Brain sonography insight into the midbrain in myotonic dystrophy type 2

Muscle Nerve. 2016 May;53(5):700-4. doi: 10.1002/mus.24927. Epub 2015 Nov 26.

Abstract

Introduction: The aim of this study was to analyze transcranial sonography (TCS) findings in genetically confirmed myotonic dystrophy type 2 (DM2) patients.

Methods: Forty DM2 patients and 38 gender- and age-matched healthy controls (HCs) underwent TCS through the pre-auricular acoustic bone window.

Results: Substantia nigra hyperechogenicity was found in 20% of DM2 patients compared with 3% of HCs. Brainstem raphe (BR) hypoechogenicity was more common in DM2 patients compared with HCs (56% vs. 10%, P < 0.01), and it was more common in patients with fatigue and excessive daytime sleepiness (P < 0.05). Diameter of the third ventricle was increased in DM2 patients compared with HCs (5.8 ± 1.7 vs. 5.1 ± 1.0 mm, P < 0.05).

Conclusions: Finding BR hypoechogenicity might have clinical implication because of the potential response to serotonin-reuptake inhibitors. TCS revealed alterations in brain structures previously not seen in MRI studies.

Keywords: brainstem raphe; fatigue; myotonic dystrophy type 2; sleepiness; substantia nigra; transcranial sonography.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Case-Control Studies
  • Cohort Studies
  • Cross-Sectional Studies
  • Echoencephalography
  • Fatigue / diagnostic imaging
  • Fatigue / etiology
  • Female
  • Humans
  • Male
  • Mesencephalon / diagnostic imaging
  • Middle Aged
  • Myotonic Dystrophy / complications
  • Myotonic Dystrophy / diagnostic imaging*
  • Raphe Nuclei / diagnostic imaging*
  • Substantia Nigra / diagnostic imaging*
  • Third Ventricle / diagnostic imaging*