Transcranial Sonography in the Diagnosis of Parkinson’s Disease: A Reliable Diagnostic Tool with High Sensitivity and Specificity

sonography (TCS) is a reliable method in the diagnosis of Parkinson’s disease (PD)and the differential diagnosis of atypical parkinsonism. Finding of hyperechogenicity of the substantia nigra (SN), which is the result of iron deposition in this midbrain structure, is highly suggestive of PD. We performed a study on 67 PD patients and 33 healthy controls in order to determine sensitivity and specificity of TCS in diagnosis of PD. Due to insufficient or completely impenetrable acoustic temporal bone TCS could not be performed in 10.2% of PD patients and 15.1% of healthy controls. Significant SN hyperechogenicity was recorded in 77.6% of PD patients and 12.1% of healthy controls. The sensitivity of TCS was 86.6% and specificity 86.2%, with the positive predictive value of 92.8%. In the PD group, SN hyperechogenicity was generally more pronounced on the side which was contralateral to the side of dominant clinical presentation. Our results are in line with the data reported by other investigators. With its high reliability, harmlessness and low cost, TCS is a diagnostic method that is today widely used in the diagnosis of PD.