Abstract
Background: Decreased brainstem raphe (BR) echogenicity detected by transcranial parenchymal sonography (TCS) is associated with depression in psychiatric and neurologic diseases. However, previous studies focusing on the relationship between motor and non-motor symptoms and echogenicity changes in BR in patients with PD yielded controversial results.Objectives: To investigate the relationship between echogenicity changes in BR detected by TCS and motor and a series of non-motor symptoms in patients with PD.Methods: Consecutive PD patients were recruited from the Second Affiliated Hospital of Soochow University. Demographic information and Motor and non-motor symptoms for all subjects were collected. TCS was used to detect the echogenicity changes in BR in PD patients.Results: One hundred and thirty-five consecutive patients with PD were enrolled in the study. The BR abnormal rate was significantly higher in PD patients with anxiety (p = 0.003) or depression (p = 0.022) than patients without. Spearman correlation analyses showed that Hamilton Rating Scale for Depression(HRSD) (r = 0.274, p = 0.002) and Parkinson's Disease Questionnaire 39-item(PDQ-39) (r = 0.208, p = 0.034) scores were positively correlated with abnormal BR echogenicity. Multivariate logistic regression analyses showed that HRSD and HAMA scores were associated with BR hypoechogenicity, the corresponding odds ratios (confidence intervals) were 1.07 (95% CI, 1.01–1.13) and 1.10(1.01–1.18), respectively. However, the PDQ-39 score was not associated with BR hypoechogenicity.Conclusion: The abnormal reduction in BR echogenicity detected by TCS is associated with depression and anxiety, but not motor symptoms in PD patients.
Highlights
Parkinson’s disease (PD) is pathologically characterized by degeneration and loss of dopamine neurons in the substantia nigra (SN) and decreased dopamine content in the striatum, which result in motor symptoms such as tremor, rigidity and bradykinesia, and non-motor symptoms such as psychiatric symptoms, cognitive dysfunction, autonomic dysfunction, sleep disorder, and abnormal sensation
The brainstem raphe (BR) abnormal rate was significantly higher in PD patients with anxiety (p = 0.003) or depression (p = 0.022) than patients without
Spearman correlation analyses showed that Hamilton Rating Scale for Depression(HRSD) (r = 0.274, p = 0.002) and Parkinson’s Disease Questionnaire 39-item(PDQ-39) (r = 0.208, p = 0.034) scores were positively correlated with abnormal BR echogenicity
Summary
Parkinson’s disease (PD) is pathologically characterized by degeneration and loss of dopamine neurons in the substantia nigra (SN) and decreased dopamine content in the striatum, which result in motor symptoms such as tremor, rigidity and bradykinesia, and non-motor symptoms such as psychiatric symptoms, cognitive dysfunction, autonomic dysfunction, sleep disorder, and abnormal sensation. Recent studies have shown that patients with depression have abnormal brainstem raphe (BR) echogenicity [3,4,5]. Combining SN hyperechogenicity with BR hypoechogenicity may be useful to detect individuals at risk for developing PD [6]. Besides depression, reduced echogenicity of BR indicated an increased risk of other non-motor symptoms in PD patients, such as urinary incontinence [9]. Bouwmans et al found no association between depression and hyperechogenic SN or hypoechogenic BR in PD patients [10]. Decreased brainstem raphe (BR) echogenicity detected by transcranial parenchymal sonography (TCS) is associated with depression in psychiatric and neurologic diseases. Previous studies focusing on the relationship between motor and non-motor symptoms and echogenicity changes in BR in patients with PD yielded controversial results
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