ABSTRACT
Objective:To apply digital analysis to quantify hyperechogenicity of substantia nigra, and explore its clinical value for diagnosis of Parkinson′s disease (PD).Methods:The cross-sectional study included 652 PD patients (PD group) and 99 healthy controls (healthy control group) from November 2017 to October 2020 in Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology. All subjects underwent transcranial sonography. The diagnostic accuracy of substantia nigra hyperechogenicity using digital analysis was compared with that in a manual measurement in PD. Furthermore, the receiver operating characteristic (ROC) curve analysis was applied to explore its diagnosis value in PD.Results:There were 482 subjects including 400 in the PD group and 82 in the healthy control group, whose quantified results of substantia nigra hyperechogenicity could be used for analysis. The ROC analysis showed that the area under the curve of the quantified larger substantia nigra hyperechoic region detection for diagnosing PD was 0.858 (95% CI 0.805-0.910), the sensitivity was 87.8%, and the specificity was 73.2%, consistent with that of doctors (area under the curve: 0.884). Further more, among these PD patients, there was no correlation between larger substantia nigra hyperechogenicity and age, age of onset, course of disease, non-motor symptoms, and motor symptoms (all P>0.05). Conclusions:Digital analysis was used to quantify the changes in substantia nigra hyperechogenicity in this seudy. The results showed that diagnostic accuracy for PD based on digital analysis was consistent with that of experienced clinicians.
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Objective:To explore the relationship between the changes of midbrain raphe nucleus echo and blood trace metals, non-motor symptoms in patients with Parkinson′s disease (PD).Methods:A total of 177 patients with PD were recruited from Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from November 2017 to December 2019. Their non-motor symptoms were assessed by a series of PD-related scales. All subjects completed transcranial color-coded sonography, and were divided into two groups according to the continuity of raphe nucleus echo. The difference of trace metals in peripheral blood and the scores of non-motor symptoms were analyzed.Results:The serum iron level of PD patients in the continuous echo of raphe nucleus group (117 cases; 15.33 （11.30, 18.93） μmol/L) was higher than that of the discontinuous group (60 cases; 12.52 （4.15, 16.00） μmol/L, t=-2.294, P=0.022), so was the scores of Scale for outcomes in PD for Autonomic Symptoms (34.00 （28.00, 39.00） vs31.00 （26.25, 36.00）， t=-2.044, P=0.041). There was no significant difference in the level of serum copper, hemoglobin, ceruloplasmin, and the scores of Movement Disorder Society Unified Parkinson′s Disease Rating Scale, Parkinson′s Disease Sleeping Scale, 39 items Parkinson′s Disease Questionnaire, Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale between the two groups. Conclusion:There was significant difference in serum iron levels and the scores of SCOPA-AUT between the two groups, but no difference in depression, sleep, and daily living ability.
ABSTRACT
Objective To investigate the correlation of substantia nigra hyperecho with essential tremor (ET) and Parkinson disease (PD).Methods The clinical data of 158 patients with ET or PD who underwent transcranial ultrasonography in Tongji Hospital from March 2016 to March 2018 were retrospectively analyzed.There were 35 patients with ET (ET group),113 patients with PD who had no previous history of ET (PD group),and 10 PD patients with previous history of ET (ET-PD group).And 58 healthy subjects served as controls (control group).The hyperechoic area of substantia nigra in different groups was compared.Results The hyperechoic areas of the substantia nigra were [0 (0,0)]cm2 (control group),[0.27(0,0.41)]cm2 (ET group),[0.33(0.21,0.40)]cm2 (ET-PD group) and [0.35(0.29,0.45)]cm2 (PD group);the differences between control group and ET group,between the ET group and PD group were statistically significant (Z=-5.24,P=0.01;Z=-3.09,P=0.02),and there were no significant difference between the ET group and ET-PD group,between ET-PD group and PD group (Z=-0.98,P=0.32;t=-0.98,P=0.33).The ratio of substantia nigra hyperechoic positive to negative in ET-PD group was 9.00 (9/1),while that in ET group was 0.94 (17/18) (OR=9.53,95％ CI:1.09-83.43,x2=3.91,P=0.04).Conclusion Substantia nigra hyperecho is an objective imaging indicator for patients with ET and PD,and has a certain differential value for their diagnosis.