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KMID : 1034720180100020133
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Journal of Neurosonology and Neuroimaging
2018 Volume.10 No. 2 p.133 ~ p.137
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Validation of Transcranial Sonographic Measurement of the Brainstem Raphe in Korean Patients with Parkinson’s Disease
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Kim Hye-Weon
Yoon Hye-Rin
Baik Jong-Sam
Han Ji-Eun
Han Sang-Won
Yu Hyun-Jeung
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Abstract
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Background: In patients with Parkinson’s disease (PD), one of the common non-motor symptoms is depression. Recent studies demonstrate that the rate of decreased echogenicity in the brainstem raphe (BR) is significantly higher in patients with PD with depression. The objective of this study was to investigate the feasibility of transcranial sonographic measurements of mesencephalic midline change in Korean patients with PD. We also questioned that there may be any differences regarding to the rate of poor temporal window (TW) between transcranial sonography and transcranial Doppler (TCD) examination.
Methods: Patients were eligible for the study if they had de novo PD and were 40 years of age or older. High-resolution B-mode ultrasound measurements of the BR were performed using a Siemens Acuson S1000 scanner (Siemens Healthcare GmbH, Erlangen, Germany) with a 2.0-3.5 MHz transducer. Reliability was estimated by Cohen’s kappa coefficient, in order to measure the degree of intra- and interobserver agreement.
Results: A total of 200 patients with PD were recruited for the study. Of these 200 patients, BR echogenicity could not be measured in 49 patients (24.5%), due to a bilateral poor TW. Compared to other TCD studies, the poor TW rate in our patient sample is lower than that found in previous studies conducted in Asian populations, including a Korean study showing a poor TW rate of 34%. A poor TW was significantly more frequent in women than men (37.6% vs. 6%, p<0.0001). The overall kappa value was excellent (к>0.8). Intra- and interobserver reliability was 0.842 and 0.821, respectively.
Conclusion: This study shows that our methodology of measuring echogenicity in the BR is applicable and provides excellent intra- and interobserver agreement in Korean patients with PD.
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KEYWORD
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Depression, Parkinson disease, Raphe nuclei, Ultrasonography, Doppler, Transcranial
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