nach oben

Journal of Neurology

Erschienen in:

01.02.2011 | Original Communication

Sonographic basal ganglia alterations are related to non-motor symptoms in multiple sclerosis

verfasst von: Sebastian Horowski, Uwe K. Zettl, Reiner Benecke, Uwe Walter

Erschienen in: Journal of Neurology | Ausgabe 2/2011

Einloggen, um Zugang zu erhalten

Abstract

The anatomical basis of cognitive dysfunction and other non-motor symptoms in multiple sclerosis (MS) is poorly understood. In MS patients, transcranial sonography (TCS) shows neurodegenerative disease-like lesions of the substantia nigra (SN) and basal ganglia, thought to reflect iron accumulation. The present study deals with the question of whether sonographic changes of SN, brainstem raphe, lenticular nucleus (LN) or caudate nucleus are related to non-motor symptoms of MS. We used TCS to investigate 54 MS patients and 54 age- and sex-matched healthy subjects. Degree of cognitive (executive) dysfunction, fatigue, depression, and urinary urge incontinence in MS patients was assessed using the Paced Auditory Serial Addition Test, the Faces Symbol Test, the Modified Fatigue Impact Scale, the Beck Depression Inventory, and the Urinary Distress Inventory. Abnormal TCS findings of SN, brainstem raphe, LN, and caudate nucleus were found in 13, 7, 11, and 6% of the healthy subjects, but in 54, 43, 62, and 41% (each, p < 0.001) of the MS patients, with similar frequency in relapsing-remitting and primary or secondary progressive MS patients. Sonographic alteration of the LN correlated with cognitive dysfunction. Combined alteration of both, LN and SN, was clearly associated with cognitive dysfunction and cognitive fatigue. The combined sonographic alteration of SN and brainstem raphe indicated severe urinary urge incontinence irrespective of the presence of spinal MS lesions. No relation was found between depression and any of the TCS findings. These findings suggest that neurodegenerative processes affecting deep brain structures contribute to cognitive and autonomic dysfunction in MS.

Hauser SL, Oksenberg JR (2006) The neurobiology of multiple sclerosis: genes, inflammation, and neurodegeneration. Neuron 52:61–76CrossRefPubMed

Nortvedt MW, Riise T, Myhr KM, Landtblom AM, Bakke A, Nylane HI (2001) Reduced quality of life among multiple sclerosis patients with sexual disturbance and bladder dysfunction. Mult Scler 7:231–235PubMed

Crayton H, Heyman RA, Rossman HS (2004) A multimodal approach to managing the symptoms of multiple sclerosis. Neurology 63(Suppl 5):S12–S18PubMed

Amato MP, Zipoli V, Portaccio E (2006) Multiple sclerosis-related cognitive changes: a review of cross-sectional and longitudinal studies. J Neurol Sci 245:41–46CrossRefPubMed

Hadjimichael O, Vollmer T, Oleen-Burkey M, North American Research Committee on Multiple Sclerosis (2008) Fatigue characteristics in multiple sclerosis: the North American Research Committee on Multiple Sclerosis (NARCOMS) survey. Health Qual Life Outcomes 6:100CrossRefPubMed

Marrie RA, Horwitz R, Cutter G, Tyry T, Campagnolo D, Vollmer T (2009) The burden of mental comorbidity in multiple sclerosis: frequent, underdiagnosed, and undertreated. Mult Scler 15:385–392CrossRefPubMed

Hadjimichael O (2002) NARCOMS report. Bladder symptoms among registry participants. Mult Scler Q Rep 21:16–19

Hohol MJ, Guttmann CR, Orav J, Mackin GA, Kikinis R, Khoury SJ, Jolesz FA, Weiner HL (1997) Serial neuropsychological assessment and magnetic resonance imaging analysis in multiple sclerosis. Arch Neurol 54:1018–1025PubMed

Zivadinov R, Sepcic J, Nasuelli D, De Masi R, Bragadin LM, Tommasi MA, Zambito-Marsala S, Moretti R, Bratina A, Ukmar M, Pozzi-Mucelli RS, Grop A, Cazzato G, Zorzon M (2001) A longitudinal study of brain atrophy and cognitive disturbances in the early phase of relapsing-remitting multiple sclerosis. J Neurol Neurosurg Psychiatry 70:773–780CrossRefPubMed

10.

Benedict RHB, Weinstock-Guttman B, Fishman I, Sharma J, Tjoa CW, Bakshi R (2004) Prediction of neuropsychological impairment in multiple sclerosis: comparison of conventional magnetic resonance imaging measures of atrophy and lesion burden. Arch Neurol 61:226–230CrossRefPubMed

11.

Sanfilipo MP, Benedict RH, Weinstock-Guttman B, Bakshi R (2006) Gray and white matter brain atrophy and neuropsychological impairment in multiple sclerosis. Neurology 66:685–692CrossRefPubMed

12.

Berg D, Supprian T, Thomae J, Warmuth-Metz M, Horowski A, Zeiler B, Magnus T, Rieckmann P, Becker G (2000) Lesion pattern in patients with multiple sclerosis and depression. Mult Scler 6:156–162PubMed

13.

Bakshi R, Czarnecki D, Shaikh ZA, Priore RL, Janardhan V, Kaliszky Z, Kinkel PR (2000) Brain MRI lesions and atrophy are related to depression in multiple sclerosis. Neuroreport 11:1153–1158CrossRefPubMed

14.

Feinstein A, Roy P, Lobaugh NJ, Feinstein K, O’Connor P, Black SE (2004) Structural brain abnormalities in multiple sclerosis patients with major depression. Neurology 62:586–590PubMed

15.

Feinstein A, O’Connor P, Akbar N, Moradzadeh L, Scott CJ, Lobaugh NJ (2010) Diffusion tensor imaging abnormalities in depressed multiple sclerosis patients. Mult Scler 16:189–196CrossRefPubMed

16.

Walter U, Kanowski M, Kaufmann J, Grossmann A, Benecke R, Niehaus L (2008) Contemporary ultrasound systems allow high-resolution transcranial imaging of small echogenic deep intracranial structures similarly as MRI: a phantom study. Neuroimage 40:551–558CrossRefPubMed

17.

Walter U, Skoloudík D, Berg D (2010) Transcranial sonography findings related to non-motor features of Parkinson’s disease. J Neurol Sci 289(1–2):123–127CrossRefPubMed

18.

Becker T, Becker G, Seufert J, Hofmann E, Lange KW, Naumann M, Lindner A, Reichmann H, Riederer P, Beckmann H, Reiners K (1997) Parkinson’s disease and depression: evidence for an alteration of the basal limbic system detected by transcranial sonography. J Neurol Neurosurg Psychiatry 63:590–596CrossRefPubMed

19.

Berg D, Supprian T, Hofmann E, Zeiler B, Jäger A, Lange KW, Reiners K, Becker T, Becker G (1999) Depression in Parkinson’s disease: brainstem midline alteration on transcranial sonography and magnetic resonance imaging. J Neurol 246:1186–1193CrossRefPubMed

20.

Walter U, Dressler D, Wolters A, Wittstock M, Benecke R (2006) Overactive bladder in Parkinson’s disease: alteration of brainstem raphe detected by transcranial sonography. Eur J Neurol 13:1291–1297CrossRefPubMed

21.

Walter U, Hoeppner J, Prudente-Morrissey L, Horowski S, Herpertz SC, Benecke R (2007) Parkinson’s disease-like midbrain sonography abnormalities are frequent in depressive disorders. Brain 130:1799–1807CrossRefPubMed

22.

Walter U, Dressler D, Wolters A, Wittstock M, Benecke R (2007) Transcranial brain sonography findings in clinical subgroups of idiopathic Parkinson’s disease. Mov Disord 22:48–54CrossRefPubMed

23.

Walter U, Wagner S, Horowski S, Benecke R, Zettl UK (2009) Transcranial brain sonography findings predict disease progression in multiple sclerosis. Neurology 73:1010–1017CrossRefPubMed

24.

Lublin FD, Reingold SC (1996) Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis. Neurology 46:907–911PubMed

25.

Polman CH, Reingold SC, Edan G, Filippi M, Hartung HP, Kappos L, Lublin FD, Metz LM, McFarland HF, O’Connor PW, Sandberg-Wollheim M, Thompson AJ, Weinshenker BG, Wolinsky JS (2005) Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria”. Ann Neurol 58:840–846CrossRefPubMed

26.

Rieckmann P, Toyka KV, Bassetti C, Beer K, Beer S, Buettner U, Chofflon M, Götschi-Fuchs M, Hess K, Kappos L, Kesselring J, Goebels N, Ludin HP, Mattle H, Schluep M, Vaney C, Baumhackl U, Berger T, Deisenhammer F, Fazekas F, Freimüller M, Kollegger H, Kristoferitsch W, Lassmann H, Markut H, Strasser-Fuchs S, Vass K, Altenkirch H, Bamborschke S, Baum K, Benecke R, Brück W, Dommasch D, Elias WG, Gass A, Gehlen W, Haas J, Haferkamp G, Hanefeld F, Hartung HP, Heesen C, Heidenreich F, Heitmann R, Hemmer B, Hense T, Hohlfeld R, Janzen RW, Japp G, Jung S, Jügelt E, Koehler J, Kölmel W, König N, Lowitzsch K, Manegold U, Melms A, Mertin J, Oschmann P, Petereit HF, Pette M, Pöhlau D, Pohl D, Poser S, Sailer M, Schmidt S, Schock G, Schulz M, Schwarz S, Seidel D, Sommer N, Stangel M, Stark E, Steinbrecher A, Tumani H, Voltz R, Weber F, Weinrich W, Weissert R, Wiendl H, Wiethölter H, Wildemann U, Zettl UK, Zipp F, Zschenderlein R, Izquierdo G, Kirjazovas A, Packauskas L, Miller D, Koncan Vracko B, Millers A, Orologas A, Panellus M, Sindic CJ, Bratic M, Svraka A, Vella NR, Stelmasiak Z, Selmaj K, Bartosik-Psujik H, Mitosek-Szewczyk K, Belniak E, Mochecka A, Bayas A, Chan A, Flachenecker P, Gold R, Kallmann B, Leussink V, Mäurer M, Ruprecht K, Stoll G, Weilbach FX, Multiple Sclerosis Therapy Consensus Group (2004) Escalating immunotherapy of multiple sclerosis-new aspects and practical application. J Neurol 251:1329–1339CrossRefPubMed

27.

Kurtzke JF (1983) Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 33:1444–1452PubMed

28.

Fischer JS, Rudick RA, Cutter GR, Reingold SC (1999) The Multiple Sclerosis Functional Composite measure (MSFC): an integrated approach to MS clinical outcome assessment. National MS Society Clinical Outcomes Assessment Task Force. Mult Scler 5:244–250PubMed

29.

Scherer P, Penner IK, Rohr A, Boldt H, Ringel I, Wilke-Burger H, Burger-Deinerth E, Isakowitsch K, Zimmermann M, Zahrnt S, Hauser R, Hilbert K, Tiel-Wilck K, Anvari K, Behringer A, Peglau I, Friedrich H, Plenio A, Benesch G, Ehret R, Nippert I, Finke G, Schulz I, Bergtholdt B, Breitkopf S, Kaskel P, Reischies F, Kugler J (2007) The Faces Symbol Test, a newly developed screening instrument to assess cognitive decline related to multiple sclerosis: first results of the Berlin Multi-Centre FST Validation Study. Mult Scler 13:402–411CrossRefPubMed

30.

Williams J, O’Rourke K, Hutchinson M, Tubridy N (2006) The Face-Symbol Test and the Symbol-Digit Test are not reliable surrogates for the Paced Auditory Serial Addition Test in multiple sclerosis. Mult Scler 12:599–604CrossRefPubMed

31.

Multiple Sclerosis Council for Clinical Practice Guidelines (1998) Fatigue and multiple sclerosis: evidence-based management strategies for fatigue in multiple sclerosis. Paralysed Veterans of America, Washington DC

32.

Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571PubMed

33.

Sullivan MJ, Weinshenker B, Mikail S, Bishop SR (1995) Screening for major depression in the early stages of multiple sclerosis. Can J Neurol Sci 22:228–231PubMed

34.

Brown JS, Posner SF, Stewart AL (1999) Urge incontinence: new health-related quality of life measures. J Am Geriatr Soc 47:980–988PubMed

35.

Borello-France D, Dusi J, O’Leary M, Misplay S, Okonski J, Leng W, Cannon-Smith T, Chancellor M (2008) Test-retest reliability of the Urge-Urinary Distress Inventory and Female Sexual Function Index in women with multiple sclerosis. Urol Nurs 28:30–35PubMed

36.

Berg D, Becker G, Zeiler B, Tucha O, Hofmann E, Preier M, Benz P, Jost W, Reiners K, Lange KW (1999) Vulnerability of the nigrostriatal system as detected by transcranial ultrasound. Neurology 53:1026–1031PubMed

37.

Walter U, Behnke S, Eyding J, Niehaus L, Postert T, Seidel G, Berg D (2007) Transcranial brain parenchyma sonography in movement disorders: state of the art. Ultrasound Med Biol 33:15–25CrossRefPubMed

38.

Berg D, Roggendorf W, Schröder U, Klein R, Tatschner T, Benz P, Tucha O, Preier M, Lange KW, Reiners K, Gerlach M, Becker G (2002) Echogenicity of the substantia nigra: association with increased iron content and marker for susceptibility to nigrostriatal injury. Arch Neurol 59:999–1005CrossRefPubMed

39.

Godau J, Klose U, Di Santo A, Schweitzer K, Berg D (2008) Multiregional brain iron deficiency in restless legs syndrome. Mov Disord 23:1184–1187CrossRefPubMed

40.

Brass SD, Benedict RH, Weinstock-Guttman B, Munschauer F, Bakshi R (2006) Cognitive impairment is associated with subcortical magnetic resonance imaging grey matter T2 hypointensity in multiple sclerosis. Mult Scler 12:437–444CrossRefPubMed

41.

Liepelt I, Wendt A, Schweitzer KJ, Wolf B, Godau J, Gaenslen A, Bruessel T, Berg D (2008) Substantia nigra hyperechogenicity assessed by transcranial sonography is related to neuropsychological impairment in the elderly population. J Neural Transm 115:993–999CrossRefPubMed

42.

Walter U, Krolikowski K, Tarnacka B, Benecke R, Czlonkowska A, Dressler D (2005) Sonographic detection of basal ganglia lesions in asymptomatic and symptomatic Wilson disease. Neurology 64:1726–1732CrossRefPubMed

43.

Maciel P, Cruz VT, Constante M, Iniesta I, Costa MC, Gallati S, Sousa N, Sequeiros J, Coutinho P, Santos MM (2005) Neuroferritinopathy: missense mutation in FTL causing early-onset bilateral pallidal involvement. Neurology 65:603–605CrossRefPubMed

44.

Da Cunha C, Wietzikoski EC, Dombrowski P, Bortolanza M, Santos LM, Boschen SL, Miyoshi E (2009) Learning processing in the basal ganglia: a mosaic of broken mirrors. Behav Brain Res 199:157–170CrossRefPubMed

45.

Krogias C, Strassburger K, Eyding J, Gold R, Norra C, Juckel G, Saft C, Ninphius D (2010) Depression in Huntington’s Disease correlates with alterations of brainstem raphe depicted by transcranial sonography. J Psychiatry Neurosci (in press)

Titel: Sonographic basal ganglia alterations are related to non-motor symptoms in multiple sclerosis
verfasst von: Sebastian Horowski
Uwe K. Zettl
Reiner Benecke
Uwe Walter
Publikationsdatum: 01.02.2011
Verlag: Springer-Verlag
Erschienen in: Journal of Neurology / Ausgabe 2/2011
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-010-5707-0

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Neurologie

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Frühe Alzheimertherapie lohnt sich

25.04.2024 AAN-Jahrestagung 2024 Nachrichten

Ist die Tau-Last noch gering, scheint der Vorteil von Lecanemab besonders groß zu sein. Und beginnen Erkrankte verzögert mit der Behandlung, erreichen sie nicht mehr die kognitive Leistung wie bei einem früheren Start. Darauf deuten neue Analysen der Phase-3-Studie Clarity AD.

Viel Bewegung in der Parkinsonforschung

25.04.2024 Parkinson-Krankheit Nachrichten

Neue arznei- und zellbasierte Ansätze, Frühdiagnose mit Bewegungssensoren, Rückenmarkstimulation gegen Gehblockaden – in der Parkinsonforschung tut sich einiges. Auf dem Deutschen Parkinsonkongress ging es auch viel um technische Innovationen.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2011

Favorable outcome with bevacizumab after poor outcome with steroids in a patient with temporal lobe and brainstem radiation necrosis

Autoimmune encephalopathy presenting as a ‘posterior circulation stroke’

Magnesium treatment for patients with refractory status epilepticus due to POLG1-mutations

Paroxysmal dysarthria and ataxia in multiple sclerosis and corresponding magnetic resonance imaging findings

Communications of the European Neurological Society

Tau and 14-3-3 of genetic and sporadic Creutzfeldt–Jakob disease patients in Israel