Neurosonological Findings Related to Non-Motor Features of Parkinson's Disease: A Systematic Review.

Cristina Del Toro Pérez,Antonio Arjona Padillo,Laura Amaya Pascasio,María Mejías Olmedo,Jesús Olivares Romero,Patricia Martínez-Sánchez,Manuel Payán Ortiz,Javier Fernández Pérez

doi:10.3390/brainsci11060776

Cristina Del Toro Pérez, Antonio Arjona Padillo + Show 6 more

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https://doi.org/10.3390/brainsci11060776

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Abstract

Non-motor symptoms (NMS) in Parkinson’s disease (PD), including neuropsychiatric or dysautonomic complaints, fatigue, or pain, are frequent and have a high impact on the patient’s quality of life. They are often poorly recognized and inadequately treated. In the recent years, the growing awareness of NMS has favored the development of techniques that complement the clinician’s diagnosis. This review provides an overview of the most important ultrasonographic findings related to the presence of various NMS. Literature research was conducted in PubMed, Scopus, and Web of Science from inception until January 2021, retrieving 23 prospective observational studies evaluating transcranial and cervical ultrasound in depression, dementia, dysautonomic symptoms, psychosis, and restless leg syndrome. Overall, the eligible articles showed good or fair quality according to the QUADAS-2 assessment. Brainstem raphe hypoechogenicity was related to the presence of depression in PD and also in depressed patients without PD, as well as to overactive bladder. Substantia nigra hyperechogenicity was frequent in patients with visual hallucinations, and larger intracranial ventricles correlated with dementia. Evaluation of the vagus nerve showed contradictory findings. The results of this systematic review demonstrated that transcranial ultrasound can be a useful complementary tool in the evaluation of NMS in PD.

Highlights

Parkinson’s disease (PD) is a chronic progressive neurodegenerative disorder characterized by its motor aspects, and by numerous non-motor symptoms (NMS)that encompass neuropsychiatric manifestation, sensory abnormalities, behavioral changes, sleep disturbances, and autonomic dysfunction
Depression and apathy are common in PD, with 40% of patients presenting apathy and 17% suffering from a major depressive disorder, occurring at any time during the course of the disease [3,4]
The present systematic review aimed to provide a comprehensive analysis of the available literature reporting ultrasound findings in Non-motor symptoms (NMS) in PD population

Summary

Introduction

Parkinson’s disease (PD) is a chronic progressive neurodegenerative disorder characterized by its motor aspects, and by numerous non-motor symptoms (NMS). That encompass neuropsychiatric manifestation, sensory abnormalities, behavioral changes, sleep disturbances, and autonomic dysfunction. NMS may be the presenting clinical feature of PD in over 20% of individuals, which usually delays PD diagnosis and an early appropriate treatment [1]. Various studies have demonstrated that NMS have a greater impact on quality of life than motor manifestations, even during the first years after diagnosis. Depression and apathy are common in PD, with 40% of patients presenting apathy and 17% suffering from a major depressive disorder, occurring at any time during the course of the disease [3,4]. Common autonomic complaints are orthostatic hypotension, 4.0/)

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