Transcranial Sonography and DaTSCAN in Early Stage Parkinson's Disease and Essential Tremor

Eur Neurol. 2016;76(5-6):252-255. doi: 10.1159/000452216. Epub 2016 Oct 18.

Abstract

Background: The diagnosis of Parkinson's disease (PD) can sometimes be a challenge in the early stages of the disease. Both transcranial sonography (TCS) and DaTSCAN are recommended as auxiliary examinations for the differential diagnosis of PD; however, only few data exist regarding their diagnostic accuracy in the early stage of PD and essential tremor (ET).

Methods: We evaluated patients with clinically suspected diagnosis of PD at early stages (Hoehn and Yahr ≤2) or ET. All patients underwent DaTSCAN and TCS with a maximum interval of 6 months. Final diagnosis was established after 1-year follow-up.

Results: From the 63 patients recruited, 3 were excluded due to transcranial insonability and 2 for uncertain clinical diagnosis. The final clinical diagnosis was ET in 44.8% and PD in 55.2%. Compared to clinical diagnosis of PD, TCS had a sensitivity of 87.5% and specificity of 96.2%; DaTSCAN sensitivity was 84.4% and specificity was 96.2%. Both diagnostic tests demonstrated a substantial level of agreement (Cohen's kappa coefficient: 0.83, 95% CI 0.68-0.97, p < 0.001).

Conclusion: TCS and DaTSCAN have similar diagnostic accuracy for the diagnosis of early stage PD versus ET.

MeSH terms

  • Diagnosis, Differential
  • Essential Tremor / diagnostic imaging
  • Humans
  • Nortropanes
  • Parkinson Disease / diagnostic imaging*
  • Sensitivity and Specificity
  • Tomography, Emission-Computed, Single-Photon / methods*
  • Ultrasonography, Doppler, Transcranial / methods*

Substances

  • Nortropanes
  • ioflupane