Value of combined midbrain sonography, olfactory and motor function assessment in the differential diagnosis of early Parkinson's disease

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usa-input-error-message selection-validation-message"> Name must be less than 100 characters </div> </div> <div class="action-panel-control-wrap existing-collections-controls"> <label for="collections-action-panel-add-to-existing" class="action-panel-label"> Choose a collection: </label> <select id="collections-action-panel-add-to-existing" class="action-panel-selector collections-action-add-to-existing" data-ga-category="save_share" data-ga-action="select_collection" data-ga-label="($('#collections-action-add-to-existing').val() === 'Favorites') ? 'Favorites' : 'non_favorites_collection'"> </select> <div class="collections-retry-load-on-error usa-input-error-message selection-validation-message"> Unable to load your collection due to an error<br> <a href="#">Please try again</a> </div> </div> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Adding..." data-pinger-ignore data-ga-category="save_share" data-ga-action="collections" data-ga-label="add"> Add </button> <button class="action-panel-cancel" aria-label="Close 'Add to Collections' panel" ref="linksrc=close_collections_panel" aria-controls="collections-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="collections" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="bibliography-action-panel" class="bibliography-action-panel action-panel in-progress-dots-panel" aria-hidden="true" data-bibliography-open-panel-enabled="false" data-bibliography-open-panel-url-hash="#open-bibliography-panel"> <div class="inner-wrap"> <h3 class="action-panel-heading"> Add to My Bibliography </h3> <form id="bibliography-action-panel-form" class="bibliography-action-panel-form action-panel-content action-form action-panel-smaller-selectors" data-add-to-bibliography-max-amount="100" data-add-to-bibliography-batch-size="10" data-bibliography-delegates-url="/list-bibliography-delegates/" data-add-to-bibliography-url="/add-to-bibliography/" data-get-article-ids-by-search-url="/get-article-ids-by-search/" data-mybib-root-url="https://www.ncbi.nlm.nih.gov/myncbi/collections/mybibliography/"> <input type="hidden" name="csrfmiddlewaretoken" value="Cz7nxrzFBf71r5seLnTMVH63tnAvCsrgnw4crP2AEf5cTyi1zscgUeLDAuIwmiXx"> <div class="action-panel-control-wrap bibliographies-controls"> <div class="choice-group"> <ul class="bibliographies-action-add radio-group-items"> <li> <input name="bibliography" id="my-bibliography" class="my-bibliography" type="radio" checked/> <label for="my-bibliography">My Bibliography</label> </li> </ul> </div> </div> <div class="bibliographies-retry-load-on-error usa-input-error-message selection-validation-message"> Unable to load your delegates due to an error<br> <a href="#">Please try again</a> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Adding..." data-pinger-ignore> Add </button> <button class="action-panel-cancel" aria-label="Close 'Add to bibliography' panel" ref="linksrc=close_bibliography_panel" aria-controls="bibliography-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="mybib" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="saved-search-action-panel" class="saved-search-action-panel action-panel " aria-hidden="true" data-saved-search-open-panel-enabled="false" data-saved-search-open-panel-url-hash="#open-saved-search-panel"> <div class="inner-wrap"> <h2 class="action-panel-heading"> Your saved search </h2> <form id="saved-search-action-panel-form" class="saved-search-action-panel-form action-panel-content action-form" data-create-saved-search-url="/create-saved-search/" data-try-search-terms-url="/try-search-term/" data-saved-search-root-url="https://www.ncbi.nlm.nih.gov/myncbi/searches/"> <input type="hidden" name="csrfmiddlewaretoken" value="Cz7nxrzFBf71r5seLnTMVH63tnAvCsrgnw4crP2AEf5cTyi1zscgUeLDAuIwmiXx"> <div class="action-panel-control-wrap"> <label for="saved-search-name" class="action-panel-label saved-search-name-label required-field-asterisk"> Name of saved search: </label> <input maxlength="200" type="text" name="saved-search-name" id="saved-search-name" class="saved-search-name" value="" required pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/"> </div> <div class="action-panel-control-wrap"> <label for="saved-search-term" class="action-panel-label required-field-asterisk"> Search terms: </label> <textarea name="saved-search-term" id="saved-search-term" class="saved-search-term" required></textarea> </div> <div class="test-search-term-wrap"> <a href="#" class="try-search-term">Test search terms</a> </div> <div class="choice-group action-panel-extra-margin-top"> <span class="action-panel-label" id="fieldset-label"> Would you like email updates of new search results? </span> <fieldset id="saved-search-alert" aria-describedby="fieldset-label"> <legend class="usa-sr-only">Saved Search Alert Radio Buttons</legend> <ul class="radio-group-items"> <li> <input type="radio" id="saved-search-alert-yes" class="saved-search-alert-yes" name="saved-search-alert" value="yes" checked> <label for="saved-search-alert-yes" class="action-panel-label">Yes</label> </li> <li> <input aria-label="No radio input" type="radio" id="saved-search-alert-no" class="saved-search-alert-no" name="saved-search-alert" value="no"> <label for="saved-search-alert-no" class="action-panel-label">No</label> </li> </ul> </fieldset> </div> <div class="alert-schedule-wrap"> <div class="action-panel-control-wrap"> <label class="action-panel-label"> Email: </label> <span aria-label="Email address" id="saved-search-email" class="action-panel-label"><span class="action-panel-label-bold"></span> (<a class="myncbi-account-settings" href="https://www.ncbi.nlm.nih.gov/account/settings/">change</a>)</span> </div> <div class="action-panel-control-wrap action-panel-extra-margin-top"> <label for="saved-search-frequency" class="action-panel-label"> Frequency: </label> <select id="saved-search-frequency" class="no-border-panel-selector saved-search-frequency"> <option value="monthly">Monthly</option> <option value="weekly">Weekly</option> <option value="daily">Daily</option> </select> </div> <div class="action-panel-control-wrap saved-search-monthly-additional"> <label for="saved-search-monthly-on-day" class="action-panel-label"> Which day? </label> <select id="saved-search-monthly-on-day" class="no-border-panel-selector"> <option value="Sunday">The first Sunday</option> <option value="Monday">The first Monday</option> <option value="Tuesday">The first Tuesday</option> <option value="Wednesday">The first Wednesday</option> <option value="Thursday">The first Thursday</option> <option value="Friday">The first Friday</option> <option value="Saturday">The first Saturday</option> <option value="day">The first day</option> <option value="weekday">The first weekday</option> </select> </div> <div class="action-panel-control-wrap saved-search-weekly-additional"> <label for="saved-search-weekly-on-day" class="action-panel-label"> Which day? </label> <select id="saved-search-weekly-on-day" class="no-border-panel-selector saved-search-weekly-on-day"> <option value="Sunday">Sunday</option> <option value="Monday">Monday</option> <option value="Tuesday">Tuesday</option> <option value="Wednesday">Wednesday</option> <option value="Thursday">Thursday</option> <option value="Friday">Friday</option> <option value="Saturday">Saturday</option> </select> </div> <div class="action-panel-control-wrap"> <label for="saved-search-report" class="action-panel-label"> Report format: </label> <select id="saved-search-report" class="no-border-panel-selector saved-search-report"> <option value="DocSum">Summary</option> <option value="DocSumText">Summary (text)</option> <option value="Abstract">Abstract</option> <option value="AbstractText">Abstract (text)</option> <option value="MEDLINE">PubMed</option> </select> </div> <div class="action-panel-control-wrap"> <label for="saved-search-amount" class="action-panel-label"> Send at most: </label> <select id="saved-search-amount" class="no-border-panel-selector saved-search-amount"> <option value="1">1 item</option> <option value="5" selected>5 items</option> <option value="10">10 items</option> <option value="20">20 items</option> <option value="50">50 items</option> <option value="100">100 items</option> <option value="200">200 items</option> </select> </div> <div> <input type="checkbox" id="saved-search-send-if-no-result" class="saved-search-send-if-no-result" name="saved-search-send-if-no-result"> <label for="saved-search-send-if-no-result" class="action-panel-label smaller-checkbox"> Send even when there aren't any new results </label> </div> <div class="action-panel-control-wrap option-text-in-email-wrap"> <label for="saved-search-email-text" class="action-panel-label"> Optional text in email: </label> <textarea name="saved-search-email-text" id="saved-search-email-text" class="saved-search-email-text"></textarea> </div> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Saving..." data-ga-category="save_share" data-ga-action="alert" data-ga-label="save"> Save </button> <button class="action-panel-cancel" aria-label="Close 'Your saved search' panel" ref="linksrc=close_saved_search_panel" aria-controls="saved-search-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="alert" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="citation-manager-action-panel" class="citation-manager-action-panel action-panel" aria-hidden="true"> <div class="inner-wrap"> <h2 class="action-panel-heading"> Create a file for external citation management software </h2> <form id="citation-manager-action-panel-form" class="action-panel-content action-form" action="/results-export-ids/" data-by-search-action="/results-export-search-data/" data-by-ids-action="/results-export-ids/" method="post" data-by-search-method="post" data-by-ids-method="post"> <input type="hidden" name="csrfmiddlewaretoken" value="Cz7nxrzFBf71r5seLnTMVH63tnAvCsrgnw4crP2AEf5cTyi1zscgUeLDAuIwmiXx"> <input name="results-format" type="hidden" value="pubmed"/> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Sending..." data-ga-category="save_share" data-ga-action="citation_manager" data-ga-label="save"> Create file </button> <button class="action-panel-cancel" aria-label="Close 'Send citations to citation manager' panel" ref="linksrc=close_citation_manager_panel" aria-controls="citation-manager-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="citation_manager" data-ga-label="cancel"> Cancel </button> </div> </form> </div> </div> <div id="rss-action-panel" class="rss-action-panel action-panel " aria-hidden="true"> <div class="inner-wrap"> <h2 class="action-panel-heading"> Your RSS Feed </h2> <form id="rss-action-panel-form" class="rss-action-panel-form action-panel-content action-form" data-create-rss-feed-url="/create-rss-feed-url/" data-search-form-term-value=""> <input type="hidden" name="csrfmiddlewaretoken" value="Cz7nxrzFBf71r5seLnTMVH63tnAvCsrgnw4crP2AEf5cTyi1zscgUeLDAuIwmiXx"> <div class="action-panel-control-wrap"> <label for="rss-name" class="action-panel-label required-field-asterisk"> Name of RSS Feed: </label> <input maxlength="200" placeholder="Name" type="text" name="rss-name" id="rss-name" class="rss-name" value='' required pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/"> </div> <div class="rss-limit-wrap"> <div class="action-panel-control-wrap action-panel-extra-margin-top"> <label for="rss-limit" class="action-panel-label"> Number of items displayed: </label> <select id="rss-limit" class="no-border-panel-selector rss-limit"> <option value="5">5</option> <option value="10">10</option> <option value="15" selected="selected">15</option> <option value="20">20</option> <option value="50">50</option> <option value="100">100</option> </select> </div> </div> <div class="action-panel-actions"> <button class="action-panel-submit" type="submit" data-loading-label="Creating..." data-ga-category="save_share" data-ga-action="alert" data-ga-label="save"> Create RSS </button> <button class="action-panel-cancel" aria-label="Close 'Your RSS' panel" ref="linksrc=close_rss_panel" aria-controls="rss-action-panel" aria-expanded="false" data-ga-category="save_share" data-ga-action="alert" data-ga-label="cancel"> Cancel </button> </div> <div class="action-panel-control-wrap rss-link-copy-wrap"> <label for="rss-link" class="usa-sr-only">RSS Link</label> <input placeholder="Your RSS Feed Link" type="text" name="rss-link" id="rss-link" class="rss-link" title="RSS Link"> <button type="button" disabled class="rss-link-copy-button disabled" data-ga-category="save_share" data-ga-action="rss" data-ga-label="copy"> Copy </button> </div> </form> </div> </div> </div> </div> <div class="article-page" id="article-page" data-article-pmid="22362921"> <aside class="page-sidebar"> <div class="inner-wrap"> <div class="full-text-links"> <div class="full-view"> <h3 class="title"> Full text links </h3> <div class="full-text-links-list"> <a class="link-item dialog-focus" href="https://jnnp.bmj.com/lookup/pmidlookup?view=long&pmid=22362921" target="_blank" rel="noopener" ref="linksrc=fulltextorjournal_fulltext&is_pmc=False&PrId=3051&itool=Abstract-def&log$=linkouticon&uid=22362921&db=pubmed&nlmid=2985191R" title="See full text options at HighWire" data-ga-category="full_text" data-ga-action="HighWire" data-ga-label="22362921" ><img src="https://cdn.ncbi.nlm.nih.gov/corehtml/query/egifs/http:--highwire.stanford.edu-icons-externalservices-pubmed-bmj_full.gif" alt="full text provider logo"><span class="text"> HighWire </span></a> </div> </div> <div class="short-view"> <a href="#" class="full-text-links-button full-text-links-dialog-trigger"> Full text links </a> </div> </div> <div class="actions-buttons sidebar"><h3 class="title">Actions</h3><div class="inner-wrap"><button class="citation-button citation-dialog-trigger" aria-label="Open dialog with citation text in different styles" data-ga-category="save_share" data-ga-action="cite" data-ga-label="open" data-all-citations-url="/22362921/citations/" data-citation-style="nlm" data-pubmed-format-link="/22362921/export/"><span class="button-label">Cite</span></button><link type="text/css" href="ncbi-overlay-block/src/overlay-block.css"><div class="collections-button-container" data-article-id="22362921" data-article-db="pubmed"><button class="collections-button collections-dialog-trigger" aria-label="Save article in MyNCBI collections." data-ga-category="collections_button" data-ga-action="click" data-ga-label="collections_button" data-collections-open-dialog-enabled="false" data-collections-open-dialog-url="https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F22362921%2F%23open-collections-dialog" data-in-collections="false"><span class="button-label">Collections</span></button><div class="overlay" role="dialog"><div id="collections-action-dialog" class="dialog collections-dialog" aria-hidden="true"><div class="title">Add to Collections</div><div class="collections-action-panel action-panel"><form id="collections-action-dialog-form" class="collections-action-panel-form action-panel-content action-form action-panel-smaller-selectors" data-existing-collections-url="/list-existing-collections/" data-add-to-existing-collection-url="/add-to-existing-collection/" data-create-and-add-to-new-collection-url="/create-and-add-to-new-collection/" data-myncbi-max-collection-name-length="100" data-collections-root-url="https://www.ncbi.nlm.nih.gov/myncbi/collections/"><input type="hidden" name="csrfmiddlewaretoken" value="Cz7nxrzFBf71r5seLnTMVH63tnAvCsrgnw4crP2AEf5cTyi1zscgUeLDAuIwmiXx"><div class="choice-group" role="radiogroup"><ul class="radio-group-items"><li><input type="radio" id="collections-action-dialog-new" class="collections-new" name="collections" value="new" data-ga-category="collections_button" data-ga-action="click" data-ga-label="collections_radio_new"><label for="collections-action-dialog-new">Create a new collection</label></li><li><input type="radio" id="collections-action-dialog-existing" class="collections-existing" name="collections" value="existing" checked="true" data-ga-category="collections_button" data-ga-action="click" data-ga-label="collections_radio_existing"><label for="collections-action-dialog-existing">Add to an existing collection</label></li></ul></div><div class="controls-wrapper"><div class="action-panel-control-wrap new-collections-controls"><label for="collections-action-dialog-add-to-new" class="action-panel-label required-field-asterisk"> Name your collection: </label><input type="text" name="add-to-new-collection" id="collections-action-dialog-add-to-new" class="collections-action-add-to-new" pattern="[^"&=<>\/]*" title="The following characters are not allowed in the Name field: "&=<>/" maxlength="100" data-ga-category="collections_button" data-ga-action="create_collection" data-ga-label="non_favorties_collection"><div class="collections-new-name-too-long usa-input-error-message selection-validation-message"> Name must be less than 100 characters </div></div><div class="action-panel-control-wrap existing-collections-controls"><label for="collections-action-dialog-add-to-existing" class="action-panel-label"> Choose a collection: </label><select id="collections-action-dialog-add-to-existing" class="action-panel-selector collections-action-add-to-existing" data-ga-category="collections_button" data-ga-action="select_collection" data-ga-label="($('.collections-action-add-to-existing').val() === 'Favorites') ? 'Favorites' : 'non_favorites_collection'"></select><div class="collections-retry-load-on-error usa-input-error-message selection-validation-message"> Unable to load your collection due to an error<br><a href="#">Please try again</a></div></div></div><div class="action-panel-actions"><button class="action-panel-submit" type="submit" data-loading-label="Adding..." data-pinger-ignore data-ga-category="collections_button" data-ga-action="click" data-ga-label="add"> Add </button><button class="action-panel-cancel" aria-label="Close 'Add to Collections' panel" ref="linksrc=close_collections_panel" aria-controls="collections-action-panel" aria-expanded="false" data-ga-category="collections_button" data-ga-action="click" data-ga-label="cancel"> Cancel </button></div></form></div></div></div></div><button class="more-actions-button more-actions-dialog-trigger" title="Open dialog with more actions to take" ref="linksrc=more_actions_btn"></button><div class="display-options" data-format-key="format" data-default-format-value="abstract" data-current-format-value="abstract" role="region"><button class="trigger usa-button" title="Change format" data-ga-category="display_options" data-ga-action="display_options_dialog"><span class="button-label">Display options</span></button><div class="dropdown" hidden><div class="title"> Display options </div><div class="content"><div class="format-container"><span class="option-label"> Format </span><select name="format" data-initial-value="abstract" aria-label="Display format" id="sidebar-actions-display-format"><option value="abstract">Abstract</option><option value="pubmed">PubMed</option><option value="pmid">PMID</option></select></div></div></div></div></div></div> <div class="social-sharing"> <h3 class="title"> Share </h3> <ul class="social-sharing-links usa-unstyled-list"> <li> <a 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<div class="article-source"> <div class="journal-actions dropdown-block"><button id="full-view-journal-trigger" class="journal-actions-trigger trigger" ref="linksrc=journal_actions_btn" title="Journal of neurology, neurosurgery, and psychiatry" tabindex="0" aria-controls="full-view-journal" aria-expanded="false" aria-label="Toggle dropdown menu for journal Journal of neurology, neurosurgery, and psychiatry" data-pinger-ignore> J Neurol Neurosurg Psychiatry </button><div id="full-view-journal" class="journal-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for journal Journal of neurology, neurosurgery, and psychiatry"><div class="title">Actions</div><div class="content"><ul class="journal-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22J+Neurol+Neurosurg+Psychiatry%22%5Bjour%5D&sort=date&sort_order=desc" data-href="/?term=%22J+Neurol+Neurosurg+Psychiatry%22%5Bjour%5D&sort=date&sort_order=desc" 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class="citation-doi"> doi: 10.1136/jnnp-2011-301719. </span> <span class="secondary-date"> Epub 2012 Feb 22. </span> </div> <h1 class="heading-title"> Value of combined midbrain sonography, olfactory and motor function assessment in the differential diagnosis of early Parkinson's disease </h1> <div class="inline-authors"> <div class="authors"> <div class="authors-list"> <span class="authors-list-item "><a class="full-name" href="/?term=Busse+K&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Knut Busse">Knut Busse</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Parkinson Clinic ‘WaldklinikBernburg GmbH’, Bernburg, Germany." href="#full-view-affiliation-1" ref="linksrc=author_aff"> 1 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Heilmann+R&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Robert Heilmann">Robert Heilmann</a><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Kleinschmidt+S&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Sabine Kleinschmidt">Sabine Kleinschmidt</a><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Abu-Mugheisib+M&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Mazen Abu-Mugheisib">Mazen Abu-Mugheisib</a><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=H%C3%B6ppner+J&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Jacqueline Höppner">Jacqueline Höppner</a><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Wunderlich+C&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Christian Wunderlich">Christian Wunderlich</a><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Gemende+I&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Irene Gemende">Irene Gemende</a><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Kaulitz+L&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Lara Kaulitz">Lara Kaulitz</a><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Wolters+A&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Alexander Wolters">Alexander Wolters</a><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Benecke+R&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Reiner Benecke">Reiner Benecke</a><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Walter+U&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Uwe Walter">Uwe Walter</a></span> </div> </div> </div> <div class="short-article-details"> Affiliations <button class="more-details" id="toggle-authors" data-alt-text="Collapse" aria-controls="expanded-authors" aria-expanded="false" data-pinger-ignore data-fetch-url="/22362921/long-authors/" data-id-prefix=""> <span class="title"> Expand </span> </button> </div> <div class="extended-article-details" id="expanded-authors" aria-hidden="true"> <div class="expanded-authors" id="full-view-expanded-authors"> <div class="affiliations"> <h3 class="title"> Affiliation </h3> <ul class="item-list"> <li data-affiliation-id="full-view-affiliation-1" id="full-view-affiliation-1" ><sup class="key">1</sup> Parkinson Clinic ‘WaldklinikBernburg GmbH’, Bernburg, Germany.</li> </ul> </div> </div> </div> <ul class="identifiers" id="full-view-identifiers"> <li> <span class="identifier pubmed"> <span class="id-label"> PMID: </span> <strong class="current-id" title="PubMed ID">22362921</strong> </span> </li> <li> <span class="identifier doi"> <span class="id-label"> DOI: </span> <a class="id-link" target="_blank" rel="noopener" ref="linksrc=article_id_link&article_id=10.1136/jnnp-2011-301719&id_type=DOI" href="https://doi.org/10.1136/jnnp-2011-301719" data-ga-category="full_text" data-ga-action="DOI" > 10.1136/jnnp-2011-301719 </a> </span> </li> </ul> <div class="in-clipboard-label " hidden> Item in Clipboard </div> </div> <div class="short-view" id="short-view-heading"> <h1 class="heading-title"> Value of combined midbrain sonography, olfactory and motor function assessment in the differential diagnosis of early Parkinson's disease </h1> <div class="short-citation"> <span class="authors-list"> <span class="authors-list-item "><span class="full-name">Knut Busse</span><span class="citation-separator"> et al.</span></span> </span> <span class="citation-journal"> J Neurol Neurosurg Psychiatry<span class="citation-separator">.</span> </span> <span class="date"> <span class="citation-year">2012 Apr</span><span class="citation-separator">.</span> </span> </div> <div class="more-article-details-section with-display-settings"> <button class="more-article-details" id="toggle-article-details" data-alt-text="Hide details" ref="linksrc=toggle_article_details" aria-controls="full-article-details" aria-expanded="false" data-fetch-url="/22362921/long-authors/" data-id-prefix=""> <span 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class="secondary-date"> Epub 2012 Feb 22. </span> </div> <div class="expanded-authors" id="short-view-expanded-authors"> <div class="authors"> <h3 class="title"> Authors </h3> <div class="authors-list"> <span class="authors-list-item "><a class="full-name" href="/?term=Busse+K&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Knut Busse">Knut Busse</a><sup class="affiliation-links"><span class="author-sup-separator"> </span><a class="affiliation-link" title="Parkinson Clinic ‘WaldklinikBernburg GmbH’, Bernburg, Germany." href="#short-view-affiliation-1" ref="linksrc=author_aff"> 1 </a></sup><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Heilmann+R&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Robert Heilmann">Robert Heilmann</a><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Kleinschmidt+S&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Sabine Kleinschmidt">Sabine Kleinschmidt</a><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Abu-Mugheisib+M&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Mazen Abu-Mugheisib">Mazen Abu-Mugheisib</a><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=H%C3%B6ppner+J&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Jacqueline Höppner">Jacqueline Höppner</a><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Wunderlich+C&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Christian Wunderlich">Christian Wunderlich</a><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Gemende+I&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Irene Gemende">Irene Gemende</a><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Kaulitz+L&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Lara Kaulitz">Lara Kaulitz</a><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Wolters+A&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Alexander Wolters">Alexander Wolters</a><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Benecke+R&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Reiner Benecke">Reiner Benecke</a><span class="comma">, </span></span><span class="authors-list-item "><a class="full-name" href="/?term=Walter+U&cauthor_id=22362921" ref="linksrc=author_name_link" data-ga-category="search" data-ga-action="author_link" data-ga-label="Uwe Walter">Uwe Walter</a></span> </div> </div> <div class="affiliations"> <h3 class="title"> Affiliation </h3> <ul class="item-list"> <li data-affiliation-id="short-view-affiliation-1" id="short-view-affiliation-1" ><sup class="key">1</sup> Parkinson Clinic ‘WaldklinikBernburg GmbH’, Bernburg, Germany.</li> </ul> </div> </div> <ul class="identifiers" id="short-view-identifiers"> <li> <span class="identifier pubmed"> <span class="id-label"> PMID: </span> <strong class="current-id" title="PubMed ID">22362921</strong> </span> </li> <li> <span class="identifier doi"> <span class="id-label"> DOI: </span> <a class="id-link" target="_blank" rel="noopener" ref="linksrc=article_id_link&article_id=10.1136/jnnp-2011-301719&id_type=DOI" href="https://doi.org/10.1136/jnnp-2011-301719" data-ga-category="full_text" data-ga-action="DOI" > 10.1136/jnnp-2011-301719 </a> </span> </li> </ul> <div class="in-clipboard-label " hidden> Item in Clipboard </div> </div> </div> </header> <div class="actions-buttons inline"><div class="inner-wrap"><button class="full-text-links-button full-text-links-dialog-trigger" title="Open dialog with full text links" ref="linksrc=full_text_links"> Full text links </button><button class="citation-button citation-dialog-trigger" aria-label="Open dialog with citation text in different styles" data-ga-category="save_share" data-ga-action="cite" data-ga-label="open" data-all-citations-url="/22362921/citations/" data-citation-style="nlm" data-pubmed-format-link="/22362921/export/"><span 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<h2 class="title"> Abstract </h2> <div class="abstract-content selected" id="eng-abstract"> <p> <strong class="sub-title"> Objective: </strong> Characteristic features of Parkinson's disease (PD) are asymmetric parkinsonian motor signs, hyposmia and substantia nigra (SN) hyperechogenicity on transcranial ultrasound. However, each of these features has limited diagnostic value as they may be present, albeit less frequently, in other parkinsonian disorders. Here, the diagnostic sensitivity and specificity of combined assessment of these three features are evaluated. </p> <p> <strong class="sub-title"> Methods: </strong> 632 patients with parkinsonism (PD, vascular parkinsonism, atypical parkinsonian syndromes, essential tremor and major depressive disorder with motor slowing) were assessed on the Unified Parkinson's disease Rating Scale for motor asymmetry (right-left score difference ≥2), the 12 item Sniffin' Sticks test (SS-12) and transcranial ultrasound. The derivation (validation) cohort consisted of 517 (115) subjects (193 (35) women; age 65.4±9.6 (62.3±10.3) years) of whom 385 (68) had PD and 132 (47) non-PD parkinsonism; another 21 (6) subjects were not included due to missing transcranial insonability. Of the validation cohort, all patients had a disease duration ≤2 years and observers were blind to diagnoses. </p> <p> <strong class="sub-title"> Results: </strong> The optimum cut-off values for discrimination of PD were SS-12 score <8 (hyposmia) and SN echogenic size ≥0.24 cm(2) (SN hyperechogenicity). Sensitivity, specificity and positive predictive values for the diagnosis of PD were as follows, for the derivation cohort: motor asymmetry 88%, 54% and 85%; hyposmia 75%, 70% and 88%; SN hyperechogenicity 90%, 63% and 88%; two features present 96%, 72% and 91%; three features present 57%, 94% and 97%; and for the validation cohort: two features present 91%, 77% and 85%; three features present 49%, 98% and 97%. </p> <p> <strong class="sub-title"> Conclusion: </strong> The combined assessment of motor asymmetry, hyposmia and SN hyperechogenicity improves diagnostic specificity and allows early diagnosis of PD. </p> </div> </div> <p class="disclaimer" id="disclaimer"> <a href="/disclaimer/" target="_blank" ga_category="literature_resources" ga_action="disclaimer_link" ga_label="under_abstract">PubMed Disclaimer</a> </p> <div class="linked-articles" id="linked-commentary"> <h2 class="title"> Comment in </h2> <ul class="item-list usa-unstyled-list"> <li class="full-docsum"> <div class="docsum-content" style="display:inline;"> <a class="docsum-title" href="/23002935/" ref="article_id=23002935&linksrc=comments_link" data-ga-category="comment_correction" data-ga-action="abstract_page_link" data-ga-label="linked-commentary"> Combined assessment of midbrain hyperechogenicity, hyposmia and motor asymmetry improves diagnostic accuracy in early Parkinson's disease. </a> <div class="docsum-citation full-citation"> <span class="docsum-authors full-authors">Poewe W, Mahlknecht P.</span> <span class="docsum-authors short-authors">Poewe W, et al.</span> <span class="docsum-journal-citation full-journal-citation">Expert Rev Neurother. 2012 Aug;12(8):911-4. doi: 10.1586/ern.12.75.</span> <span class="docsum-journal-citation short-journal-citation">Expert Rev Neurother. 2012.</span> <span class="citation-part">PMID: <span class="docsum-pmid">23002935</span></span> <span class="publication-type spaced-citation-item citation-part">Review.</span> </div> </div> </li> </ul> </div> <div class="similar-articles" id="similar"> <h2 class="title"> Similar articles </h2> <ul class="articles-list" id="similar-articles-list"> <li class="full-docsum"> <div class="docsum-content" style="display:inline;"> <a class="docsum-title" href="/24839905/" ref="article_id=24839905&linksrc=similar_articles_link&ordinalpos=1" data-ga-category="similar_article" data-ga-action="24839905" data-ga-label=""> Diagnostic value of combined assessment of olfaction and sustantia nigra hyperechogenicity for Parkinson's disease. </a> <div class="docsum-citation full-citation"> <span class="docsum-authors full-authors">López Hernández N, García Escrivá A, Shalabi Benavent M.</span> <span class="docsum-authors short-authors">López Hernández N, et al.</span> <span class="docsum-journal-citation full-journal-citation">Neurologia. 2015 Oct;30(8):496-501. doi: 10.1016/j.nrl.2014.03.010. 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class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Humans"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Humans"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Humans" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Humans"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Humans"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Humans"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Male" tabindex="0" aria-controls="keyword-actions-mesh-terms-8" aria-expanded="false" data-pinger-ignore> Male </button><div id="keyword-actions-mesh-terms-8" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Male"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Male%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Male%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Male"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Male"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Male" 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href="/?term=%22Middle+Aged%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Middle+Aged%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Middle Aged"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Middle Aged"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Middle+Aged" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Middle Aged"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Middle Aged"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Middle Aged"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Movement Disorders / diagnosis" tabindex="0" aria-controls="keyword-actions-mesh-terms-10" aria-expanded="false" data-pinger-ignore> Movement Disorders / diagnosis </button><div id="keyword-actions-mesh-terms-10" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Movement Disorders / diagnosis"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Movement+Disorders%2Fdiagnosis%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Movement+Disorders%2Fdiagnosis%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Movement Disorders/diagnosis"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Movement Disorders / diagnosis"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" 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ref="linksrc=add_to_search_link" role="button" data-search-term=""Movement Disorders/epidemiology"[MAJR]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Movement Disorders/epidemiology"[MAJR]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link" aria-label="Toggle dropdown menu for keyword Olfaction Disorders / diagnosis" tabindex="0" aria-controls="keyword-actions-mesh-terms-12" aria-expanded="false" data-pinger-ignore> Olfaction Disorders / diagnosis </button><div id="keyword-actions-mesh-terms-12" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Olfaction Disorders / diagnosis"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Olfaction+Disorders%2Fdiagnosis%22%5BMeSH%5D&sort=date&sort_order=desc" data-href="/?term=%22Olfaction+Disorders%2Fdiagnosis%22%5BMeSH%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Olfaction Disorders/diagnosis"[MeSH]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Olfaction Disorders / diagnosis"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Olfaction+Disorders" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Olfaction Disorders / diagnosis"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Olfaction Disorders/diagnosis"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Olfaction Disorders/diagnosis"[MeSH]" href="#"> Add to Search 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ref="linksrc=add_to_search_link" role="button" data-search-term=""Parkinson Disease/diagnostic imaging"[MeSH]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Parkinson Disease/diagnostic imaging"[MeSH]" href="#"> Add to Search </a></li></ul></div></div></div></li><li><div class="keyword-actions dropdown-block"><button class="keyword-actions-trigger trigger keyword-link major" aria-label="Toggle dropdown menu for keyword Parkinson Disease / epidemiology*" tabindex="0" aria-controls="keyword-actions-mesh-terms-major-16" aria-expanded="false" data-pinger-ignore> Parkinson Disease / epidemiology* </button><div id="keyword-actions-mesh-terms-major-16" class="keyword-actions-dropdown dropdown dropdown-container" hidden aria-label="Dropdown menu for keyword Parkinson Disease / epidemiology*"><div class="title">Actions</div><div class="content"><ul class="keyword-actions-links"><li><a class="search-in-pubmed-link dropdown-block-link" href="/?term=%22Parkinson+Disease%2Fepidemiology%22%5BMAJR%5D&sort=date&sort_order=desc" data-href="/?term=%22Parkinson+Disease%2Fepidemiology%22%5BMAJR%5D&sort=date&sort_order=desc" ref="linksrc=search_in_pubmed_keyword_link&mesh="Parkinson Disease/epidemiology"[MAJR]" data-ga-category="search" data-ga-action="mesh_term" data-ga-label="Parkinson Disease / epidemiology*"> Search in PubMed </a></li><li><a class="search-in-mesh-link dropdown-block-link" ref="linksrc=search_in_mesh_link" href="https://www.ncbi.nlm.nih.gov/mesh?term=Parkinson+Disease" data-ga-category="search_mesh" data-ga-action="mesh_term_link" data-ga-label="Parkinson Disease / epidemiology*"> Search in MeSH </a></li><li><a class="add-to-search-link dropdown-block-link" ref="linksrc=add_to_search_link" role="button" data-search-term=""Parkinson Disease/epidemiology"[MAJR]" data-ga-category="search" data-ga-action="add_to_search" data-ga-label=""Parkinson Disease/epidemiology"[MAJR]" href="#"> Add to Search 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Value of combined midbrain sonography, olfactory and motor function assessment in the differential diagnosis of early Parkinson's disease - PubMed