Enlarged hyperechogenic substantia nigra is related to motor performance and olfaction in the elderly
Identifieur interne : 002763 ( Main/Corpus ); précédent : 002762; suivant : 002764Enlarged hyperechogenic substantia nigra is related to motor performance and olfaction in the elderly
Auteurs : Daniela Berg ; Klaus Seppi ; Inga Liepelt ; Katherine Schweitzer ; Frank Wollenweber ; Björn Wolf ; Ulrich Dillmann ; Heike Stockner ; Jana Godau ; Stefan Kiechl ; Alexandra Gaenslen ; Johann Willeit ; Adriana Di Santo ; Walter Maetzler ; Thomas Gasser ; Werner Poewe ; Stefanie BehnkeSource :
- Movement Disorders [ 0885-3185 ] ; 2010-07-30.
English descriptors
Abstract
Enlarged substantia nigra hyperechogenicity (SN+) assessed by transcranial sonography (TCS) may be associated with Parkinson's disease (PD) risk markers such as impaired motor performance and hyposmia. The aim of this multicenter cross‐sectional study was to define the association between SN+ and these risk markers in a large population older than 50 years without the diagnosis of PD. In three centers (Tuebingen, Homburg, and Innsbruck), 1,839 individuals were examined. The echostatus of the SN was assessed by TCS, motor performance by the Unified Parkinson's Disease Rating Scale (UPDRS) motor score, and olfactory function with Sniffin' Sticks. From the 1,603 subjects included in the analysis, 16.2% were SN+, 23.0% scored above zero in the UPDRS motor section, and 28.0% were hyposmic as defined by less than 75% correctly classified Sniffin' Sticks. SN+ was associated with a UPDRS motor score above zero (OR 1.45, 95% CI 1.08–1.96) and with a lower odor identification capability (OR 1.48, 95% CI 1.12–1.96). The combination of these two features (OR 1.98, 95% CI 1.25–3.15) and UPDRS motor scores ≥3 lead to higher OR. It is concluded that SN+, impaired motor performance, and hyposmia are frequently observed in the elderly and in isolation are unspecific and of limited use to predict a subject's risk for PD. Whether the association of SN+ with both impaired motor performance and hyposmia as seen in this study predicts an increased risk for the development of PD needs to be evaluated in the follow‐up investigations. © 2010 Movement Disorder Society
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DOI: 10.1002/mds.23114
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uniqKey="Schweitzer K" first="Katherine" last="Schweitzer">Katherine Schweitzer</name><affiliation><mods:affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Wollenweber, Frank" sort="Wollenweber, Frank" uniqKey="Wollenweber F" first="Frank" last="Wollenweber">Frank Wollenweber</name><affiliation><mods:affiliation>Department of Neurology, University Hospital, Homburg Saar, Germany</mods:affiliation></affiliation></author><author><name sortKey="Wolf, Bjorn" sort="Wolf, Bjorn" uniqKey="Wolf B" first="Björn" last="Wolf">Björn Wolf</name><affiliation><mods:affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Dillmann, Ulrich" sort="Dillmann, Ulrich" uniqKey="Dillmann U" first="Ulrich" last="Dillmann">Ulrich Dillmann</name><affiliation><mods:affiliation>Department of Neurology, University Hospital, Homburg Saar, Germany</mods:affiliation></affiliation></author><author><name sortKey="Stockner, Heike" sort="Stockner, Heike" uniqKey="Stockner H" first="Heike" last="Stockner">Heike Stockner</name><affiliation><mods:affiliation>Department of Neurology, University of Innsbruck, Innsbruck, Austria</mods:affiliation></affiliation></author><author><name sortKey="Godau, Jana" sort="Godau, Jana" uniqKey="Godau J" first="Jana" last="Godau">Jana Godau</name><affiliation><mods:affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Kiechl, Stefan" sort="Kiechl, Stefan" uniqKey="Kiechl S" first="Stefan" last="Kiechl">Stefan Kiechl</name><affiliation><mods:affiliation>Department of Neurology, University of Innsbruck, Innsbruck, Austria</mods:affiliation></affiliation></author><author><name sortKey="Gaenslen, Alexandra" sort="Gaenslen, Alexandra" uniqKey="Gaenslen A" first="Alexandra" last="Gaenslen">Alexandra Gaenslen</name><affiliation><mods:affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Willeit, Johann" sort="Willeit, Johann" uniqKey="Willeit J" first="Johann" last="Willeit">Johann Willeit</name><affiliation><mods:affiliation>Department of Neurology, University of Innsbruck, Innsbruck, Austria</mods:affiliation></affiliation></author><author><name sortKey="Santo, Adriana Di" sort="Santo, Adriana Di" uniqKey="Santo A" first="Adriana Di" last="Santo">Adriana Di Santo</name><affiliation><mods:affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Maetzler, Walter" sort="Maetzler, Walter" uniqKey="Maetzler W" first="Walter" last="Maetzler">Walter Maetzler</name><affiliation><mods:affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Gasser, Thomas" sort="Gasser, Thomas" uniqKey="Gasser T" first="Thomas" last="Gasser">Thomas Gasser</name><affiliation><mods:affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</mods:affiliation></affiliation></author><author><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name><affiliation><mods:affiliation>Department of Neurology, University of Innsbruck, Innsbruck, Austria</mods:affiliation></affiliation></author><author><name sortKey="Behnke, Stefanie" sort="Behnke, Stefanie" uniqKey="Behnke S" first="Stefanie" last="Behnke">Stefanie Behnke</name><affiliation><mods:affiliation>Department of Neurology, University Hospital, Homburg Saar, Germany</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2010-07-30">2010-07-30</date><biblScope unit="volume">25</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="1464">1464</biblScope><biblScope unit="page" to="1469">1469</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">C0E03284366772921F8428DB8687CCB8ED938200</idno><idno type="DOI">10.1002/mds.23114</idno><idno type="ArticleID">MDS23114</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease/parkinsonism</term><term>cohort studies</term><term>ultrasound</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Enlarged substantia nigra hyperechogenicity (SN+) assessed by transcranial sonography (TCS) may be associated with Parkinson's disease (PD) risk markers such as impaired motor performance and hyposmia. The aim of this multicenter cross‐sectional study was to define the association between SN+ and these risk markers in a large population older than 50 years without the diagnosis of PD. In three centers (Tuebingen, Homburg, and Innsbruck), 1,839 individuals were examined. The echostatus of the SN was assessed by TCS, motor performance by the Unified Parkinson's Disease Rating Scale (UPDRS) motor score, and olfactory function with Sniffin' Sticks. From the 1,603 subjects included in the analysis, 16.2% were SN+, 23.0% scored above zero in the UPDRS motor section, and 28.0% were hyposmic as defined by less than 75% correctly classified Sniffin' Sticks. SN+ was associated with a UPDRS motor score above zero (OR 1.45, 95% CI 1.08–1.96) and with a lower odor identification capability (OR 1.48, 95% CI 1.12–1.96). The combination of these two features (OR 1.98, 95% CI 1.25–3.15) and UPDRS motor scores ≥3 lead to higher OR. It is concluded that SN+, impaired motor performance, and hyposmia are frequently observed in the elderly and in isolation are unspecific and of limited use to predict a subject's risk for PD. Whether the association of SN+ with both impaired motor performance and hyposmia as seen in this study predicts an increased risk for the development of PD needs to be evaluated in the follow‐up investigations. © 2010 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Daniela Berg MD</name><affiliations><json:string>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</json:string></affiliations></json:item><json:item><name>Klaus Seppi MD</name><affiliations><json:string>Department of Neurology, University of Innsbruck, Innsbruck, Austria</json:string></affiliations></json:item><json:item><name>Inga Liepelt PhD</name><affiliations><json:string>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</json:string></affiliations></json:item><json:item><name>Katherine Schweitzer MD</name><affiliations><json:string>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</json:string></affiliations></json:item><json:item><name>Frank Wollenweber MD</name><affiliations><json:string>Department of Neurology, University Hospital, Homburg Saar, Germany</json:string></affiliations></json:item><json:item><name>Björn Wolf</name><affiliations><json:string>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</json:string></affiliations></json:item><json:item><name>Ulrich Dillmann MD</name><affiliations><json:string>Department of Neurology, University Hospital, Homburg Saar, Germany</json:string></affiliations></json:item><json:item><name>Heike Stockner MD</name><affiliations><json:string>Department of Neurology, University of Innsbruck, Innsbruck, Austria</json:string></affiliations></json:item><json:item><name>Jana Godau MD</name><affiliations><json:string>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</json:string></affiliations></json:item><json:item><name>Stefan Kiechl MD</name><affiliations><json:string>Department of Neurology, University of Innsbruck, Innsbruck, Austria</json:string></affiliations></json:item><json:item><name>Alexandra Gaenslen MD</name><affiliations><json:string>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</json:string></affiliations></json:item><json:item><name>Johann Willeit MD</name><affiliations><json:string>Department of Neurology, University of Innsbruck, Innsbruck, Austria</json:string></affiliations></json:item><json:item><name>Adriana Di Santo</name><affiliations><json:string>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</json:string></affiliations></json:item><json:item><name>Walter Maetzler MD</name><affiliations><json:string>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</json:string></affiliations></json:item><json:item><name>Thomas Gasser MD</name><affiliations><json:string>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</json:string></affiliations></json:item><json:item><name>Werner Poewe MD</name><affiliations><json:string>Department of Neurology, University of Innsbruck, Innsbruck, Austria</json:string></affiliations></json:item><json:item><name>Stefanie Behnke MD</name><affiliations><json:string>Department of Neurology, University Hospital, Homburg Saar, Germany</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>cohort studies</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease/parkinsonism</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>ultrasound</value></json:item></subject><articleId><json:string>MDS23114</json:string></articleId><language><json:string>eng</json:string></language><abstract>Enlarged substantia nigra hyperechogenicity (SN+) assessed by transcranial sonography (TCS) may be associated with Parkinson's disease (PD) risk markers such as impaired motor performance and hyposmia. The aim of this multicenter cross‐sectional study was to define the association between SN+ and these risk markers in a large population older than 50 years without the diagnosis of PD. In three centers (Tuebingen, Homburg, and Innsbruck), 1,839 individuals were examined. The echostatus of the SN was assessed by TCS, motor performance by the Unified Parkinson's Disease Rating Scale (UPDRS) motor score, and olfactory function with Sniffin' Sticks. From the 1,603 subjects included in the analysis, 16.2% were SN+, 23.0% scored above zero in the UPDRS motor section, and 28.0% were hyposmic as defined by less than 75% correctly classified Sniffin' Sticks. SN+ was associated with a UPDRS motor score above zero (OR 1.45, 95% CI 1.08–1.96) and with a lower odor identification capability (OR 1.48, 95% CI 1.12–1.96). The combination of these two features (OR 1.98, 95% CI 1.25–3.15) and UPDRS motor scores ≥3 lead to higher OR. It is concluded that SN+, impaired motor performance, and hyposmia are frequently observed in the elderly and in isolation are unspecific and of limited use to predict a subject's risk for PD. Whether the association of SN+ with both impaired motor performance and hyposmia as seen in this study predicts an increased risk for the development of PD needs to be evaluated in the follow‐up investigations. © 2010 Movement Disorder Society</abstract><qualityIndicators><score>6.733</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 810 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>3</keywordCount><abstractCharCount>1568</abstractCharCount><pdfWordCount>3769</pdfWordCount><pdfCharCount>24430</pdfCharCount><pdfPageCount>6</pdfPageCount><abstractWordCount>247</abstractWordCount></qualityIndicators><title>Enlarged hyperechogenic substantia nigra is related to motor performance and olfaction in the 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elderly</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>WILEY</p></availability><date>2010</date></publicationStmt><notesStmt><note type="content">*Potential conflict of interest: Nothing to report.</note><note>Universities of Homburg, Innsbruck, and Tuebingen</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Enlarged hyperechogenic substantia nigra is related to motor performance and olfaction in the elderly</title><author><persName><forename type="first">Daniela</forename><surname>Berg</surname></persName><roleName type="degree">MD</roleName><note type="correspondence"><p>Correspondence: Department of neurodegenerative diseases, Hertie Institute for Clinical Brain Research, Hoppe Seyler‐Str. 3, D‐72076 Tuebingen, Germany</p></note><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</affiliation></author><author><persName><forename type="first">Klaus</forename><surname>Seppi</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurology, University of Innsbruck, Innsbruck, Austria</affiliation></author><author><persName><forename type="first">Inga</forename><surname>Liepelt</surname></persName><roleName type="degree">PhD</roleName><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</affiliation></author><author><persName><forename type="first">Katherine</forename><surname>Schweitzer</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</affiliation></author><author><persName><forename type="first">Frank</forename><surname>Wollenweber</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurology, University Hospital, Homburg Saar, Germany</affiliation></author><author><persName><forename type="first">Björn</forename><surname>Wolf</surname></persName><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</affiliation></author><author><persName><forename type="first">Ulrich</forename><surname>Dillmann</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurology, University Hospital, Homburg Saar, Germany</affiliation></author><author><persName><forename type="first">Heike</forename><surname>Stockner</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurology, University of Innsbruck, Innsbruck, Austria</affiliation></author><author><persName><forename type="first">Jana</forename><surname>Godau</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</affiliation></author><author><persName><forename type="first">Stefan</forename><surname>Kiechl</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurology, University of Innsbruck, Innsbruck, Austria</affiliation></author><author><persName><forename type="first">Alexandra</forename><surname>Gaenslen</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</affiliation></author><author><persName><forename type="first">Johann</forename><surname>Willeit</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurology, University of Innsbruck, Innsbruck, Austria</affiliation></author><author><persName><forename type="first">Adriana Di</forename><surname>Santo</surname></persName><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</affiliation></author><author><persName><forename type="first">Walter</forename><surname>Maetzler</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</affiliation></author><author><persName><forename type="first">Thomas</forename><surname>Gasser</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</affiliation></author><author><persName><forename type="first">Werner</forename><surname>Poewe</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurology, University of Innsbruck, Innsbruck, Austria</affiliation></author><author><persName><forename type="first">Stefanie</forename><surname>Behnke</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurology, University Hospital, Homburg Saar, Germany</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2010-07-30"></date><biblScope unit="volume">25</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="1464">1464</biblScope><biblScope unit="page" to="1469">1469</biblScope></imprint></monogr><idno type="istex">C0E03284366772921F8428DB8687CCB8ED938200</idno><idno type="DOI">10.1002/mds.23114</idno><idno type="ArticleID">MDS23114</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2010</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Enlarged substantia nigra hyperechogenicity (SN+) assessed by transcranial sonography (TCS) may be associated with Parkinson's disease (PD) risk markers such as impaired motor performance and hyposmia. The aim of this multicenter cross‐sectional study was to define the association between SN+ and these risk markers in a large population older than 50 years without the diagnosis of PD. In three centers (Tuebingen, Homburg, and Innsbruck), 1,839 individuals were examined. The echostatus of the SN was assessed by TCS, motor performance by the Unified Parkinson's Disease Rating Scale (UPDRS) motor score, and olfactory function with Sniffin' Sticks. From the 1,603 subjects included in the analysis, 16.2% were SN+, 23.0% scored above zero in the UPDRS motor section, and 28.0% were hyposmic as defined by less than 75% correctly classified Sniffin' Sticks. SN+ was associated with a UPDRS motor score above zero (OR 1.45, 95% CI 1.08–1.96) and with a lower odor identification capability (OR 1.48, 95% CI 1.12–1.96). The combination of these two features (OR 1.98, 95% CI 1.25–3.15) and UPDRS motor scores ≥3 lead to higher OR. It is concluded that SN+, impaired motor performance, and hyposmia are frequently observed in the elderly and in isolation are unspecific and of limited use to predict a subject's risk for PD. Whether the association of SN+ with both impaired motor performance and hyposmia as seen in this study predicts an increased risk for the development of PD needs to be evaluated in the follow‐up investigations. © 2010 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>cohort studies</term></item><item><term>Parkinson's disease/parkinsonism</term></item><item><term>ultrasound</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2009-12-09">Received</change><change when="2010-02-27">Registration</change><change when="2010-07-30">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/C0E03284366772921F8428DB8687CCB8ED938200/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. Disord.</title></titleGroup></publicationMeta><publicationMeta level="part" position="100"><doi origin="wiley" registered="yes">10.1002/mds.v25:10</doi><numberingGroup><numbering type="journalVolume" number="25">25</numbering><numbering type="journalIssue">10</numbering></numberingGroup><coverDate startDate="2010-07-30">30 July 2010</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="190" status="forIssue"><doi origin="wiley" registered="yes">10.1002/mds.23114</doi><idGroup><id type="unit" value="MDS23114"></id></idGroup><countGroup><count type="pageTotal" number="6"></count></countGroup><titleGroup><title type="articleCategory">Research Article</title><title type="tocHeading1">Research Articles</title></titleGroup><copyright ownership="thirdParty">Copyright © 2010 Movement Disorder Society</copyright><eventGroup><event type="manuscriptReceived" date="2009-12-09"></event><event type="manuscriptRevised" date="2010-02-16"></event><event type="manuscriptAccepted" date="2010-02-27"></event><event type="firstOnline" date="2010-03-29"></event><event type="publishedOnlineFinalForm" date="2010-07-23"></event><event type="publishedOnlineAcceptedOrEarlyUnpaginated" date="2010-03-29"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.5.2 mode:FullText source:FullText result:FullText" date="2011-06-21"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-31"></event></eventGroup><numberingGroup><numbering type="pageFirst">1464</numbering><numbering type="pageLast">1469</numbering></numberingGroup><correspondenceTo>Department of neurodegenerative diseases, Hertie Institute for Clinical Brain Research, Hoppe Seyler‐Str. 3, D‐72076 Tuebingen, Germany</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS23114.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="1"></count><count type="tableTotal" number="2"></count><count type="referenceTotal" number="33"></count><count type="wordTotal" number="4464"></count></countGroup><titleGroup><title type="main" xml:lang="en">Enlarged hyperechogenic substantia nigra is related to motor performance and olfaction in the elderly<link href="#fn3"></link></title><title type="short" xml:lang="en">SN+ Related to Motor Performance and Olfaction</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Daniela</givenNames><familyName>Berg</familyName><degrees>MD</degrees></personName><contactDetails><email normalForm="daniela.berg@uni-tuebingen.de">daniela.berg@uni‐tuebingen.de</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Klaus</givenNames><familyName>Seppi</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Inga</givenNames><familyName>Liepelt</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Katherine</givenNames><familyName>Schweitzer</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Frank</givenNames><familyName>Wollenweber</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Björn</givenNames><familyName>Wolf</familyName></personName></creator><creator xml:id="au7" creatorRole="author" 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affiliationRef="#af3"><personName><givenNames>Stefanie</givenNames><familyName>Behnke</familyName><degrees>MD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="DE" type="organization"><unparsedAffiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="AT" type="organization"><unparsedAffiliation>Department of Neurology, University of Innsbruck, Innsbruck, Austria</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="DE" type="organization"><unparsedAffiliation>Department of Neurology, University Hospital, Homburg Saar, Germany</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">cohort studies</keyword><keyword xml:id="kwd2">Parkinson's disease/parkinsonism</keyword><keyword xml:id="kwd3">ultrasound</keyword></keywordGroup><fundingInfo><fundingAgency>Universities of Homburg, Innsbruck, and Tuebingen</fundingAgency></fundingInfo><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Enlarged substantia nigra hyperechogenicity (SN+) assessed by transcranial sonography (TCS) may be associated with Parkinson's disease (PD) risk markers such as impaired motor performance and hyposmia. The aim of this multicenter cross‐sectional study was to define the association between SN+ and these risk markers in a large population older than 50 years without the diagnosis of PD. In three centers (Tuebingen, Homburg, and Innsbruck), 1,839 individuals were examined. The echostatus of the SN was assessed by TCS, motor performance by the Unified Parkinson's Disease Rating Scale (UPDRS) motor score, and olfactory function with Sniffin' Sticks. From the 1,603 subjects included in the analysis, 16.2% were SN+, 23.0% scored above zero in the UPDRS motor section, and 28.0% were hyposmic as defined by less than 75% correctly classified Sniffin' Sticks. SN+ was associated with a UPDRS motor score above zero (OR 1.45, 95% CI 1.08–1.96) and with a lower odor identification capability (OR 1.48, 95% CI 1.12–1.96). The combination of these two features (OR 1.98, 95% CI 1.25–3.15) and UPDRS motor scores ≥3 lead to higher OR. It is concluded that SN+, impaired motor performance, and hyposmia are frequently observed in the elderly and in isolation are unspecific and of limited use to predict a subject's risk for PD. Whether the association of SN+ with both impaired motor performance and hyposmia as seen in this study predicts an increased risk for the development of PD needs to be evaluated in the follow‐up investigations. © 2010 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn3"><p>Potential conflict of interest: Nothing to report.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Enlarged hyperechogenic substantia nigra is related to motor performance and olfaction in the elderly</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>SN+ Related to Motor Performance and Olfaction</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Enlarged hyperechogenic substantia nigra is related to motor performance and olfaction in the elderly</title></titleInfo><name type="personal"><namePart type="given">Daniela</namePart><namePart type="family">Berg</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</affiliation><description>Correspondence: Department of neurodegenerative diseases, Hertie Institute for Clinical Brain Research, Hoppe Seyler‐Str. 3, D‐72076 Tuebingen, Germany</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Klaus</namePart><namePart type="family">Seppi</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, University of Innsbruck, Innsbruck, Austria</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Inga</namePart><namePart type="family">Liepelt</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Katherine</namePart><namePart type="family">Schweitzer</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Frank</namePart><namePart type="family">Wollenweber</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, University Hospital, Homburg Saar, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Björn</namePart><namePart type="family">Wolf</namePart><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ulrich</namePart><namePart type="family">Dillmann</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, University Hospital, Homburg Saar, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Heike</namePart><namePart type="family">Stockner</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, University of Innsbruck, Innsbruck, Austria</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jana</namePart><namePart type="family">Godau</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Stefan</namePart><namePart type="family">Kiechl</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, University of Innsbruck, Innsbruck, Austria</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alexandra</namePart><namePart type="family">Gaenslen</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Johann</namePart><namePart type="family">Willeit</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, University of Innsbruck, Innsbruck, Austria</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Adriana Di</namePart><namePart type="family">Santo</namePart><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Walter</namePart><namePart type="family">Maetzler</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Thomas</namePart><namePart type="family">Gasser</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Werner</namePart><namePart type="family">Poewe</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, University of Innsbruck, Innsbruck, Austria</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Stefanie</namePart><namePart type="family">Behnke</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, University Hospital, Homburg Saar, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2010-07-30</dateIssued><dateCaptured encoding="w3cdtf">2009-12-09</dateCaptured><dateValid encoding="w3cdtf">2010-02-27</dateValid><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">2</extent><extent unit="references">33</extent><extent unit="words">4464</extent></physicalDescription><abstract lang="en">Enlarged substantia nigra hyperechogenicity (SN+) assessed by transcranial sonography (TCS) may be associated with Parkinson's disease (PD) risk markers such as impaired motor performance and hyposmia. The aim of this multicenter cross‐sectional study was to define the association between SN+ and these risk markers in a large population older than 50 years without the diagnosis of PD. In three centers (Tuebingen, Homburg, and Innsbruck), 1,839 individuals were examined. The echostatus of the SN was assessed by TCS, motor performance by the Unified Parkinson's Disease Rating Scale (UPDRS) motor score, and olfactory function with Sniffin' Sticks. From the 1,603 subjects included in the analysis, 16.2% were SN+, 23.0% scored above zero in the UPDRS motor section, and 28.0% were hyposmic as defined by less than 75% correctly classified Sniffin' Sticks. SN+ was associated with a UPDRS motor score above zero (OR 1.45, 95% CI 1.08–1.96) and with a lower odor identification capability (OR 1.48, 95% CI 1.12–1.96). The combination of these two features (OR 1.98, 95% CI 1.25–3.15) and UPDRS motor scores ≥3 lead to higher OR. It is concluded that SN+, impaired motor performance, and hyposmia are frequently observed in the elderly and in isolation are unspecific and of limited use to predict a subject's risk for PD. Whether the association of SN+ with both impaired motor performance and hyposmia as seen in this study predicts an increased risk for the development of PD needs to be evaluated in the follow‐up investigations. © 2010 Movement Disorder Society</abstract><note type="content">*Potential conflict of interest: Nothing to report.</note><note type="funding">Universities of Homburg, Innsbruck, and Tuebingen</note><subject lang="en"><genre>Keywords</genre><topic>cohort studies</topic><topic>Parkinson's disease/parkinsonism</topic><topic>ultrasound</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. 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