Klinische Neurophysiologie 2010; 41 - ID11
DOI: 10.1055/s-0030-1250840

Transcranial brain sonography in Huntington's Disease: depression correlates with the detection of hypoechogenic mesencephalic raphe structures

C Krogias 1, K Straßburger 1, J Eyding 1, R Gold 1, C Norra 2, G Juckel 2, C Saft 1, D Ninphius 2
  • 1St. Josef-Hospital, Klinikum der Ruhr Universität Bochum, Neurologie, Bochum, Deutschland
  • 2LWL-Universitätsklinik Bochum, Psychiatrie, Bochum, Deutschland

Background:

Transcranial sonography (TCS) has become a new diagnostic tool in the evaluation of extrapyramidal disorders. Furthermore, recent studies report alterations of mesencephalic raphe structures in unipolar depression and in depressed Parkinson patients. Aim of this study was to evaluate TCS findings in patients with Huntington's disease in correlation with their neurological and psychiatric status.

Methods:

Thirty-nine patients with genetically confirmed Huntington's disease were included (mean age 47.9, 23 females): Neurological and psychiatric statuses including standardized scales were assessed by independent physicians. Echogenicities of basal ganglia were investigated according to examination protocol for extrapyramidal disorders using a Siemens Sonoline® Elegra system. The sonography examiner was blinded for clinical data.

Results:

Sixteen patients (41.0%) showed hyperechogenicity of the Substantia nigra, seven patients (20.6%) of the caudate nucleus and six patients (17.1%) of the lentiform nucleus. Twenty-one patients (53.8%) showed symptoms of depression at the time of evaluation, and of those 15 (71.4%) had hypoechogenic raphe structures. Thirty patients (76.9%) had a history of depressive episode, 19 (63.3%) of them with hypoechogenic raphe. All nine patients without any history of depressive episode showed normal echogenicity of raphe structures (Sensitivity=63.3%, Specificity=100%). Twelve (70.6%) of the 17 HD-patients who showed psychiatric disturbances prior the occurrence of motor symptoms exhibited pathological raphe echogenicity (Sensitivity=70.6%, Specificity=68.2%).

Conclusions:

As a novel finding, a relationship between mesencephalic raphe echogenicity and depressive state could be identified in Huntington's disease. An alteration of the serotonergic brainstem raphe might be involved in the pathogenesis of depression in Huntington's disease.