İsveç parkinsonizm hastalarında transkraniyal sonografinin tanı değeri: Uzun süreli takip ile retrospektif kohort çalışması.

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IntroductionAlthough transcranial sonography (TCS) assessing hyperechogenic substantia nigra (SN+) as biomarker for Parkinsońs disease (PD) has been introduced elsewhere, the clinical relevance and accuracy in a Swedish population is still unknown.MethodsThis retrospective single-center study included 74 patients with predominantly early-stage parkinsonism at first visit who had been examined by TCS from 2013 to 2017 to determine the SN+ biomarker status in relation to PD, atypical parkinsonian disorders (APS), essential tremor (ET) and vascular/secondary/ unspecified parkinsonism, with the aim of long-term follow-up to confirm the clinical diagnosis. The cut-off value for SN+ was regarded as the 90 % percentile of SN echogenicity in a local healthy cohort (here, 0.23 cm2).ResultsIn 2024, the mean follow-up time was 95 months. Three patients (4 %) without transcranial bone were excluded. SN+ was found in 38/51 patients with finally diagnosed PD and 4/20 patients with other final clinical diagnoses (p 2 vs. 0.23 ± 0.10 [0.18-0.29] cm2, p 0.035).ConclusionAfter a follow-up of up to 8 years, to maximize diagnostic certainty, our findings support the use of TCS as a valuable add-on tool in PD diagnostics in a Swedish patient population, already in the early stage of disease but not for screening.

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