Transcranial Brain Parenchyma Ultrasonography in Neurodegenerative and Psychiatric Diseases – an Update

Transcranial sonography (TCS) has been recently recognized as a reliable and sensitive tool in detecting basal ganglia (BG) abnormalities in several movement disorders, where different patterned hyperechogenic lesions were demonstrated. TCS revealed reduced echogenicity of the brainstem raphe (BR) as a characteristic finding in unipolar depression and in depression associated with Parkinson's (PD) or Wilson's disease (WD), but not in healthy adults, schizophrenia, multiple sclerosis with depression or Parkinson's disease without concomitant depression.
TCS showed substantia nigra hyperechogenicity in idiopathic PD and lenticular nuclei hyperechogenicity as a characteristic finding in atypical parkinsonian syndromes. TCS also revealed BG hyperechogenic changes in several other movement disorders with trace metal accumulation such as WD, several forms of spinocerebelar ataxia as well as some entities of neurodegeneration with brain metal accumulation.
The increasingly broad application of TCS in the early and differential diagnosis of neurodegenerative and psychiatric disorders in many centers all over the world is probably the best evidence for the value of the method.
Main advantages include the easy applicability, the fact that it is quick and repeatedly performable with no limitations as known from other neuroimaging techniques and that it is relatively cheap and side effect free.

View on .pdf file