Abstract
As a noninvasive technique, transcranial sonography (TCS) of substantia nigra (SN) has gradually showed its effectiveness not only in diagnosis but also in understanding clinical features of Parkinson’s Disease (PD). This study aimed to further evaluate TCS for clinical diagnosis of PD, and to explore the association between sonographic manifestations and visual hallucinations (VH). A total of 226 subjects including 141 PD patients and 85 controls were recruited. All participants received TCS. A series of rating scales to evaluate motor and non-motor symptoms were performed in PD patients. Results showed that 172 subjects were successfully assessed by TCS. The area of SN was greater in PD patients than that in controls (P < 0.001). As receiver-operating characteristic (ROC) curve analysis showed, the best cutoff value for the larger SN echogenicity size was 23.5 mm2 (sensitivity 70.3%, specificity 77.0%). Patients with VH had larger SN area (P = 0.019), as well as higher Non-Motor Symptoms Scale (NMSS) scores (P = 0.018). Moreover, binary logistic regression analysis indicated that SN hyperechogenicity (odds ratio = 4.227, P = 0.012) and NMSS scores (odds ratio = 0.027, P = 0.042) could be the independent predictors for VH. In conclusion, TCS can be used as an auxiliary diagnostic tool for Parkinson’s disease. Increased SN echogenicity is correlated with VH in Parkinson’s disease, possibly because the brain stem is involved in the mechanism in the onset of VH. Further studies are needed to confirm these findings.
Highlights
Parkinson’s disease (PD) is one of the most common neurodegenerative diseases
Our objective is to evaluate the validity of transcranial sonography (TCS) for the diagnosis of PD in Chinese population, and to investigate the correlation of sonographic manifestations with clinical features, especially in visual hallucinations (VH)
Among the 226 subjects, TCS was successfully performed in 172 subjects
Summary
Chinese Medicine, Beijing 100029, China 5 Institute of Clinical Medicine, China Academy of Chinese Medical. Sciences, Beijing 100700, China an effective diagnostic technique [1], it has not been widely used due to high expense and radio action. The diagnosis of PD mainly relies on clinical manifestations [2]. Transcranial sonography (TCS) is potentially useful for the diagnosis of PD by showing the structural changes in substantia nigra (SN). Even though previous studies have proved that the specificity was 88.2–85% and the sensitivity was 84–94.9% in diagnostic accuracy of TCS in PD patients [3, 4], and the concordance rate between TCS patterns and PD diagnosis increased from 87 to 95% in a 4year follow-up [5]. The data based on Chinese population need to be supplemented
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