Abstract
Background: Vagal parasympathetic neurons are prone to degeneration in Parkinson's disease (PD). High-resolution ultrasound can precisely estimate the cross-sectional (CSA) area of peripheral nerves. Here, we tested the hypothesis that vagus CSA is reduced in PD.Methods: We included 56 healthy controls (HCs) and 63 patients with PD. Using a high-end ultrasound system equipped with a high-frequency transducer, five images were obtained of each nerve. The hypoechoic neuronal tissue was delineated offline with dedicated software and the CSA extracted.Results: In the initial PD vs. HC comparison, no statistically significant differences were observed in mean left vagus CSA (HC: 1.97 mm2, PD: 1.89 mm2, P = 0.36) nor in mean right vagus CSA (HC: 2.37 mm2, PD: 2.23 mm2, P = 0.17). The right vagus CSA was significantly larger than the left vagus CSA in both groups (P < 0.0001). Females were overrepresented in the HC group and presented with generally smaller vagus CSAs. Consequently, sex-adjusted CSA was significantly smaller for the right vagus nerve of the PD group (P = 0.041), but not for the left.Conclusion: A small but significant reduction in sex-adjusted right vagus CSA was observed in patients with PD. The left vagus CSA was not significantly reduced in patients with PD. Ultrasound may not be a suitable method to detecting vagal axonal loss in individual patients.
Highlights
The vagus nerve may play a crucial role in the pathogenesis of Parkinson’s disease (PD)
Vagal parasympathetic neurons that project to most of the gastrointestinal tract serve as entrance to the dorsal motor
In the healthy controls (HCs) group, mean right vagus CSA was 0.4 mm2 larger than mean left vagus CSA
Summary
The vagus nerve may play a crucial role in the pathogenesis of Parkinson’s disease (PD). It has been hypothesized that α-synuclein aggregates form in the enteric nervous system, and spread via the autonomic nervous system to the central nervous system [1] In this context, vagal parasympathetic neurons that project to most of the gastrointestinal tract serve as entrance to the dorsal motor. The DMV and the vagus nerve itself are among the most frequently affected structures in postmortem PD studies [4,5,6,7]. This is accompanied by up to 50% DMV motor neuron loss in deceased patients [8,9,10]. We tested the hypothesis that vagus CSA is reduced in PD
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