Using transcranial sonography to differentiate PSP-P and RS

This recently-published German research is about transcranial sonographic findings when PSP patients are examined. The findings correspond to which type of PSP the patients have — Richardson’s Syndrome (RS) or PSP-Parkinsonism (PSP-P).

Reading between the lines, it seems that the findings for those with PSP-P are similar to the findings of those with Parkinson’s Disease (eg, a hyperechogenic substantia nigra). So, transcranial sonography may not be a good tool to differentiate between PSP and PD.

Robin

Movement Disorders. 2010 Mar 2. [Epub ahead of print]

Substantia nigra echogenicity in progressive supranuclear palsy.

Ebentheuer J, Canelo M, Trautmann E, Trenkwalder C.
Paracelsus-Elena-Klinik, Center of Parkinsonism and Movement Disorders, Kassel, Germany.

A normoechogenic substantia nigra (SN) is a typical finding in transcranial sonography in patients with progressive supranuclear palsy (PSP), whereas in patients with Parkinson’s disease a hyperechogenic SN is characteristic.

A recent classification scheme recommends the differentiation of PSP patients into those with Richardson’s syndrome (RS) and those with PSP-Parkinsonism (PSP-P).

We investigated 34 PSP patients (27 RS, 7 PSP-P) with ultrasound of the substantia nigra in search of differentiations in the two groups.

We found that most of the PSP-P patients, according to recently published criteria, had a hyperechogenic SN (6 of 7): right (cm(2)) median 0.22, 25% percentile 0.21 and 75% percentile 0.36 (cm(2)); left (cm(2)) median 0.21, 25% percentile 0.20 and 75% percentile 0.30 and a normal third ventricle (mean mm) +/-SD: 7.1 +/- 2.43).

In RS patients a normoechogenic SN (26 of 27) and an enlarged third ventricle (mean mm) +/-SD: 10.3 +/- 2.41) was found.

These differences may elucidate the pathological differences of RS and PSP-P.

PubMed ID#: 20198715 (see pubmed.gov for this abstract only)