Penumoencephalographic findings in parkinsonism

Area of Science:

• Neurology
• Radiology
• Neuroimaging

Background:

• Parkinsonism encompasses conditions affecting movement, often involving atrophy.
• Distinguishing between parkinsonism subtypes and other neurodegenerative diseases like Huntington chorea is clinically significant.

Purpose of the Study:

• To investigate patterns of brain atrophy in patients with unilateral and generalized parkinsonism using pneumoencephalography.
• To evaluate the utility of specific ventricular measurements, particularly the frontal horn to septum-caudate distance (FH/S-C) ratio, in differentiating parkinsonism from Huntington chorea.

Main Methods:

• Retrospective analysis of pneumoencephalograms from 19 patients with unilateral parkinsonism and 26 with generalized parkinsonism.
• Measurement of cortical and central (ventricular) atrophy, including frontal horn width (FH), septum-caudate distance (S-C), and ventricular body span (VBS).
• Calculation and comparison of the FH/S-C ratio between parkinsonism groups and with previously reported data for Huntington chorea.

Main Results:

• Cortical atrophy was observed in 46.7% and central atrophy in 77.8% of patients.
• Patients with unilateral parkinsonism showed less cortical atrophy and smaller VBS and S-C measurements compared to generalized parkinsonism.
• A FH/S-C ratio > 1.40 was found in 73.3% of parkinsonism patients, whereas < 1.40 was seen in 96.4% of Huntington chorea patients.

Conclusions:

• Ventricular enlargement, particularly central atrophy, is common in parkinsonism.
• The FH/S-C ratio may serve as a useful imaging biomarker to help differentiate parkinsonism from Huntington chorea, with a ratio ≤ 1.40 being more indicative of Huntington chorea.