ronald B Postuma; Isabelle Arnulf; Birgit Hogl; Alex Iranzo; Tomoyuki Miyamoto; Yves Dauvilliers; Wolfgang Oertel; Yo-El Ju; Monica Puligheddu; Poul Jennum; Amelie Pelletier; Christina Wolfson; Smaranda Leu-Semenescu; Birgit Frauscher; Masayuki Miyamoto; Valerie Cochen De Cock; Marcus M Unger; Karin Stiasny-Kolster; Maria Livia Fantini; Jacques Y Montplaisir Journal: Mov Disord Date: 2012-05-30 Impact factor: 10.338
Authors: Daniela Berg; Ronald B Postuma; Charles H Adler; Bastiaan R Bloem; Piu Chan; Bruno Dubois; Thomas Gasser; Christopher G Goetz; Glenda Halliday; Lawrence Joseph; Anthony E Lang; Inga Liepelt-Scarfone; Irene Litvan; Kenneth Marek; José Obeso; Wolfgang Oertel; C Warren Olanow; Werner Poewe; Matthew Stern; Günther Deuschl Journal: Mov Disord Date: 2015-10 Impact factor: 10.338
Authors: Dong H Lee; Jungsu S Oh; Jee H Ham; Jae J Lee; Injoo Lee; Phil H Lee; Jae S Kim; Young H Sohn Journal: Neurology Date: 2015-09-09 Impact factor: 9.910
Authors: R D Abbott; H Petrovitch; L R White; K H Masaki; C M Tanner; J D Curb; A Grandinetti; P L Blanchette; J S Popper; G W Ross Journal: Neurology Date: 2001-08-14 Impact factor: 9.910