Transcranial sonography in brain disorders with trace metal accumulation.

Transcranial sonography (TCS) can detect trace metal accumulation in deep brain structures with higher sensitivity than conventional MRI. Especially, increased iron content in the substantia nigra in Parkinson's disease, increased copper content in the lenticular nucleus (LN) in Wilson's disease and idiopathic dystonia, and increased manganese content in the LN in manganese-induced Parkinsonism were detected with TCS, even in subjects with normal MRI. TCS, therefore, might be useful to detect an increased risk of developing neurological symptoms in relatives of patients with Parkinson's or Wilson's disease. The exact mechanism of how an elevated trace metal content leads to an increased echogenicity needs to be further elucidated.

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