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Kozel J, Školoudík D, Ressner P, Michalčová P, Dušek P, Hanzlíková P, Dvořáčková N, Heryán T, Bártová P. Echogenicity of Brain Structures in Huntington's Disease Patients Evaluated by Transcranial Sonography - Magnetic Resonance Fusion Imaging using Virtual Navigator and Digital Image Analysis. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2023; 44:495-502. [PMID: 37224875 DOI: 10.1055/a-2081-1635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE Transcranial sonography (TCS) magnetic resonance (MR) fusion imaging and digital image analysis are useful tools for the evaluation of various brain pathologies. This study aimed to compare the echogenicity of predefined brain structures in Huntington's disease (HD) patients and healthy controls by TCS-MR fusion imaging using Virtual Navigator and digitized image analysis. MATERIALS AND METHODS The echogenicity of the caudate nucleus (CN), substantia nigra (SN), lentiform nucleus (LN), insula, and brainstem raphe (BR) evaluated by TCS-MR fusion imaging using digitized image analysis was compared between 21 HD patients and 23 healthy controls. The cutoff values of echogenicity indices for the CN, LN, insula, and BR with optimal sensitivity and specificity were calculated using receiver operating characteristic analysis. RESULTS The mean echogenicity indices for the CN (67.0±22.6 vs. 37.9±7.6, p<0.0001), LN (110.7±23.6 vs. 59.7±11.1, p<0.0001), and insula (121.7±39.1 vs. 70.8±23.0, p<0.0001) were significantly higher in HD patients than in healthy controls. In contrast, BR echogenicity (24.8±5.3 vs. 30.1±5.3, p<0.001) was lower in HD patients than in healthy controls. The area under the curve was 90.9%, 95.5%, 84.1%, and 81.8% for the CN, LN, insula, and BR, respectively. The sensitivity and specificity were 86% and 96%, respectively, for the CN and 90% and 100%, respectively, for the LN. CONCLUSION Increased CN, LN, and insula echogenicity and decreased BR echogenicity are typical findings in HD patients. The high sensitivity and specificity of the CN and LN hyperechogenicity in TCS-MR fusion imaging make them promising diagnostic markers for HD.
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Affiliation(s)
- Jiří Kozel
- Center for Health Research, University of Ostrava Faculty of Medicine, Ostrava, Czech Republic
| | - David Školoudík
- Center for Health Research, University of Ostrava Faculty of Medicine, Ostrava, Czech Republic
| | - Pavel Ressner
- Neurology, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czech Republic
| | - Patricie Michalčová
- Center for Health Research, University of Ostrava Faculty of Medicine, Ostrava, Czech Republic
| | - Petr Dušek
- Neurology, The First Faculty of Medicine, Charles University, Praha, Czech Republic
| | - Pavla Hanzlíková
- Radiodiagnostics, University Hospital Ostrava, Ostrava, Czech Republic
| | - Nina Dvořáčková
- Medical Genetics, University Hospital Ostrava, Ostrava, Czech Republic
| | - Tomáš Heryán
- Center for Health Research, University of Ostrava Faculty of Medicine, Ostrava, Czech Republic
| | - Petra Bártová
- Neurology, University Hospital Ostrava, Ostrava, Czech Republic
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Khan MA, Haider N, Singh T, Bandopadhyay R, Ghoneim MM, Alshehri S, Taha M, Ahmad J, Mishra A. Promising biomarkers and therapeutic targets for the management of Parkinson's disease: recent advancements and contemporary research. Metab Brain Dis 2023; 38:873-919. [PMID: 36807081 DOI: 10.1007/s11011-023-01180-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 02/04/2023] [Indexed: 02/23/2023]
Abstract
Parkinson's disease (PD) is one of the progressive neurological diseases which affect around 10 million population worldwide. The clinical manifestation of motor symptoms in PD patients appears later when most dopaminergic neurons have degenerated. Thus, for better management of PD, the development of accurate biomarkers for the early prognosis of PD is imperative. The present work will discuss the potential biomarkers from various attributes covering biochemical, microRNA, and neuroimaging aspects (α-synuclein, DJ-1, UCH-L1, β-glucocerebrosidase, BDNF, etc.) for diagnosis, recent development in PD management, and major limitations with current and conventional anti-Parkinson therapy. This manuscript summarizes potential biomarkers and therapeutic targets, based on available preclinical and clinical evidence, for better management of PD.
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Affiliation(s)
- Mohammad Ahmed Khan
- Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India
| | - Nafis Haider
- Prince Sultan Military College of Health Sciences, Dhahran, 34313, Saudi Arabia
| | - Tanveer Singh
- Department of Neuroscience and Experimental Therapeutics, College of Medicine, Texas A&M University Health Science Center, Bryan, TX, 77807, USA
| | - Ritam Bandopadhyay
- Department of Pharmacology, School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, 144411, Punjab, India
| | - Mohammed M Ghoneim
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, Ad Diriyah, 13713, Saudi Arabia
| | - Sultan Alshehri
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Murtada Taha
- Prince Sultan Military College of Health Sciences, Dhahran, 34313, Saudi Arabia
| | - Javed Ahmad
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran, 11001, Saudi Arabia
| | - Awanish Mishra
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER) - Guwahati, Sila Katamur (Halugurisuk), Kamrup, Changsari, Assam, 781101, India.
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Brunner C, Schreiber SJ, Bokemeyer M, Ransmayr G, Struhal W, Olbert ED, Alhani N, Vosko MR. Value of ultrasound fusion imaging in detecting vascular cerebral white matter pathology. Ultrasound J 2022; 14:25. [PMID: 35713746 PMCID: PMC9206046 DOI: 10.1186/s13089-022-00275-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Transcranial sonography is beside magnetic resonance imaging (MRI) and computed tomography, a well-established imaging method for evaluation of brain parenchyma and already implicated in various neurological disorders as bed-side investigation possibility in clinical routine. The aim of this study was the qualitative assessment detecting vascular white matter hyperintensities (WMHs), with ultrasound fusion-imaging technique (UFI) and to find the optimal location for their visualization in accordance to the grade of WMHs and to possibly providing a standardized protocol for clinical use. RESULTS 29 patients with WMHs of variable degree quantified according to Fazekas grading scale (n = 13 I; n = 9 II; n = 7 III) and 11 subjects with normal findings on MRI were identified for further analysis. Ultrasound images were analyzed to a standardized protocol and predefined anatomical landmarks. UFI could visualize the MRI-verified WMHs in 147 of 161 localizations (91%). The overall ultrasound detection rate of WMHs increased with higher degree of WMHs burden (I:85%, II:94%, III:97%). The highest sensitivity was achieved at the contralateral central part (CPc) (97%) of the lateral ventricle. The inter-rater analysis between 2 independent raters, who were blinded to the patient's diagnosis and assessed only the B-mode ultrasound images, indicated an 86% agreement with an overall moderate strength of agreement (κ: 0.489, p < 0.0005) for all localizations. The highest accordance within raters was shown at the CPc; 92% (κ: 0.645, p < 0.0005). CONCLUSIONS This explorative study describes prospectively the ultrasound detection of periventricular vascular WMHs based on MRI lesions using UFI. Transcranial ultrasound (TCS) could serve as an additional screening opportunity for the detection of incidental WMLs during routine TCS investigations to initiate early vascular risk factor modification in primary prevention.
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Affiliation(s)
- Cornelia Brunner
- Department of Neurology, Karl Landsteiner University of Health Sciences, University Hospital Tulln, Alter Ziegelweg 10, 3430, Tulln, Austria
- Department of Neurology, Kepler University Hospital, 2, Krankenhausstraße 09, 4020, Linz, Austria
- Department of Neurology, Asklepios Clinic Brandenburg, Anton-Saefkow-Allee 2, 14772, Brandenburg an der Havel, Germany
| | - Stephan Joachim Schreiber
- Department of Neurology, Asklepios Clinic Brandenburg, Anton-Saefkow-Allee 2, 14772, Brandenburg an der Havel, Germany
- Department of Neurology, Oberhavel Kliniken, Clinic Hennigsdorf, Marwitzer Straße 91, 16761, Hennigsdorf, Germany
| | - Martin Bokemeyer
- Department of Neurology, Asklepios Clinic Brandenburg, Anton-Saefkow-Allee 2, 14772, Brandenburg an der Havel, Germany
| | - Gerhard Ransmayr
- Department of Neurology, Kepler University Hospital, 2, Krankenhausstraße 09, 4020, Linz, Austria
| | - Walter Struhal
- Department of Neurology, Karl Landsteiner University of Health Sciences, University Hospital Tulln, Alter Ziegelweg 10, 3430, Tulln, Austria
| | - Elisabeth Daniela Olbert
- Department of Neurology, Karl Landsteiner University of Health Sciences, University Hospital Tulln, Alter Ziegelweg 10, 3430, Tulln, Austria
| | - Naela Alhani
- Department of Neurology, Karl Landsteiner University of Health Sciences, University Hospital Tulln, Alter Ziegelweg 10, 3430, Tulln, Austria
| | - Milan Rastislav Vosko
- Department of Neurology, Kepler University Hospital, 2, Krankenhausstraße 09, 4020, Linz, Austria.
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Gouda NA, Elkamhawy A, Cho J. Emerging Therapeutic Strategies for Parkinson’s Disease and Future Prospects: A 2021 Update. Biomedicines 2022; 10:biomedicines10020371. [PMID: 35203580 PMCID: PMC8962417 DOI: 10.3390/biomedicines10020371] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 11/16/2022] Open
Abstract
Parkinson’s disease (PD) is a neurodegenerative disorder pathologically distinguished by degeneration of dopaminergic neurons in the substantia nigra pars compacta. Muscle rigidity, tremor, and bradykinesia are all clinical motor hallmarks of PD. Several pathways have been implicated in PD etiology, including mitochondrial dysfunction, impaired protein clearance, and neuroinflammation, but how these factors interact remains incompletely understood. Although many breakthroughs in PD therapy have been accomplished, there is currently no cure for PD, only trials to alleviate the related motor symptoms. To reduce or stop the clinical progression and mobility impairment, a disease-modifying approach that can directly target the etiology rather than offering symptomatic alleviation remains a major unmet clinical need in the management of PD. In this review, we briefly introduce current treatments and pathophysiology of PD. In addition, we address the novel innovative therapeutic targets for PD therapy, including α-synuclein, autophagy, neurodegeneration, neuroinflammation, and others. Several immunomodulatory approaches and stem cell research currently in clinical trials with PD patients are also discussed. Moreover, preclinical studies and clinical trials evaluating the efficacy of novel and repurposed therapeutic agents and their pragmatic applications with encouraging outcomes are summarized. Finally, molecular biomarkers under active investigation are presented as potentially valuable tools for early PD diagnosis.
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Affiliation(s)
- Noha A. Gouda
- College of Pharmacy and Integrated Research Institute for Drug Development, Dongguk University-Seoul, Goyang 10326, Korea; (N.A.G.); (A.E.)
| | - Ahmed Elkamhawy
- College of Pharmacy and Integrated Research Institute for Drug Development, Dongguk University-Seoul, Goyang 10326, Korea; (N.A.G.); (A.E.)
- Department of Pharmaceutical Organic Chemistry, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Jungsook Cho
- College of Pharmacy and Integrated Research Institute for Drug Development, Dongguk University-Seoul, Goyang 10326, Korea; (N.A.G.); (A.E.)
- Correspondence:
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Školoudík D, Mašková J, Dušek P, Blahuta J, Soukup T, Burgetová A, Bártová P. Digitized Image Analysis of Insula Echogenicity Detected by TCS-MR Fusion Imaging in Wilson's and Early-Onset Parkinson's Diseases. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:842-848. [PMID: 31924422 DOI: 10.1016/j.ultrasmedbio.2019.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 11/02/2019] [Accepted: 12/11/2019] [Indexed: 06/10/2023]
Abstract
Transcranial sonography (TCS) can reveal pathology in brain structures including insula. This study compared insula echogenicity among 22 patients with Wilson's disease (WD), 21 patients with early-onset Parkinson's disease (EO-PD) and 24 healthy patients. Echogenicity of predefined brain structures (insula, lentiform nucleus, caudate nucleus, substantia nigra and raphe nuclei) was evaluated using digitized analysis of TCS fusion imaging with magnetic resonance. Cortical, subcortical and cerebellar atrophy and ventricle diameters were determined from magnetic resonance images. The mean echogenicity index of insula did not differ between males and females (p = 0.92), but the echogenicity of insula was higher in patients with WD than in patients with EO-PD and healthy patients (p < 0.05). The substantia nigra echogenicity was higher in patients with EO-PD, and lentiform nucleus echogenicity was higher in patients with WD (p < 0.05). The echogenicity of insula correlated with lentiform nucleus echogenicity (r = 0.75) but not with age (r = -0.14), disease duration (r = -0.36), symptom severity (r = 0.28), cortical (r = 0.11) nor subcortical (r = 0.05) atrophy.
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Affiliation(s)
- David Školoudík
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic; Department of Neurology, University Hospital Ostrava, Ostrava, Czech Republic.
| | - Jana Mašková
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Petr Dušek
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic; Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jiří Blahuta
- Institute of Computer Science, Faculty of Philosophy and Science, Silesian University in Opava, Opava, Czech Republic
| | - Tomáš Soukup
- Institute of Computer Science, Faculty of Philosophy and Science, Silesian University in Opava, Opava, Czech Republic
| | - Andrea Burgetová
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Petra Bártová
- Department of Neurology, Ostrava University Medical Faculty and University Hospital Ostrava, Ostrava, Czech Republic
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Tao A, Chen G, Deng Y, Xu R. Accuracy of Transcranial Sonography of the Substantia Nigra for Detection of Parkinson's Disease: A Systematic Review and Meta-analysis. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:628-641. [PMID: 30612821 DOI: 10.1016/j.ultrasmedbio.2018.11.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/31/2018] [Accepted: 11/26/2018] [Indexed: 06/09/2023]
Abstract
A systematic review and meta-analysis were conducted to evaluate the diagnostic accuracy of substantia nigra hyper-echogenicity by transcranial sonography (TCS) for the diagnosis of Parkinson's disease (PD). PubMed, Embase and the Cochrane Library were electronically searched from inception to June 2018 for all relevant studies. The methodological quality of each study was evaluated by two independent reviewers, who used the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Articles reporting information sufficient to calculate the sensitivity and specificity of TCS to diagnose PD were included. Statistical analysis included data pooling, heterogeneity testing, sensitivity analyses and forest meta-regression. Thirty-nine studies (3123 participants with PD) were analyzed. The pooled sensitivity and specificity of TCS were 0.84 (95% confidence interval: 0.81-0.87) and 0.85 (0.80-0.88), respectively, for differentiating PD from normal controls or participants with other parkinsonian syndromes. In the secondary outcome, PD participants exhibited a significant increase in substantia nigra areas than either normal controls (0.14 [0.12-0.16], p < 0.0001) or participants with other parkinsonian syndromes (0.11 [0.08-0.13], p < 0.0001). This meta-analysis revealed the high diagnostic performance of TCS in differentiating patients with PD from both normal controls and participants with other parkinsonian syndromes.
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Affiliation(s)
- Anyu Tao
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guangzhi Chen
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Youbin Deng
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Renfan Xu
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Transcranial B-Mode Sonography in Movement Disorders. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 143:179-212. [PMID: 30473195 DOI: 10.1016/bs.irn.2018.10.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Applying a 2-4MHz probe at the temporal bone window transcranial B-mode sonography (TCS) enables the depiction of the brain parenchyma through the intact skull. Meanwhile it has been applied for the diagnosis and the differential diagnosis of movement disorders for decades. In the first part of this chapter, we summarize the technical requirements and describe the ultrasound method for optimal TCS examination. Imaging planes and the relevant structures are explained in detail. In the second part of the chapter, we focus on the role of substantia nigra hyperechogenicity for the diagnosis of Parkinson's disease (PD) and prodromal PD. In this part, we also mention the role of TCS in atypical and secondary Parkinsonian syndromes and other movement disorders. Summarizing all these information we explain how TCS can be helpful for the differential diagnosis of movement disorders. The current data show that TCS is an easily applicable and economic imaging method which can be used as an additional tool for the diagnosis of PD with a high sensitivity (>85%), specificity (>80%) and inter-rater reliability (>84%) as well as for the differential diagnosis of movement disorders. Lately, TCS has also been utilized in further areas such as the detection of individuals at risk for PD or the determination of electrode localization in patients with deep brain stimulation. An insufficient temporal bone window especially in the elderly and the necessity of an experienced investigator are limitations of this method.
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Emamzadeh FN, Surguchov A. Parkinson's Disease: Biomarkers, Treatment, and Risk Factors. Front Neurosci 2018; 12:612. [PMID: 30214392 PMCID: PMC6125353 DOI: 10.3389/fnins.2018.00612] [Citation(s) in RCA: 263] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 08/13/2018] [Indexed: 12/14/2022] Open
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder caused mainly by lack of dopamine in the brain. Dopamine is a neurotransmitter involved in movement, motivation, memory, and other functions; its level is decreased in PD brain as a result of dopaminergic cell death. Dopamine loss in PD brain is a cause of motor deficiency and, possibly, a reason of the cognitive deficit observed in some PD patients. PD is mostly not recognized in its early stage because of a long latency between the first damage to dopaminergic cells and the onset of clinical symptoms. Therefore, it is very important to find reliable molecular biomarkers that can distinguish PD from other conditions, monitor its progression, or give an indication of a positive response to a therapeutic intervention. PD biomarkers can be subdivided into four main types: clinical, imaging, biochemical, and genetic. For a long time protein biomarkers, dopamine metabolites, amino acids, etc. in blood, serum, cerebrospinal liquid (CSF) were considered the most promising. Among the candidate biomarkers that have been tested, various forms of α-synuclein (α-syn), i.e., soluble, aggregated, post-translationally modified, etc. were considered potentially the most efficient. However, the encouraging recent results suggest that microRNA-based analysis may bring considerable progress, especially if it is combined with α-syn data. Another promising analysis is the advanced metabolite profiling of body fluids, called "metabolomics" which may uncover metabolic fingerprints specific for various stages of PD. Conventional pharmacological treatment of PD is based on the replacement of dopamine using dopamine precursors (levodopa, L-DOPA, L-3,4 dihydroxyphenylalanine), dopamine agonists (amantadine, apomorphine) and MAO-B inhibitors (selegiline, rasagiline), which can be used alone or in combination with each other. Potential risk factors include environmental toxins, drugs, pesticides, brain microtrauma, focal cerebrovascular damage, and genomic defects. This review covers molecules that might act as the biomarkers of PD. Then, PD risk factors (including genetics and non-genetic factors) and PD treatment options are discussed.
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Affiliation(s)
- Fatemeh N. Emamzadeh
- Division of Biomedical and Life Sciences, Faculty of Health and Medicine, University of Lancaster, Lancaster, United Kingdom
| | - Andrei Surguchov
- Department of Neurology, Kansas University Medical Center, Kansas City, KS, United States
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Sakalauskas A, Špečkauskienė V, Laučkaitė K, Jurkonis R, Rastenytė D, Lukoševičius A. Transcranial Ultrasonographic Image Analysis System for Decision Support in Parkinson Disease. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:1753-1761. [PMID: 29331072 DOI: 10.1002/jum.14528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/29/2017] [Accepted: 10/19/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Transcranial ultrasonography (US) is a relatively new neuroimaging modality proposed for early diagnostics of Parkinson disease (PD). The main limitation of transcranial US image-based diagnostics is a high degree of subjectivity caused by low quality of the transcranial images. The article presents a developed image analysis system and evaluates the potential of automated image analysis on transcranial US. METHODS The system consists of algorithms for the segmentation and assessment of informative brain regions (midbrain and substantia nigra) and a decision support subsystem, which is equipped with 64 classification algorithms. Transcranial US images of 191 participants (118 patients with a clinical PD diagnosis and 73 healthy control participants) were analyzed. RESULTS The diagnostic sensitivity and specificity achieved by the proposed system were 85% and 75%, respectively. CONCLUSIONS Digital transcranial US image analysis is challenging, and the application of a such system as the sole instrument for decisions in clinical practice remains inconclusive. However, the proposed system could be used as a supplementary tool for automated assessment of US parameters for decision support in PD diagnostics and to reduce observer variability.
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Affiliation(s)
- Andrius Sakalauskas
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Vita Špečkauskienė
- Department of Physics, Mathematics, and Biophysics, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Kristina Laučkaitė
- Department of Neurology, Lithuanian University of Health Sciences, Academy of Medicine, Kaunas, Lithuania
| | - Rytis Jurkonis
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Daiva Rastenytė
- Department of Neurology, Lithuanian University of Health Sciences, Academy of Medicine, Kaunas, Lithuania
| | - Arūnas Lukoševičius
- Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
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Favaretto S, Walter U, Baracchini C, Cagnin A. Transcranial Sonography in Neurodegenerative Diseases with Cognitive Decline. J Alzheimers Dis 2017; 61:29-40. [DOI: 10.3233/jad-170382] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Silvia Favaretto
- Department of Neurosciences (DNS), University of Padova, Padova, Italy
| | - Uwe Walter
- Department of Neurology, University of Rostock, Rostock, Germany
| | | | - Annachiara Cagnin
- Department of Neurosciences (DNS), University of Padova, Padova, Italy
- San Camillo Hospital IRCCS, Venice, Italy
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Lotankar S, Prabhavalkar KS, Bhatt LK. Biomarkers for Parkinson's Disease: Recent Advancement. Neurosci Bull 2017; 33:585-597. [PMID: 28936761 PMCID: PMC5636742 DOI: 10.1007/s12264-017-0183-5] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 07/03/2017] [Indexed: 12/12/2022] Open
Abstract
As a multi-factorial degenerative disease, Parkinson's disease (PD) leads to tremor, gait rigidity, and hypokinesia, thus hampering normal living. As this disease is usually detected in the later stages when neurons have degenerated completely, cure is on hold, ultimately leading to death due to the lack of early diagnostic techniques. Thus, biomarkers are required to detect the disease in the early stages when prevention is possible. Various biomarkers providing early diagnosis of the disease include those of imaging, cerebrospinal fluid, oxidative stress, neuroprotection, and inflammation. Also, biomarkers, alone or in combination, are used in the diagnosis and evolution of PD. This review encompasses various biomarkers available for PD and discusses recent advances in their development.
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Affiliation(s)
- Sharvari Lotankar
- Department of Pharmacology, SVKM's Dr Bhanuben Nanavati College of Pharmacy, Vile Parle (W), Mumbai, India
| | - Kedar S Prabhavalkar
- Department of Pharmacology, SVKM's Dr Bhanuben Nanavati College of Pharmacy, Vile Parle (W), Mumbai, India.
| | - Lokesh K Bhatt
- Department of Pharmacology, SVKM's Dr Bhanuben Nanavati College of Pharmacy, Vile Parle (W), Mumbai, India
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Šilhán P, Hýža M, Hosák L, Perničková D, Vantuch J, Jelínková M, Školoudík D. Relationship between rapheal echogenicity and personality as possible markers of a disposition to develop depressive and anxiety disorders. Psychiatry Res Neuroimaging 2017; 263:70-75. [PMID: 28366872 DOI: 10.1016/j.pscychresns.2017.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 02/11/2017] [Accepted: 03/24/2017] [Indexed: 11/28/2022]
Abstract
Early diagnosis of anxiety and depression may be facilitated by the use of neurobiological markers. In depression and panic disorder, transcranial sonography (TCS) has revealed decreased echogenicity of the brainstem raphe (BR). The aim of the present study was to detect whether decreased echogenicity of the BR correlates with personality features described in the five-dimension model, especially neuroticism. We examined 100 healthy volunteers using quantitative and qualitative TCS, the five-dimension revised NEO Personality Inventory, Beck´s scales of anxiety and depression, and the Social Re-adjustment Rating Scale (SRRS). Visual BR anechogenicity was found in 11 subjects, BR hypoechogenicity in 29 subjects, and normal BR echogenicity in 60 subjects. The visual assessment correlated with the digital assessment. Comparing the groups with visual BR anechogenicity and BR normoechogenicity, only increased SRRS score and increased agreeableness z-score were significant. Our hypothesis that BR hypoechogenicity reflects an inclination for depression and anxiety characterized by the personality dimension neuroticism was not supported. However, this disposition may be present in a different state, such as stress.
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Affiliation(s)
- Petr Šilhán
- Department of Psychiatry, University Hospital Ostrava, 17. listopadu 1790, 708 52 Ostrava-Poruba, Czech Republic.
| | - Martin Hýža
- Department of Psychiatry, University Hospital Ostrava, 17. listopadu 1790, 708 52 Ostrava-Poruba, Czech Republic.
| | - Ladislav Hosák
- Department of Psychiatry, Faculty of Medicine in Hradec Králové, Charles University, Šimkova 870, 500 38 Hradec Králové1, Czech Republic; Department of Psychiatry, University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic.
| | - Denisa Perničková
- Department of Psychiatry, University Hospital Ostrava, 17. listopadu 1790, 708 52 Ostrava-Poruba, Czech Republic.
| | - Jan Vantuch
- Department of Psychiatry, University Hospital Ostrava, 17. listopadu 1790, 708 52 Ostrava-Poruba, Czech Republic.
| | - Monika Jelínková
- Department of Neurology, University Hospital Ostrava, 17. listopadu 1790, 708 52 Ostrava-Poruba, Czech Republic; Department of Neurology, Hospital with Oupatient Clinic Karviná-Ráj, Vydmuchov 399/5, 734 01 Karviná-Ráj, Czech Republic.
| | - David Školoudík
- Department of Neurology, University Hospital Ostrava, 17. listopadu 1790, 708 52 Ostrava-Poruba, Czech Republic; Department of Nursing, Faculty of Health Science, Palacký University, Hněvotínská 3, 779 00 Olomouc, Czech Republic.
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The measuring of substantia nigra hyperechogenicity in an Italian cohort of Parkinson disease patients: a case/control study (NOBIS Study). J Neural Transm (Vienna) 2017; 124:869-879. [DOI: 10.1007/s00702-017-1724-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 04/11/2017] [Indexed: 10/19/2022]
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14
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Walter U, Rosales R, Rocco A, Westenberger A, Domingo A, Go CL, Brüggemann N, Klein C, Lee LV, Dressler D. Sonographic alteration of substantia nigra is related to parkinsonism-predominant course of X-linked dystonia-parkinsonism. Parkinsonism Relat Disord 2017; 37:43-49. [DOI: 10.1016/j.parkreldis.2017.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/25/2016] [Accepted: 01/09/2017] [Indexed: 12/30/2022]
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15
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Walter U, Zach H, Liepelt-Scarfone I, Maetzler W. Hilfreiche Zusatzuntersuchungen beim idiopathischen Parkinson-Syndrom. DER NERVENARZT 2017; 88:365-372. [PMID: 28289798 DOI: 10.1007/s00115-017-0289-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- U Walter
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Rostock, Rostock, Deutschland
| | - H Zach
- Universitätsklinik für Neurologie, Medizinische Universität Wien, Wien, Österreich
- Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Radboud University Medical Centre, Nijmegen, Niederlande
| | - I Liepelt-Scarfone
- Hertie Institut für klinische Hirnforschung, Universität Tübingen und Deutsches Zentrum für Neurodegenerative Erkrankungen, Tübingen, Deutschland
| | - W Maetzler
- Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Arnold-Heller-Straße 3, 24105, Kiel, Deutschland.
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Fernandes RDCL, Rosso ALZD, Vincent MB, Araújo NC. Use of Gray-Level Histograms to Assess Substantia Nigra Echogenicity in Transcranial Sonography Images of Parkinson Disease Patients. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2016. [DOI: 10.1177/8756479316667083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A substantial body of research has shown that Parkinson disease (PD) patients display an enlarged hyperechogenic substantia nigra (SN) by transcranial sonography (TCS). Nonetheless, the categorization of SN echogenicity is still subjective. A method is described to quantify SN echogenicity based on the gray-level histograms of digitized TCS images. In 31 PD patients and 57 controls, the gray-scale mean (GSM) of the SN, mesencephalon, and basal cisterns and their ratios were assessed using image-editing computer software. The GSM values were compared between the groups and correlated with age, SN area, and disease duration. The SN GSM was significantly higher in the PD group ( P < .05) with a positive correlation with age but not with disease duration. In this cohort of participants, mesencephalon echogenicity was found to increase with disease duration. These results would suggest quantitatively SN hyperechogenicity in PD. Quantifying SN echogenicity is feasible and might minimize subjectivity in PD diagnosis by TCS. The method has the potential to disclose subtle changes in other midbrain structures’ echogenicity engendered by the disease process as well.
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Mašková J, Školoudík D, Burgetová A, Fiala O, Brůha R, Záhoráková D, Serranová T, Slovák M, Ulmanová O, Růžička E, Dušek P. Comparison of transcranial sonography-magnetic resonance fusion imaging in Wilson's and early-onset Parkinson's diseases. Parkinsonism Relat Disord 2016; 28:87-93. [DOI: 10.1016/j.parkreldis.2016.04.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 04/20/2016] [Accepted: 04/26/2016] [Indexed: 11/16/2022]
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Pilotto A, Yilmaz R, Berg D. Developments in the role of transcranial sonography for the differential diagnosis of parkinsonism. Curr Neurol Neurosci Rep 2016; 15:43. [PMID: 26008814 DOI: 10.1007/s11910-015-0566-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In the last two decades transcranial sonography (TCS) has developed as a valuable, supplementary tool in the diagnosis and differential diagnosis of movement disorders. In this review, we highlight recent evidence supporting TCS as a reliable method in the differential diagnosis of parkinsonism, combining substantia nigra (SN), basal ganglia and ventricular system findings. Moreover, several studies support SN hyperechogenicity as one of most important risk factors for Parkinson's disease (PD). The advantages of TCS include short investigation time, low cost and lack of radiation. Principal limitations are still the dependency on the bone window and operator experience. New automated algorithms may reduce the role of investigator skill in the assessment and interpretation, increasing TCS diagnostic reliability. Based on the convincing evidence available, the EFNS accredited the method of TCS a level A recommendation for supporting the diagnosis of PD and its differential diagnosis from secondary and atypical parkinsonism. An increasing number of training programmes is extending the use of this technique in clinical practice.
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Affiliation(s)
- Andrea Pilotto
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
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Šilhán P, Jelínková M, Walter U, Pavlov Praško J, Herzig R, Langová K, Školoudík D. Transcranial sonography of brainstem structures in panic disorder. Psychiatry Res 2015; 234:137-43. [PMID: 26371456 DOI: 10.1016/j.pscychresns.2015.09.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 05/23/2015] [Accepted: 09/02/2015] [Indexed: 02/07/2023]
Abstract
Panic disorder has been associated with altered serotonin metabolism in the brainstem raphe. The aim of study was to evaluate the BR echogenicity on transcranial sonography (TCS) in panic disorder. A total of 96 healthy volunteers were enrolled in the "derivation" cohort, and 26 healthy volunteers and 26 panic disorder patients were enrolled in the "validation" cohort. TCS echogenicity of brainstem raphe and substantia nigra was assessed on anonymized images visually and by means of digitized image analysis. Significantly reduced brainstem raphe echogenicity was detected more frequently in panic disorder patients than in controls using both visual (68% vs. 31%) and digitized image analysis (52% vs. 12%). The optimal cut-off value of digitized brainstem raphe echogenicity indicated the diagnosis of panic disorder with a sensitivity of 64% and a specificity of 73%, and corresponded to the 30th percentile in the derivation cohort. Reduced brainstem raphe echogenicity was associated with shorter treatment duration, and, by trend, lower severity of anxiety. No relationship was found between echogenicity of brainstem raphe or substantia nigra and age, gender, severity of panic disorder, or severity of depression. Patients with panic disorder exhibit changes of brainstem raphe on TCS suggesting an alteration of the central serotonergic system.
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Affiliation(s)
- Petr Šilhán
- Department of Psychiatry, University Hospital, Ostrava, Czech Republic
| | - Monika Jelínková
- Department of Neurology, University Hospital, 17 listopadu 1780, CZ-708 56 Ostrava, Czech Republic; Department of Neurology, Hospital Karviná-Ráj, Czech Republic
| | - Uwe Walter
- Department of Neurology, University of Rostock, Rostock, Germany
| | - Ján Pavlov Praško
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacký University, University Hospital, Olomouc, Czech Republic
| | - Roman Herzig
- Department of Neurology, Charles University Faculty of Medicine, University Hospital, Hradec Králové, Czech Republic
| | - Kateřina Langová
- Department of Biophysics, Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacký University, Olomouc, Czech Republic
| | - David Školoudík
- Department of Neurology, University Hospital, 17 listopadu 1780, CZ-708 56 Ostrava, Czech Republic; Department of Nursing, Faculty of Health Science, Palacký University, Olomouc, Czech Republic.
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