Both imaging modalities demonstrating reasonable diagnostic accuracy here. The problem with TCS is the subjectivity of the assessment and the fact that is (probably) a static risk marker rather than and diagnostic aid...
Eur Neurol. 2016 Oct 18;76(5-6):252-255. [Epub ahead of print]
Jesus-Ribeiro J, Freire A, Sargento-Freitas J, Sousa M, Silva F, Moreira F, Cunha MJ, Walter U, Januário C.
BACKGROUND:
The diagnosis of Parkinson's disease (PD) can sometimes be a challenge in the early stages of the disease. Both transcranial sonography (TCS) and DaTSCAN are recommended as auxiliary examinations for the differential diagnosis of PD; however, only few data exist regarding their diagnostic accuracy in the early stage of PD and essential tremor (ET).
METHODS:
We evaluated patients with clinically suspected diagnosis of PD at early stages (Hoehn and Yahr ≤2) or ET. All patients underwent DaTSCAN and TCS with a maximum interval of 6 months. Final diagnosis was established after 1-year follow-up.
RESULTS:
From the 63 patients recruited, 3 were excluded due to transcranial insonability and 2 for uncertain clinical diagnosis. The final clinical diagnosis was ET in 44.8% and PD in 55.2%. Compared to clinical diagnosis of PD, TCS had a sensitivity of 87.5% and specificity of 96.2%; DaTSCAN sensitivity was 84.4% and specificity was 96.2%. Both diagnostic tests demonstrated a substantial level of agreement (Cohen's kappa coefficient: 0.83, 95% CI 0.68-0.97, p < 0.001).
CONCLUSION:
TCS and DaTSCAN have similar diagnostic accuracy for the diagnosis of early stage PD versus ET.
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