Department of Ultrasound, the Third Xiangya Hospital of Central South University, Changsha, China.
Department of Neurology, Xiangya Hospital, Central South University, 87 Xiangya Rd, Changsha, China.
Neurol Sci. 2024 Feb;45(2):455-465. doi: 10.1007/s10072-023-07107-x. Epub 2023 Oct 11.
Progressive supranuclear palsy (PSP) is an atypical parkinsonism that presents with different phenotypes. There are still no validated diagnostic biomarkers for early diagnosis of PSP. Transcranial sonography (TCS) is a promising tool in the differential diagnosis of parkinsonian disorders; however, there are no systematic investigations about the application of TCS in PSP patients. Therefore, we performed a systematic review and meta-analysis to discuss the role of TCS in diagnosing PSP by systematically searching PubMed, Cochrane Library, Chinese National Knowledge Infrastructure and Wan Fang databases. Of 66 obtained records, 16 articles, including 366 patients with PSP, were included. Our results showed the estimated random-effects pooled prevalence of substantia nigra hyperechogenicity in patients with PSP was 22% (95% CI 12-32%), lenticular nucleus hyperechogenicity was 70% (95% CI 52-82%), and enlarged third ventricle was 71% (95% CI 55-85%). Additionally, a normal echogenicity substantia nigra in TCS showed 70% sensitivity (95% CI 56-81%) and 86% specificity (95% CI 75-86%) to differentiate PSP from Parkinson's disease. In conclusion, TCS is an important supplementary biomarker for diagnosing PSP. At the same time, the diagnostic value of TCS in discriminating PSP from other atypical parkinsonism and between different PSP phenotypes needs further exploration.
进行性核上性麻痹（PSP）是一种非典型帕金森病，表现出不同的表型。目前仍然没有经过验证的诊断生物标志物用于 PSP 的早期诊断。经颅超声（TCS）是帕金森病鉴别诊断中一种很有前途的工具；然而，目前还没有关于 TCS 在 PSP 患者中应用的系统研究。因此，我们进行了系统回顾和荟萃分析，通过系统地搜索 PubMed、Cochrane 图书馆、中国国家知识基础设施和万方数据库，来探讨 TCS 在诊断 PSP 中的作用。在获得的 66 份记录中，有 16 篇文章，包括 366 例 PSP 患者，被纳入分析。我们的结果表明，PSP 患者黑质回声过高的估计随机效应合并患病率为 22%（95%CI 12-32%），壳核回声过高的患病率为 70%（95%CI 52-82%），第三脑室扩大的患病率为 71%（95%CI 55-85%）。此外，TCS 中黑质回声正常对鉴别 PSP 与帕金森病的敏感性为 70%（95%CI 56-81%），特异性为 86%（95%CI 75-86%）。总之，TCS 是诊断 PSP 的重要辅助生物标志物。同时，TCS 在鉴别 PSP 与其他非典型帕金森病以及不同 PSP 表型之间的诊断价值还需要进一步探索。
