Abstract
Background: Recent histopathological studies revealed degeneration of the dorsal motor nucleus early in the course of Parkinson's disease (PD). Degeneration of the vagus nerve (VN) axons following neurodegeneration of brainstem vagal nuclei should be detectable by high-resolution ultrasound (HRUS) as a thinning of the VNs.Methods: We measured both VNs cross-sectional area (VN-CSA) of 35 patients with PD and 35 age- and sex-matched healthy controls at the level of the thyroid gland using HRUS.Results: On both sides, the VN-CSA was significantly smaller in PD patients than in controls (right: 2.1 ± 0.4 vs. 2.3 ± 0.5 mm2, left 1.5 ± 0.4 vs. 1.8 ± 0.4 mm2; both p < 0.05). There was no correlation between the right or left VN-CSA and age, the Hoehn & Yahr stage, disease duration, the motor part of the Unified Parkinson's Disease Rating Scale score, the Montreal Cognitive Assessment score, or the Non-motor Symptoms Questionnaire, and Scale for Parkinson's disease score including its gastrointestinal domain.Conclusions: These findings provide evidencethat atrophy of the VNs in PD patients can be detected in-vivo by HRUS.
Highlights
In Parkinson’s disease (PD) autonomic dysfunction may precede the occurrence of the cardinal motor-symptoms by many years (1)
As shown by Braak and co-workers, the central neurodegenerative process of PD often starts with the deposition of phosphorylated α-synuclein in the vagal dorsal motor nucleus (DMN) from where it spreads to the mid-brain and the cortex (3)
There is growing evidence that the vagus nerves (VN) might play a prominent role in the propagation of phosphorylated αsynuclein from the gut to the lower brainstem (1), there are no studies investigating their morphology in PD patients in vivo
Summary
In Parkinson’s disease (PD) autonomic dysfunction may precede the occurrence of the cardinal motor-symptoms by many years (1). Dysfunction of the gastrointestinal tract is often present in the prodromal phase of PD and results in constipation, gastroparesis or nausea (1). Most parts of the gastrointestinal tract receive their parasympathetic input via the vagus nerves (VN) (2). Morphological changes in (peripheral) nerves due to axonal degeneration are subtle and, hard to detect in-vivo. Recent histopathological studies revealed degeneration of the dorsal motor nucleus early in the course of Parkinson’s disease (PD). Degeneration of the vagus nerve (VN) axons following neurodegeneration of brainstem vagal nuclei should be detectable by high-resolution ultrasound (HRUS) as a thinning of the VNs
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