Department of Neurology, Wakayama Medical University, Wakayama, Japan.
Eur J Neurol. 2012 Mar;19(3):411-6. doi: 10.1111/j.1468-1331.2011.03533.x. Epub 2011 Oct 7.
Appropriate diagnostic biomarkers are useful for improving speed and accuracy of a diagnosis. Substantia nigra (SN) hyperechogenicity visualized by transcranial sonography (TCS), olfactory dysfunction, and the reduced uptake of (123) I-metaiodobenzylguanidine (MIBG) in myocardial scintigraphy have been suggested as potential biomarkers for the identification of Parkinson's disease (PD).
To evaluate the diagnostic potential of these tests and to determine whether combining them increases their diagnostic power.
Subjects were 44 patients with clinically diagnosed PD and 36 healthy controls. TCS of the SN, the odor stick identification test for Japanese (OSIT-J), and MIBG myocardial scintigraphy were conducted.
Eleven patients with PD (25%) and four controls (11%) were excluded because of an insufficient acoustic temporal bone window in the TCS. Thus, 33 patients with PD and 32 healthy controls were finally included. The diagnostic sensitivity of TCS, OSIT-J, and MIBG myocardial scintigraphy was 78.8%, 84.8%, and 60.6%, respectively. The specificity of TCS and OSIT-J was 93.8% and 78.1%, respectively. The combination of TCS of the SN and OSIT-J substantially increased the sensitivity to a sufficient level for discriminating patients with PD from controls.
TCS of the SN and olfactory testing play complementary roles in increasing diagnostic power in PD. As both tests are easy to perform, noninvasive, and inexpensive, the combination of TCS of the SN and olfactory testing may contribute to early and accurate diagnosis of PD.
适当的诊断生物标志物有助于提高诊断的速度和准确性。经颅超声（TCS）可见的黑质（SN）高回声、嗅觉功能障碍以及心肌闪烁显像中（123）I-间碘苄胍（MIBG）摄取减少，已被认为是识别帕金森病（PD）的潜在生物标志物。
评估这些测试的诊断潜力，并确定将它们结合使用是否可以提高其诊断能力。
研究对象为 44 名临床诊断为 PD 的患者和 36 名健康对照者。对 SN 进行 TCS、日本气味棒识别测试（OSIT-J）和 MIBG 心肌闪烁显像检查。
由于 TCS 中颞骨声窗不足，11 名 PD 患者（25%）和 4 名对照者（11%）被排除在外。因此，最终纳入 33 名 PD 患者和 32 名健康对照者。TCS、OSIT-J 和 MIBG 心肌闪烁显像的诊断敏感性分别为 78.8%、84.8%和 60.6%。TCS 和 OSIT-J 的特异性分别为 93.8%和 78.1%。SN 的 TCS 和 OSIT-J 的组合显著提高了从对照组中区分 PD 患者的敏感性，使其达到足够的水平。
SN 的 TCS 和嗅觉测试在提高 PD 的诊断能力方面发挥互补作用。由于这两种测试都易于操作、非侵入性且价格低廉，因此 SN 的 TCS 和嗅觉测试的组合可能有助于 PD 的早期和准确诊断。
