Transcranial ultrasound examination of the brain parenchyma in neuropsychiatric diseases

Transcranial sonography (TCS) is a highly sensitive non-invasive ultrasound method for the detection of early and specific echogenic changes in the basal ganglia (BG) of patients suffering from some neurodegenerative diseases. TCS showed substantia nigra hyperechogenicity as a typical echo feature in idiopathic Parkinson's disease (PD) and lenticular nuclei hyperechogenicity as a characteristic finding in atypical Parkinsonian syndromes. Discontinuity or hypoechoic appearance of the raphe is a common finding in patients with unipolar depression or depression associated with certain neurodegenerative disorders. TCS also shows hyperechoic changes in the basal ganglia in movement disorders associated with the accumulation of certain metals, such as Wilson's disease (WD), some neurodegenerative entities with metal accumulation, as well as in certain forms of spinocerebellar ataxia. TCS is a reliable neuroimaging method for early differential diagnosis and monitoring of patients with neurodegenerative and psychiatric diseases.