Transcranial ultrasound in neurodegeneration with brain iron accumulation (NBIA)

Eur J Paediatr Neurol. 2012 Mar;16(2):175-8. doi: 10.1016/j.ejpn.2011.07.009. Epub 2011 Aug 3.


NBIA/HSS is a neurodegenerative disorder associated with iron accumulation in specific brain regions. To date, the diagnosis is obtained by typical MRI changes followed by genetic mutation analysis. This procedure is laborious and limited to a few specially equipped medical centres. Since transcranial sonography (TCS) is widely used for the early diagnosis of PD in adults displaying parenchymal metal deposits, it is likely to be a reliable diagnostic tool for the early diagnosis of NBIA. In 7 patients with proven NBIA and 13 age-matched controls without record of neurological disease TCS was performed by an experienced ultrasound examiner. Data were analysed by two blinded investigators regarding hyperechogenicity and size of the substantia nigra (SN). SN size and hyperechogenicity was significantly increased in patients with NBIA compared to controls (students t-test: p < 0.001). TCS appears to be a non-invasive and inexpensive screening technique in patients with suspected NBIA. Performed by an experienced physician, it could enable an earlier diagnosis and pre-selection of patients for the MRI scan and genetic testing, which are still the diagnostic gold standard.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Brain Chemistry
  • Child
  • Child, Preschool
  • Female
  • Globus Pallidus / diagnostic imaging
  • Globus Pallidus / pathology
  • Humans
  • Iron Overload / diagnostic imaging*
  • Iron Overload / genetics
  • Magnetic Resonance Imaging
  • Male
  • Mutation / physiology
  • Neurodegenerative Diseases / diagnostic imaging*
  • Neurodegenerative Diseases / etiology
  • Neurodegenerative Diseases / genetics
  • Pantothenate Kinase-Associated Neurodegeneration / diagnostic imaging*
  • Pantothenate Kinase-Associated Neurodegeneration / genetics
  • Phosphotransferases (Alcohol Group Acceptor) / genetics
  • Substantia Nigra / diagnostic imaging
  • Substantia Nigra / pathology
  • Ultrasonography
  • Young Adult


  • Phosphotransferases (Alcohol Group Acceptor)
  • pantothenate kinase