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A typical hyperechogenicity ot the substantia nigra (SN), known to be prevalent in more than 90% of Parkinsons's disease patients, can be demonstrated with the method of transcranial sonography (Berg, 2008). This method is reliable, non-invasive, commonly available and easily applicable and therefore it constitutes a valuable screening instrument.
Imaging is done with a transtemporal approach and with the transducer placed at the preauricular site while the patient is in a supine position. The brain parenchyma is scanned from both temporal bone windows. Structures of the brainstem, basal ganglia and ventricles can be visualized. Extension of the ventricular system as well as of echogenic signals at the substantia nigra are measured quantitatively. Changes of echogenicity of the basal ganglia and the hippocampus are documented semiquantitatively. Within the butterfly-shaped mesencephalic brainstem, the SN of Parkinson's disease patients can be detected as hyperechogenic structure.

Hyperechogenicity seems to be independent from the stage of disease and serves therefore as a valuable marker for the early differential diagnosis of Parkinsonian syndromes. First studies indicate that this ultrasound feature may even constitute a risk marker for Parkinson's disease. This hypothesis is currently investigated in longitudinal studies.
Course contents: for learning the technique we are offering two-day intensive training courses. Within these courses, participants get the opportunity to investigate themselves patients suffering from different movement disorders with transcranial sonography under constant supervision. The practical part will be completed by theoretical units with informations about the background of the method, technical aspects und future applications.
Course programme: for further information to the course contents please refer to our TCS course program
Appointments: available on request. As we can affiliate only 2 participants per course, please contact us in advance
Expenses: per day and guest we charge a compensational fee of 250€
Contact / Organisation: if you are interested and for further informations, please contact:
Dr. Bettina Faust
Department of Neurodegeneration
Hertie-Institute for Clincial Brain Research
Center for Neurology,
Hoppe-Seyler-Str.3
D-72076 Tübingen
bettina.faust(at)klinikum.uni-tuebingen.de