Transcranial sonography characteristics and their influencing factors in patients with restless leg syndrome / 中华神经医学杂志

Objective:To investigate the characteristics of transcranial sonography (TCS) in patients with restless legs syndrome (RLS), and analyze the correlations of scores of RLS Self-rating Severity Scale by International Restless Leg Syndrome Study Group (IRLS) and TCS parameters with clinical data of these patients.Methods:Twenty-one patients with RLS admitted to the Sleep Disorder Clinic of our hospital from September 2020 to January 2021 were selected as RLS group, and 23 healthy controls at the same time period were recruited as control group. IRLS was used to evaluate the severity of patients in the RLS group, and the 14-item Hamilton anxiety rating scale (HAMA-14) and 24-item Hamilton depression rating scale (HAMD-24) were used to evaluate the anxiety and depression of subjects from the 2 groups. Pittsburgh Sleep Quality Scale (PSQI), Insomnia Severity Index (ISI) and Epworth Sleepiness Scale (ESS) were used to evaluate the sleep quality of subjects from the 2 groups. TCS was used to examine the occurrence of hypoechoic substantia nigra and raphe nucleus rupture and the width of the third ventricle in the two groups. The clinical data and TCS parameters of patients in the 2 groups were compared, and the correlations of IRLS scores and TCS parameters with clinical features of patients in the RLS group were analyzed.Results:As compared with those in the control group, the HAMA-14, HAMD-24, ISI and PSQI scores in the RLS group were statistically higher ( P<0.05). As compared with the control group, RLS group had significantly higher proportion of patients with hypoechoic substantia nigra or raphe nucleus rupture ( P<0.05). In RLS patients, the IRLS scores were positively correlated with HAMA-14, HAMD-24, and ISI scores ( P<0.05); ESS scores were negatively correlated with hypoechoic substantia nigra and width of the third ventricle ( rs=-2.005, P=0.045; r=-0.477, P=0.029); width of the third ventricle was negatively correlated with gender (male) and years of education ( rs=-0.592, P=0.005; r=-0.627, P=0.002), and positively correlated with age and course of the disease ( r=0.756, P<0.001; r=0.167, P=0.047). Conclusions:Patients with RLS are prone to anxiety, depression and sleep disorders; their TCS shows hypoechoic substantia nigra and raphe nucleus rupture. RLS severity may affect HAMA-14, HAMD-24, and ISI scores. Gender, age, years of education, course of disease, and ESS scores of RLS patients may affect TCS related parameters.

Study on laterality of Parkinson's disease under transcranial ultrasound / 中风与神经疾病杂志

@#To explore the laterality of SN+ area in patients with PD under TCS，and to further analyze its correlation with clinical data，in order to have a more comprehensive understanding of Parkinson's disease.Methods 81 patients with Parkinson's disease were collected，and the differences between SN+O and SN+N，SN+L and SN+R under transcranial ultrasound，and the correlation between SN+O and S/M and clinical data in patients with EOPD and LOPD were analyzed.Nonparametric test was used for difference analysis and spearman correlation was used for correlation analysis.Results The SN+O of PD was significantly larger than that of SN+N，and there was no significant difference in SN+ between left and right substantia nigra.The SN+O of early-onset PD was negatively correlated with the age of onset.Conclusion The area of SN+ on both sides of Parkinson's disease was asymmetrical under transcranial ultrasound.SN+O in Parkinson's disease was significantly larger than that in SN+N.The larger S/M often occurred in patients with early-onset PD rather than in patients with late-onset PD.Subgroup analysis showed that the age of onset of EOPD was negatively correlated with SN+O.SN+O and S/M in Parkinson's disease are not affected by age，disease duration，severity，autonomic nervous dysfunction and depression，but their stability as biomarkers needs to be further studied.

Eeffect of patent ductus ateriosus on cerebral haemodynamic changes and morbidity of periventricular-intraventricular hemorrhage in preterm infants / 中华实用儿科临床杂志

Objective To investigate the cerebral haemodynamics change and morbidity of periventricular-intraventricular hemorrhages(PIVH) in premature infants with or without patent ductus ateriosus (PDA).Methods Bedside Echocardiography and transcranial sonography (TCS) were performed on 85 cases of preterm infants in 48 h,48 to 96 h,96 to 120 h,120 to 168 h after birth (gestational age≤34 weeks and birth weight≤2 000 g).PDA,peak systolic velocity (Vs),end-diastolic velocity (Vd),pulsatility index (PI) and resistant index (RI) of anterior and middle cerebral artery(ACA and MCA) and PIVH were monitored simutaneously.Results According to the Echocardiography and clinical symptoms,all the cases were divided into 3 groups:haemodynamic significant PDA group (hsPDA group,n =23),non-hsPDA group(nhsPDA group,n =38) and non-PDA group(nPDA group,n =24).The mean birth weight and gestational age did not differ significantly among the 3 groups.Single and multiple Logistic analysis indicated that invasive mechanical ventilation less than 48 h after birth was related to hsPDA (x2 =11.182,P =0.019; OR =10.06,P =0.039).Repetitive measurement deviation analysis found that:Vd of ACA and MCA were lower in the hsPDA group than those in the nhsPDA group (P =0.000,P =0.001) and the nPDA group (P =0.003,P =0.013),while PI and RI were higher than in the other 2 groups.Compared with non-closed group,at 7 days after birth in hsPDA group,RI and PI of closed group were significantly lower,while Vd was significantly higher.Nevertheless,there was no significant difference in hemodynamic parameters when comparison with nPDA group at 7 days after birth.There was no statistical difference in the grading and severity of PIVH with or without PDA.However,the rate of severe PIVH was found higher in hsPDA group than the other 2 groups(17.39％ vs 8.33％ vs 5.26％,x2 =2.405,P =0.280).Conclusions The invasive mechanical ventilation less than 48 h after birth was probably associated with preterm hsPDA.HsPDA could result in major cerebral haemodynamic changes and increase the morbidity of severe PIVH.

Achados de ultrassonografia transcraniana na doença de Parkinson e no tremor essencial: relato de casos / Transcranial sonography findings in Parkinson's disease and essential tremor: cases report

A ultrassonografia transcraniana tem sido objeto de investigação como ferramenta diagnóstica em neurologia nos últimos anos. Ela permite boa visualização de estruturas cerebrais situadas na linha média, sítio frequente de anormalidades nas doenças do movimento. Relatamos os casos de pacientes com a doença de Parkinson e o tremor essencial em que a ultrassonografia transcraniana foi capaz de sugerir o diagnóstico.

Over the last years, transcranial sonography has been investigated as a diagnostic tool in neurology. It allows a good visualization of midline brain structures, a frequent site of involvement in movement disorders. The authors discuss cases of Parkinson's disease and essential tremor where transcranial sonography could suggest the diagnosis of the condition.

Aplicações da ultrassonografia transcraniana no diagnóstico dos distúrbios do movimento / Applications of the transcranial sonography for the diagnosis of the movement disorders

A evolução dos sistemas de hardware e software dos modernos equipamentos de ultrassonografia permitiu que as pequenas estruturas intracranianas, antes consideradas inacessíveis ao ultrassom, pudessem ser estudadas através do crânio intacto. Um dos campos que mais se beneficiaram das aplicações práticas desse novo método foram aschamadas doenças do sistema extrapiramidal. Observou-se que os pacientes com doença de Parkinson manifestam um sinal característico ao estudo com ultrassom: a hiperecogenicidade da substantia nigra mesencefálica com 90% de valor preditivo positivo. Além disso, o estudo com ultrassom transcraniano pode também ser útil para o diagnósticodiferencial das formas secundárias de parkinsonismo e ainda para a avaliação das síndromes parkinsoniana atípicas. Outras doenças que podem ser avaliadas com o uso da ecografia transcraniana são a síndrome das pernas inquietas, algumas formas de distonias e a doença de Wilson. O presente artigo objetiva expor as atuais aplicações clínicasdesse novo método de investigação por imagem das doenças extrapiramidais.

The evolution of the hardware and software systems of modern ultrasound equipments has allowed the study of some of the small intracranial structures to be performed through the intact skull. One of the areas that benefited most of the applications for this new method is the so-called extra-pyramidal system diseases. It was observed thatpatients with Parkinson?s disease have a characteristic signal on the ultrasound study: hyperechogenicity of the mesencephalic substantia nigra with 90% positive predictive value. Moreover, the intracranial ultrasound may also be useful for the differential diagnosis of secondary forms of parkinsonism and also for the evaluation of atypicalparkinsonian syndromes. The other diseases that can be evaluated with the use of transcranial ultrasound are the restless legs syndrome, Wilson?s disease and dystonia. This article aims to expose the reader to the current clinical applications of this new method of imaging for investigation of the movement disorders.

A ultrassonografia transcraniana como método diagnóstico em neurologia. Parte I: Princípios e metodologia / Transcranial ultrasonography as a diagnostic method in neurology. Part I: Principles and methodology

A ultrassonografia transcraniana (USTC) é uma promissora técnica de neuroimagem para a investigação de distúrbios do movimento. O exame tem baixo custo, é inócuo, não é invasivo e pode ser realizado nos pacientes com movimentos involuntários sem sedação. As suas limitações incluem dependência de janela óssea adequada e de experiência e qualificação do examinador. Os valores de referência, no momento, só existem para pacientes da Europa, Estados Unidos da América e Ásia. A primeira parte do artigo apresenta alguns aspectos da técnica do exame; a segunda parte faz uma revisão da bibliografia disponível sobre a utilização da USTC em doenças neurológicas, particularmente na doença de Parkinson.

Transcranial sonography (TCS) is a promising neuroimaging technique for investigating movement disorders. The exam is inexpensive, harmless, non-invasive, and quick to perform in moving patients. Its limitations include its dependency on an adequate bone window and on qualified personnel. Reference values only exist for patients from Europe, North America and Asia. In the first part of this paper we present some technical aspects of the exam; the second part reviews the bibliography about TCS in neurological diseases, Parkinson's disease above all.

Analysis of cerebral vascular hemodynamic changes in patients with essential hypertension / 重庆医科大学学报

Objective:Use transcranial Doppler ultrasound(TCD)to investigate cerebrovascular hemodynamic changes in patients with essential hypertension and provide clinical evidence for prevention of stroke.Methods:2 025 individuals who joined in physical examination were randomly selected and classified into two groups as hypertension group of 892 cases and control group of 1 133 cases.Hypertesion group is divided into 3 subgroups as normal hypertension group,complicated with glucose or lipid metabolism disorder groups.The main observational parameters through their TCD tests were systolic blood flow velocity(Vs),diastolic blood flow velocity(Vd),mean velocity(Vm),resistant index(RI),pulsatility index(PI).Results:(1)The basilar artery blood flow velocity(Vs,Vm, Vd)of patients with essential Hypertension were significantly lower than control group,Vd of middle cerebral artery decreased in hypertensive patients.On the other hand,RI and PI of the patients were higher than control group(P