Value of combined midbrain sonography, olfactory and motor function assessment in the differential diagnosis of early Parkinson's disease
Identifieur interne : 000E99 ( Main/Corpus ); précédent : 000E98; suivant : 000F00Value of combined midbrain sonography, olfactory and motor function assessment in the differential diagnosis of early Parkinson's disease
Auteurs : Knut Busse ; Robert Heilmann ; Sabine Kleinschmidt ; Mazen Abu-Mugheisib ; Jacqueline Höppner ; Christian Wunderlich ; Irene Gemende ; Lara Kaulitz ; Alexander Wolters ; Reiner Benecke ; Uwe WalterSource :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2012-04.
Abstract
Objective Characteristic features of Parkinson's disease (PD) are asymmetric parkinsonian motor signs, hyposmia and substantia nigra (SN) hyperechogenicity on transcranial ultrasound. However, each of these features has limited diagnostic value as they may be present, albeit less frequently, in other parkinsonian disorders. Here, the diagnostic sensitivity and specificity of combined assessment of these three features are evaluated. Methods 632 patients with parkinsonism (PD, vascular parkinsonism, atypical parkinsonian syndromes, essential tremor and major depressive disorder with motor slowing) were assessed on the Unified Parkinson's disease Rating Scale for motor asymmetry (right–left score difference ≥2), the 12 item Sniffin' Sticks test (SS-12) and transcranial ultrasound. The derivation (validation) cohort consisted of 517 (115) subjects (193 (35) women; age 65.4±9.6 (62.3±10.3) years) of whom 385 (68) had PD and 132 (47) non-PD parkinsonism; another 21 (6) subjects were not included due to missing transcranial insonability. Of the validation cohort, all patients had a disease duration ≤2 years and observers were blind to diagnoses. Results The optimum cut-off values for discrimination of PD were SS-12 score <8 (hyposmia) and SN echogenic size ≥0.24 cm2 (SN hyperechogenicity). Sensitivity, specificity and positive predictive values for the diagnosis of PD were as follows, for the derivation cohort: motor asymmetry 88%, 54% and 85%; hyposmia 75%, 70% and 88%; SN hyperechogenicity 90%, 63% and 88%; two features present 96%, 72% and 91%; three features present 57%, 94% and 97%; and for the validation cohort: two features present 91%, 77% and 85%; three features present 49%, 98% and 97%. Conclusion The combined assessment of motor asymmetry, hyposmia and SN hyperechogenicity improves diagnostic specificity and allows early diagnosis of PD.
Url:
DOI: 10.1136/jnnp-2011-301719
Links to Exploration step
ISTEX:118E80CF4A0EB49CB4D6B6B931550341F37D28FELe document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Value of combined midbrain sonography, olfactory and motor function assessment in the differential diagnosis of early Parkinson's disease</title><author><name sortKey="Busse, Knut" sort="Busse, Knut" uniqKey="Busse K" first="Knut" last="Busse">Knut Busse</name><affiliation><mods:affiliation>Parkinson Clinic ‘Waldklinik Bernburg GmbH’, Bernburg, Germany</mods:affiliation></affiliation></author><author><name sortKey="Heilmann, Robert" sort="Heilmann, Robert" uniqKey="Heilmann R" first="Robert" last="Heilmann">Robert Heilmann</name><affiliation><mods:affiliation>Department of Neurology, University of Rostock, Rostock, Germany</mods:affiliation></affiliation></author><author><name sortKey="Kleinschmidt, Sabine" sort="Kleinschmidt, Sabine" uniqKey="Kleinschmidt S" first="Sabine" last="Kleinschmidt">Sabine Kleinschmidt</name><affiliation><mods:affiliation>Department of Neurology, University of Rostock, Rostock, Germany</mods:affiliation></affiliation></author><author><name sortKey="Abu Mugheisib, Mazen" sort="Abu Mugheisib, Mazen" uniqKey="Abu Mugheisib M" first="Mazen" last="Abu-Mugheisib">Mazen Abu-Mugheisib</name><affiliation><mods:affiliation>Department of Neurology, University of Rostock, Rostock, Germany</mods:affiliation></affiliation></author><author><name sortKey="Hoppner, Jacqueline" sort="Hoppner, Jacqueline" uniqKey="Hoppner J" first="Jacqueline" last="Höppner">Jacqueline Höppner</name><affiliation><mods:affiliation>Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany</mods:affiliation></affiliation></author><author><name sortKey="Wunderlich, Christian" sort="Wunderlich, Christian" uniqKey="Wunderlich C" first="Christian" last="Wunderlich">Christian Wunderlich</name><affiliation><mods:affiliation>Parkinson Clinic ‘Waldklinik Bernburg GmbH’, Bernburg, Germany</mods:affiliation></affiliation></author><author><name sortKey="Gemende, Irene" sort="Gemende, Irene" uniqKey="Gemende I" first="Irene" last="Gemende">Irene Gemende</name><affiliation><mods:affiliation>Parkinson Clinic ‘Waldklinik Bernburg GmbH’, Bernburg, Germany</mods:affiliation></affiliation></author><author><name sortKey="Kaulitz, Lara" sort="Kaulitz, Lara" uniqKey="Kaulitz L" first="Lara" last="Kaulitz">Lara Kaulitz</name><affiliation><mods:affiliation>Department of Neurology, University of Rostock, Rostock, Germany</mods:affiliation></affiliation></author><author><name sortKey="Wolters, Alexander" sort="Wolters, Alexander" uniqKey="Wolters A" first="Alexander" last="Wolters">Alexander Wolters</name><affiliation><mods:affiliation>Department of Neurology, University of Rostock, Rostock, Germany</mods:affiliation></affiliation></author><author><name sortKey="Benecke, Reiner" sort="Benecke, Reiner" uniqKey="Benecke R" first="Reiner" last="Benecke">Reiner Benecke</name><affiliation><mods:affiliation>Department of Neurology, University of Rostock, Rostock, Germany</mods:affiliation></affiliation></author><author><name sortKey="Walter, Uwe" sort="Walter, Uwe" uniqKey="Walter U" first="Uwe" last="Walter">Uwe Walter</name><affiliation><mods:affiliation>Department of Neurology, University of Rostock, Rostock, Germany</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: uwe.walter@med.uni-rostock.de</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:118E80CF4A0EB49CB4D6B6B931550341F37D28FE</idno><date when="2012" year="2012">2012</date><idno type="doi">10.1136/jnnp-2011-301719</idno><idno type="url">https://api.istex.fr/document/118E80CF4A0EB49CB4D6B6B931550341F37D28FE/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000E99</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Value of combined midbrain sonography, olfactory and motor function assessment in the differential diagnosis of early Parkinson's disease</title><author><name sortKey="Busse, Knut" sort="Busse, Knut" uniqKey="Busse K" first="Knut" last="Busse">Knut Busse</name><affiliation><mods:affiliation>Parkinson Clinic ‘Waldklinik Bernburg GmbH’, Bernburg, Germany</mods:affiliation></affiliation></author><author><name sortKey="Heilmann, Robert" sort="Heilmann, Robert" uniqKey="Heilmann R" first="Robert" last="Heilmann">Robert Heilmann</name><affiliation><mods:affiliation>Department of Neurology, University of Rostock, Rostock, Germany</mods:affiliation></affiliation></author><author><name sortKey="Kleinschmidt, Sabine" sort="Kleinschmidt, Sabine" uniqKey="Kleinschmidt S" first="Sabine" last="Kleinschmidt">Sabine Kleinschmidt</name><affiliation><mods:affiliation>Department of Neurology, University of Rostock, Rostock, Germany</mods:affiliation></affiliation></author><author><name sortKey="Abu Mugheisib, Mazen" sort="Abu Mugheisib, Mazen" uniqKey="Abu Mugheisib M" first="Mazen" last="Abu-Mugheisib">Mazen Abu-Mugheisib</name><affiliation><mods:affiliation>Department of Neurology, University of Rostock, Rostock, Germany</mods:affiliation></affiliation></author><author><name sortKey="Hoppner, Jacqueline" sort="Hoppner, Jacqueline" uniqKey="Hoppner J" first="Jacqueline" last="Höppner">Jacqueline Höppner</name><affiliation><mods:affiliation>Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany</mods:affiliation></affiliation></author><author><name sortKey="Wunderlich, Christian" sort="Wunderlich, Christian" uniqKey="Wunderlich C" first="Christian" last="Wunderlich">Christian Wunderlich</name><affiliation><mods:affiliation>Parkinson Clinic ‘Waldklinik Bernburg GmbH’, Bernburg, Germany</mods:affiliation></affiliation></author><author><name sortKey="Gemende, Irene" sort="Gemende, Irene" uniqKey="Gemende I" first="Irene" last="Gemende">Irene Gemende</name><affiliation><mods:affiliation>Parkinson Clinic ‘Waldklinik Bernburg GmbH’, Bernburg, Germany</mods:affiliation></affiliation></author><author><name sortKey="Kaulitz, Lara" sort="Kaulitz, Lara" uniqKey="Kaulitz L" first="Lara" last="Kaulitz">Lara Kaulitz</name><affiliation><mods:affiliation>Department of Neurology, University of Rostock, Rostock, Germany</mods:affiliation></affiliation></author><author><name sortKey="Wolters, Alexander" sort="Wolters, Alexander" uniqKey="Wolters A" first="Alexander" last="Wolters">Alexander Wolters</name><affiliation><mods:affiliation>Department of Neurology, University of Rostock, Rostock, Germany</mods:affiliation></affiliation></author><author><name sortKey="Benecke, Reiner" sort="Benecke, Reiner" uniqKey="Benecke R" first="Reiner" last="Benecke">Reiner Benecke</name><affiliation><mods:affiliation>Department of Neurology, University of Rostock, Rostock, Germany</mods:affiliation></affiliation></author><author><name sortKey="Walter, Uwe" sort="Walter, Uwe" uniqKey="Walter U" first="Uwe" last="Walter">Uwe Walter</name><affiliation><mods:affiliation>Department of Neurology, University of Rostock, Rostock, Germany</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: uwe.walter@med.uni-rostock.de</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2012-04">2012-04</date><biblScope unit="volume">83</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="441">441</biblScope></imprint><idno type="ISSN">0022-3050</idno></series><idno type="istex">118E80CF4A0EB49CB4D6B6B931550341F37D28FE</idno><idno type="DOI">10.1136/jnnp-2011-301719</idno><idno type="href">jnnp-83-441.pdf</idno><idno type="ArticleID">jnnp-2011-301719</idno><idno type="PMID">22362921</idno><idno type="local">jnnp;83/4/441</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-3050</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Objective Characteristic features of Parkinson's disease (PD) are asymmetric parkinsonian motor signs, hyposmia and substantia nigra (SN) hyperechogenicity on transcranial ultrasound. However, each of these features has limited diagnostic value as they may be present, albeit less frequently, in other parkinsonian disorders. Here, the diagnostic sensitivity and specificity of combined assessment of these three features are evaluated. Methods 632 patients with parkinsonism (PD, vascular parkinsonism, atypical parkinsonian syndromes, essential tremor and major depressive disorder with motor slowing) were assessed on the Unified Parkinson's disease Rating Scale for motor asymmetry (right–left score difference ≥2), the 12 item Sniffin' Sticks test (SS-12) and transcranial ultrasound. The derivation (validation) cohort consisted of 517 (115) subjects (193 (35) women; age 65.4±9.6 (62.3±10.3) years) of whom 385 (68) had PD and 132 (47) non-PD parkinsonism; another 21 (6) subjects were not included due to missing transcranial insonability. Of the validation cohort, all patients had a disease duration ≤2 years and observers were blind to diagnoses. Results The optimum cut-off values for discrimination of PD were SS-12 score <8 (hyposmia) and SN echogenic size ≥0.24 cm2 (SN hyperechogenicity). Sensitivity, specificity and positive predictive values for the diagnosis of PD were as follows, for the derivation cohort: motor asymmetry 88%, 54% and 85%; hyposmia 75%, 70% and 88%; SN hyperechogenicity 90%, 63% and 88%; two features present 96%, 72% and 91%; three features present 57%, 94% and 97%; and for the validation cohort: two features present 91%, 77% and 85%; three features present 49%, 98% and 97%. Conclusion The combined assessment of motor asymmetry, hyposmia and SN hyperechogenicity improves diagnostic specificity and allows early diagnosis of PD.</div></front></TEI><istex><corpusName>bmj</corpusName><author><json:item><name>Knut Busse</name><affiliations><json:string>Parkinson Clinic ‘Waldklinik Bernburg GmbH’, Bernburg, Germany</json:string></affiliations></json:item><json:item><name>Robert Heilmann</name><affiliations><json:string>Department of Neurology, University of Rostock, Rostock, Germany</json:string></affiliations></json:item><json:item><name>Sabine Kleinschmidt</name><affiliations><json:string>Department of Neurology, University of Rostock, Rostock, Germany</json:string></affiliations></json:item><json:item><name>Mazen Abu-Mugheisib</name><affiliations><json:string>Department of Neurology, University of Rostock, Rostock, Germany</json:string></affiliations></json:item><json:item><name>Jacqueline Höppner</name><affiliations><json:string>Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany</json:string></affiliations></json:item><json:item><name>Christian Wunderlich</name><affiliations><json:string>Parkinson Clinic ‘Waldklinik Bernburg GmbH’, Bernburg, Germany</json:string></affiliations></json:item><json:item><name>Irene Gemende</name><affiliations><json:string>Parkinson Clinic ‘Waldklinik Bernburg GmbH’, Bernburg, Germany</json:string></affiliations></json:item><json:item><name>Lara Kaulitz</name><affiliations><json:string>Department of Neurology, University of Rostock, Rostock, Germany</json:string></affiliations></json:item><json:item><name>Alexander Wolters</name><affiliations><json:string>Department of Neurology, University of Rostock, Rostock, Germany</json:string></affiliations></json:item><json:item><name>Reiner Benecke</name><affiliations><json:string>Department of Neurology, University of Rostock, Rostock, Germany</json:string></affiliations></json:item><json:item><name>Uwe Walter</name><affiliations><json:string>Department of Neurology, University of Rostock, Rostock, Germany</json:string><json:string>E-mail: uwe.walter@med.uni-rostock.de</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Movement disorders</value></json:item></subject><language><json:string>eng</json:string></language><abstract>Objective Characteristic features of Parkinson's disease (PD) are asymmetric parkinsonian motor signs, hyposmia and substantia nigra (SN) hyperechogenicity on transcranial ultrasound. However, each of these features has limited diagnostic value as they may be present, albeit less frequently, in other parkinsonian disorders. Here, the diagnostic sensitivity and specificity of combined assessment of these three features are evaluated. Methods 632 patients with parkinsonism (PD, vascular parkinsonism, atypical parkinsonian syndromes, essential tremor and major depressive disorder with motor slowing) were assessed on the Unified Parkinson's disease Rating Scale for motor asymmetry (right–left score difference ≥2), the 12 item Sniffin' Sticks test (SS-12) and transcranial ultrasound. The derivation (validation) cohort consisted of 517 (115) subjects (193 (35) women; age 65.4±9.6 (62.3±10.3) years) of whom 385 (68) had PD and 132 (47) non-PD parkinsonism; another 21 (6) subjects were not included due to missing transcranial insonability. Of the validation cohort, all patients had a disease duration ≤2 years and observers were blind to diagnoses. Results The optimum cut-off values for discrimination of PD were SS-12 score >8 (hyposmia) and SN echogenic size ≥0.24 cm2 (SN hyperechogenicity). Sensitivity, specificity and positive predictive values for the diagnosis of PD were as follows, for the derivation cohort: motor asymmetry 88%, 54% and 85%; hyposmia 75%, 70% and 88%; SN hyperechogenicity 90%, 63% and 88%; two features present 96%, 72% and 91%; three features present 57%, 94% and 97%; and for the validation cohort: two features present 91%, 77% and 85%; three features present 49%, 98% and 97%. Conclusion The combined assessment of motor asymmetry, hyposmia and SN hyperechogenicity improves diagnostic specificity and allows early diagnosis of PD.</abstract><qualityIndicators><score>8.5</score><pdfVersion>1.4</pdfVersion><pdfPageSize>595.276 x 793.701 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>1</keywordCount><abstractCharCount>1874</abstractCharCount><pdfWordCount>5242</pdfWordCount><pdfCharCount>34406</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>268</abstractWordCount></qualityIndicators><title>Value of combined midbrain sonography, olfactory and motor function assessment in the differential diagnosis of early Parkinson's disease</title><pmid><json:string>22362921</json:string></pmid><genre><json:string>research-article</json:string></genre><host><volume>83</volume><pages><first>441</first></pages><issn><json:string>0022-3050</json:string></issn><issue>4</issue><genre></genre><language><json:string>unknown</json:string></language><eissn><json:string>1468-330X</json:string></eissn><title>Journal of Neurology, Neurosurgery & Psychiatry</title></host><publicationDate>2012</publicationDate><copyrightDate>2012</copyrightDate><doi><json:string>10.1136/jnnp-2011-301719</json:string></doi><id>118E80CF4A0EB49CB4D6B6B931550341F37D28FE</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/118E80CF4A0EB49CB4D6B6B931550341F37D28FE/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/118E80CF4A0EB49CB4D6B6B931550341F37D28FE/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/118E80CF4A0EB49CB4D6B6B931550341F37D28FE/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a">Value of combined midbrain sonography, olfactory and motor function assessment in the differential diagnosis of early Parkinson's disease</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>BMJ Publishing Group Ltd</publisher><availability><p>BMJ</p></availability><date>2012-02-22</date></publicationStmt><notesStmt><note>KB and RH contributed equally to this work.</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Value of combined midbrain sonography, olfactory and motor function assessment in the differential diagnosis of early Parkinson's disease</title><author><persName><forename type="first">Knut</forename><surname>Busse</surname></persName><affiliation>Parkinson Clinic ‘Waldklinik Bernburg GmbH’, Bernburg, Germany</affiliation></author><author><persName><forename type="first">Robert</forename><surname>Heilmann</surname></persName><affiliation>Department of Neurology, University of Rostock, Rostock, Germany</affiliation></author><author><persName><forename type="first">Sabine</forename><surname>Kleinschmidt</surname></persName><affiliation>Department of Neurology, University of Rostock, Rostock, Germany</affiliation></author><author><persName><forename type="first">Mazen</forename><surname>Abu-Mugheisib</surname></persName><affiliation>Department of Neurology, University of Rostock, Rostock, Germany</affiliation></author><author><persName><forename type="first">Jacqueline</forename><surname>Höppner</surname></persName><affiliation>Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany</affiliation></author><author><persName><forename type="first">Christian</forename><surname>Wunderlich</surname></persName><affiliation>Parkinson Clinic ‘Waldklinik Bernburg GmbH’, Bernburg, Germany</affiliation></author><author><persName><forename type="first">Irene</forename><surname>Gemende</surname></persName><affiliation>Parkinson Clinic ‘Waldklinik Bernburg GmbH’, Bernburg, Germany</affiliation></author><author><persName><forename type="first">Lara</forename><surname>Kaulitz</surname></persName><affiliation>Department of Neurology, University of Rostock, Rostock, Germany</affiliation></author><author><persName><forename type="first">Alexander</forename><surname>Wolters</surname></persName><affiliation>Department of Neurology, University of Rostock, Rostock, Germany</affiliation></author><author><persName><forename type="first">Reiner</forename><surname>Benecke</surname></persName><affiliation>Department of Neurology, University of Rostock, Rostock, Germany</affiliation></author><author corresp="yes"><persName><forename type="first">Uwe</forename><surname>Walter</surname></persName><email>uwe.walter@med.uni-rostock.de</email><affiliation>Department of Neurology, University of Rostock, Rostock, Germany</affiliation></author></analytic><monogr><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="pISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2012-04"></date><biblScope unit="volume">83</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="441">441</biblScope></imprint></monogr><idno type="istex">118E80CF4A0EB49CB4D6B6B931550341F37D28FE</idno><idno type="DOI">10.1136/jnnp-2011-301719</idno><idno type="href">jnnp-83-441.pdf</idno><idno type="ArticleID">jnnp-2011-301719</idno><idno type="PMID">22362921</idno><idno type="local">jnnp;83/4/441</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2012-02-22</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Objective Characteristic features of Parkinson's disease (PD) are asymmetric parkinsonian motor signs, hyposmia and substantia nigra (SN) hyperechogenicity on transcranial ultrasound. However, each of these features has limited diagnostic value as they may be present, albeit less frequently, in other parkinsonian disorders. Here, the diagnostic sensitivity and specificity of combined assessment of these three features are evaluated. Methods 632 patients with parkinsonism (PD, vascular parkinsonism, atypical parkinsonian syndromes, essential tremor and major depressive disorder with motor slowing) were assessed on the Unified Parkinson's disease Rating Scale for motor asymmetry (right–left score difference ≥2), the 12 item Sniffin' Sticks test (SS-12) and transcranial ultrasound. The derivation (validation) cohort consisted of 517 (115) subjects (193 (35) women; age 65.4±9.6 (62.3±10.3) years) of whom 385 (68) had PD and 132 (47) non-PD parkinsonism; another 21 (6) subjects were not included due to missing transcranial insonability. Of the validation cohort, all patients had a disease duration ≤2 years and observers were blind to diagnoses. Results The optimum cut-off values for discrimination of PD were SS-12 score <8 (hyposmia) and SN echogenic size ≥0.24 cm2 (SN hyperechogenicity). Sensitivity, specificity and positive predictive values for the diagnosis of PD were as follows, for the derivation cohort: motor asymmetry 88%, 54% and 85%; hyposmia 75%, 70% and 88%; SN hyperechogenicity 90%, 63% and 88%; two features present 96%, 72% and 91%; three features present 57%, 94% and 97%; and for the validation cohort: two features present 91%, 77% and 85%; three features present 49%, 98% and 97%. Conclusion The combined assessment of motor asymmetry, hyposmia and SN hyperechogenicity improves diagnostic specificity and allows early diagnosis of PD.</p></abstract></profileDesc><revisionDesc><change when="2012-02-22">Created</change><change when="2012-04">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/118E80CF4A0EB49CB4D6B6B931550341F37D28FE/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">jnnp</journal-id><journal-id journal-id-type="nlm-ta">J Neurol Neurosurg Psychiatry</journal-id><journal-id journal-id-type="publisher-id">jnnp</journal-id><journal-title>Journal of Neurology, Neurosurgery & Psychiatry</journal-title><abbrev-journal-title abbrev-type="publisher">J Neurol Neurosurg Psychiatry</abbrev-journal-title><abbrev-journal-title>J Neurol Neurosurg Psychiatry</abbrev-journal-title><issn pub-type="ppub">0022-3050</issn><issn pub-type="epub">1468-330X</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">jnnp-2011-301719</article-id><article-id pub-id-type="doi">10.1136/jnnp-2011-301719</article-id><article-id pub-id-type="other">jnnp;83/4/441</article-id><article-id pub-id-type="other">jnnp;jnnp-2011-301719</article-id><article-id pub-id-type="pmid">22362921</article-id><article-id pub-id-type="other">441</article-id><article-id pub-id-type="other">jnnp-2011-301719</article-id><article-categories><subj-group subj-group-type="heading"><subject>Movement disorders</subject></subj-group><series-title>Research paper</series-title></article-categories><title-group><article-title>Value of combined midbrain sonography, olfactory and motor function assessment in the differential diagnosis of early Parkinson's disease</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Busse</surname><given-names>Knut</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Heilmann</surname><given-names>Robert</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Kleinschmidt</surname><given-names>Sabine</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Abu-Mugheisib</surname><given-names>Mazen</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Höppner</surname><given-names>Jacqueline</given-names></name><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Wunderlich</surname><given-names>Christian</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Gemende</surname><given-names>Irene</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Kaulitz</surname><given-names>Lara</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Wolters</surname><given-names>Alexander</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Benecke</surname><given-names>Reiner</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Walter</surname><given-names>Uwe</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib></contrib-group><aff id="aff1"><label>1</label>Parkinson Clinic ‘Waldklinik Bernburg GmbH’, Bernburg, Germany</aff><aff id="aff2"><label>2</label>Department of Neurology, University of Rostock, Rostock, Germany</aff><aff id="aff3"><label>3</label>Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany</aff><author-notes><corresp><label>Correspondence to</label> Dr Professor U Walter, Department of Neurology, University of Rostock, Gehlsheimer Str 20, D-18147 Rostock, Germany; <email>uwe.walter@med.uni-rostock.de</email></corresp><fn fn-type="other"><p>KB and RH contributed equally to this work.</p></fn></author-notes><pub-date pub-type="epub-original"><day>22</day><month>2</month><year>2012</year></pub-date><pub-date pub-type="ppub"><month>4</month><year>2012</year></pub-date><pub-date pub-type="epub"><day>22</day><month>2</month><year>2012</year></pub-date><volume>83</volume><volume-id pub-id-type="other">83</volume-id><volume-id pub-id-type="other">83</volume-id><issue>4</issue><issue-id pub-id-type="other">jnnp;83/4</issue-id><issue-id pub-id-type="other">4</issue-id><issue-id pub-id-type="other">83/4</issue-id><fpage>441</fpage><history><date date-type="received"><day>25</day><month>10</month><year>2011</year></date><date date-type="rev-recd"><day>22</day><month>12</month><year>2011</year></date><date date-type="accepted"><day>3</day><month>1</month><year>2012</year></date></history><permissions><copyright-statement>© 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</copyright-statement><copyright-year>2012</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="jnnp-83-441.pdf"></self-uri><abstract><sec><title>Objective</title><p>Characteristic features of Parkinson's disease (PD) are asymmetric parkinsonian motor signs, hyposmia and substantia nigra (SN) hyperechogenicity on transcranial ultrasound. However, each of these features has limited diagnostic value as they may be present, albeit less frequently, in other parkinsonian disorders. Here, the diagnostic sensitivity and specificity of combined assessment of these three features are evaluated.</p></sec><sec><title>Methods</title><p>632 patients with parkinsonism (PD, vascular parkinsonism, atypical parkinsonian syndromes, essential tremor and major depressive disorder with motor slowing) were assessed on the Unified Parkinson's disease Rating Scale for motor asymmetry (right–left score difference ≥2), the 12 item Sniffin' Sticks test (SS-12) and transcranial ultrasound. The derivation (validation) cohort consisted of 517 (115) subjects (193 (35) women; age 65.4±9.6 (62.3±10.3) years) of whom 385 (68) had PD and 132 (47) non-PD parkinsonism; another 21 (6) subjects were not included due to missing transcranial insonability. Of the validation cohort, all patients had a disease duration ≤2 years and observers were blind to diagnoses.</p></sec><sec><title>Results</title><p>The optimum cut-off values for discrimination of PD were SS-12 score <8 (hyposmia) and SN echogenic size ≥0.24 cm<sup>2</sup> (SN hyperechogenicity). Sensitivity, specificity and positive predictive values for the diagnosis of PD were as follows, for the derivation cohort: motor asymmetry 88%, 54% and 85%; hyposmia 75%, 70% and 88%; SN hyperechogenicity 90%, 63% and 88%; two features present 96%, 72% and 91%; three features present 57%, 94% and 97%; and for the validation cohort: two features present 91%, 77% and 85%; three features present 49%, 98% and 97%.</p></sec><sec><title>Conclusion</title><p>The combined assessment of motor asymmetry, hyposmia and SN hyperechogenicity improves diagnostic specificity and allows early diagnosis of PD.</p></sec></abstract></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><partName>Research paper</partName><title>Value of combined midbrain sonography, olfactory and motor function assessment in the differential diagnosis of early Parkinson's disease</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><partName>Research paper</partName><title>Value of combined midbrain sonography, olfactory and motor function assessment in the differential diagnosis of early Parkinson's disease</title></titleInfo><name type="personal"><namePart type="given">Knut</namePart><namePart type="family">Busse</namePart><affiliation>Parkinson Clinic ‘Waldklinik Bernburg GmbH’, Bernburg, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Robert</namePart><namePart type="family">Heilmann</namePart><affiliation>Department of Neurology, University of Rostock, Rostock, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sabine</namePart><namePart type="family">Kleinschmidt</namePart><affiliation>Department of Neurology, University of Rostock, Rostock, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mazen</namePart><namePart type="family">Abu-Mugheisib</namePart><affiliation>Department of Neurology, University of Rostock, Rostock, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jacqueline</namePart><namePart type="family">Höppner</namePart><affiliation>Department of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Christian</namePart><namePart type="family">Wunderlich</namePart><affiliation>Parkinson Clinic ‘Waldklinik Bernburg GmbH’, Bernburg, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Irene</namePart><namePart type="family">Gemende</namePart><affiliation>Parkinson Clinic ‘Waldklinik Bernburg GmbH’, Bernburg, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Lara</namePart><namePart type="family">Kaulitz</namePart><affiliation>Department of Neurology, University of Rostock, Rostock, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alexander</namePart><namePart type="family">Wolters</namePart><affiliation>Department of Neurology, University of Rostock, Rostock, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Reiner</namePart><namePart type="family">Benecke</namePart><affiliation>Department of Neurology, University of Rostock, Rostock, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal" displayLabel="corresp"><namePart type="given">Uwe</namePart><namePart type="family">Walter</namePart><affiliation>Department of Neurology, University of Rostock, Rostock, Germany</affiliation><affiliation>E-mail: uwe.walter@med.uni-rostock.de</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2012-04</dateIssued><dateCreated encoding="w3cdtf">2012-02-22</dateCreated><copyrightDate encoding="w3cdtf">2012</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>Objective Characteristic features of Parkinson's disease (PD) are asymmetric parkinsonian motor signs, hyposmia and substantia nigra (SN) hyperechogenicity on transcranial ultrasound. However, each of these features has limited diagnostic value as they may be present, albeit less frequently, in other parkinsonian disorders. Here, the diagnostic sensitivity and specificity of combined assessment of these three features are evaluated. Methods 632 patients with parkinsonism (PD, vascular parkinsonism, atypical parkinsonian syndromes, essential tremor and major depressive disorder with motor slowing) were assessed on the Unified Parkinson's disease Rating Scale for motor asymmetry (right–left score difference ≥2), the 12 item Sniffin' Sticks test (SS-12) and transcranial ultrasound. The derivation (validation) cohort consisted of 517 (115) subjects (193 (35) women; age 65.4±9.6 (62.3±10.3) years) of whom 385 (68) had PD and 132 (47) non-PD parkinsonism; another 21 (6) subjects were not included due to missing transcranial insonability. Of the validation cohort, all patients had a disease duration ≤2 years and observers were blind to diagnoses. Results The optimum cut-off values for discrimination of PD were SS-12 score <8 (hyposmia) and SN echogenic size ≥0.24 cm2 (SN hyperechogenicity). Sensitivity, specificity and positive predictive values for the diagnosis of PD were as follows, for the derivation cohort: motor asymmetry 88%, 54% and 85%; hyposmia 75%, 70% and 88%; SN hyperechogenicity 90%, 63% and 88%; two features present 96%, 72% and 91%; three features present 57%, 94% and 97%; and for the validation cohort: two features present 91%, 77% and 85%; three features present 49%, 98% and 97%. Conclusion The combined assessment of motor asymmetry, hyposmia and SN hyperechogenicity improves diagnostic specificity and allows early diagnosis of PD.</abstract><note type="footnotes">KB and RH contributed equally to this work.</note><relatedItem type="host"><titleInfo><title>Journal of Neurology, Neurosurgery & Psychiatry</title></titleInfo><titleInfo type="abbreviated"><title>J Neurol Neurosurg Psychiatry</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0022-3050</identifier><identifier type="eISSN">1468-330X</identifier><identifier type="PublisherID">jnnp</identifier><identifier type="PublisherID-hwp">jnnp</identifier><identifier type="PublisherID-nlm-ta">J Neurol Neurosurg Psychiatry</identifier><part><date>2012</date><detail type="volume"><caption>vol.</caption><number>83</number></detail><detail type="issue"><caption>no.</caption><number>4</number></detail><extent unit="pages"><start>441</start></extent></part></relatedItem><identifier type="istex">118E80CF4A0EB49CB4D6B6B931550341F37D28FE</identifier><identifier type="DOI">10.1136/jnnp-2011-301719</identifier><identifier type="href">jnnp-83-441.pdf</identifier><identifier type="ArticleID">jnnp-2011-301719</identifier><identifier type="PMID">22362921</identifier><identifier type="local">jnnp;83/4/441</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</accessCondition><recordInfo><recordContentSource>BMJ</recordContentSource></recordInfo></mods></metadata><annexes><json:item><original>true</original><mimetype>image/jpeg</mimetype><extension>jpeg</extension><uri>https://api.istex.fr/document/118E80CF4A0EB49CB4D6B6B931550341F37D28FE/annexes/jpeg</uri></json:item></annexes><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/ParkinsonV1/Data/Main/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000E99 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Corpus/biblio.hfd -nk 000E99 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= ParkinsonV1
|flux= Main
|étape= Corpus
|type= RBID
|clé= ISTEX:118E80CF4A0EB49CB4D6B6B931550341F37D28FE
|texte= Value of combined midbrain sonography, olfactory and motor function assessment in the differential diagnosis of early Parkinson's disease
}}
| This area was generated with Dilib version V0.6.23. |  |