Abstract
Based on the topographic distribution of α-synuclein-enriched Lewy bodies, it has been hypothesized that Parkinson's disease may start in the gastrointestinal tract and gain access to the central nervous system via the vagus nerve. Since ultrasonography is a powerful tool to study peripheral nerve disturbances, we conducted ultrasonography of the vagus nerve in 32 patients with Parkinson's disease, 15 disease controls and 15 healthy controls. The cross-sectional area and echogenicity measured on transverse scans of the vagus nerve did not differ significantly between these groups. Therefore, the observed intraneuronal changes in Parkinson's disease are not associated with ultrasonographic disruptions of the vagus nerve integrity.HIGHLIGHTS We studied ultrasonography of the vagus nerve in 32 patients with Parkinson's disease and in 15 disease controls and 15 healthy controls.The sonographic cross-sectional area measured using high-frequency linear array transducers did not differ significantly between both groups.Ultrasonography of the vagal nerve does not reflect cellular damage caused by α-synuclein-enriched Lewy bodies in nerves of patients with Parkinson's disease.
Highlights
It has been hypothesized that neuropathological process that lead to Parkinson’s disease may start in the enteric nervous system and spread rostrocranial via the vagus nerve to the substantia nigra [1,2,3]
The cross-sectional area (CSA) of right vagus nerve was significantly positively correlated with the bradykinesia score
Ultrasonography of the vagus nerve can support the diagnosis of several neuropathies
Summary
It has been hypothesized that neuropathological process that lead to Parkinson’s disease may start in the enteric nervous system and spread rostrocranial via the vagus nerve to the substantia nigra [1,2,3]. This gut-brain transmission scenario is controversially discussed within the movement disorders community [4]. The pathological α-synuclein signature can be observed in the peripheral nervous system in patients with Parkinson’s disease [5]. Since high-frequency ultrasonography provides a valuable tool to study both peripheral nerves and the vagus nerve and is increasingly being used in the diagnosis of polyneuropathies [6], we aimed to answer the question whether patients with Parkinson’s disease have sonographic abnormalities in the vagus nerve
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