The role of transcranial sonography in differentiation of dementia subtypes: an introduction of a new diagnostic method



Transcranial sonography (TCS) is increasingly used for the diagnosis of neurodegenerative disorders. We assessed the role of third ventricle width (TVW), midbrain area (MA), and midbrain circumference (MC) by TCS for diagnosis and differentiation of dementia.


A cross-sectional study was designed in 59 patients with dementia including 19 patients with Alzheimer’s disease (AD), 10 Dementia with Lewy bodies (DLB), 23 Frontotemporal dementia (FTD) and 7 Vascular dementia (VaD), and 22 normal-cognition individuals. Both case and control groups were matched by age, sex, and educational level. The dementia patients were divided into two subgroups: cortical-dominant dementia (CDD) including AD and FTD; and subcortical-dominant dementia (SDD) including DLB and VaD. TCS was performed through a temporal window, in which the size of TVW and midbrain was measured by trans-thalamic and trans-mesencephalic planes, respectively.


The mean TVW was 0.85 ± 0.3 cm and 0.66 ± 0.2 cm in dementia patients and the control group, respectively (p < 0.01). The MA/MC were smaller in dementia patients compared with the control group (p < 0.05 and p < 0.01). The TVW in CDD (p = 0.003) and SDD (p = 0.027), but only MA/MC in SDD (p < 0.05), was statistically different compared with the control group.


The measurement of TVW and midbrain size by TCS can be used for diagnosis and differentiation of dementia. Patients with CDD and SDD have larger TVW than the control group, whereas patients with SDD have smaller midbrain sizes.

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This research was presented as a residency thesis in Tehran University of medical science. We are thankful to our colleagues in Dementia clinic of Hazrat-e-Rasool hospital who provided expertise that greatly assisted the research, especially Dr. Fahimeh Haji-Akhoundi, and also, we thank Dr. Siavash Adibeyk, Dr. Nima Mohsenzadeh, and Dr. Neda Gharahi greatly for their friendly collaboration in this research. We would also like to show our gratitude to Dr. Gholamali Shahidi and Dr. Amir Hassan Habibi for comments that greatly improved the manuscript.


This study was resulted from a residency thesis which was recorded by number 1773 date 2014/3/6 at Tehran University of medical science research committee. There was no other funding to this study.

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Five authors were contributed in this manuscript. Dr. Mostafa Almasi-Dooghaee is the first author and both Dr. Babak Zamani and Dr. Mostafa Almasi-Dooghaee are the corresponding author, equally. All of the authors are agree with authorship rules. Dr. Babak Zamani and Dr. Mohammad Rohani play the important role in referring the patients. The diagnosis of dementia and its type and performing the transcranial sonography were performed by Dr. Babak Zamani and Dr. Mostafa Almasi-Dooghaee. The collecting and analysis of the data and writing of the manuscript were handled by Dr. Mostafa Almasi-Dooghaee, Dr. Atefeh Imani, and Dr. Shabnam Nadjafi.

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Correspondence to Mostafa Almasi-Dooghaee.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

All procedures performed in this study were in accordance with the ethical standards of the Tehran university of Medical science.

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Almasi-Dooghaee, M., Rohani, M., Imani, A. et al. The role of transcranial sonography in differentiation of dementia subtypes: an introduction of a new diagnostic method. Neurol Sci 42, 275–283 (2021).

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  • Transcranial sonography
  • Third ventricle
  • Midbrain
  • Dementia
  • Cortical dementia
  • Subcortical dementia