Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany.
Mov Disord. 2010 Jul 30;25(10):1464-9. doi: 10.1002/mds.23114.
Enlarged substantia nigra hyperechogenicity (SN+) assessed by transcranial sonography (TCS) may be associated with Parkinson's disease (PD) risk markers such as impaired motor performance and hyposmia. The aim of this multicenter cross-sectional study was to define the association between SN+ and these risk markers in a large population older than 50 years without the diagnosis of PD. In three centers (Tuebingen, Homburg, and Innsbruck), 1,839 individuals were examined. The echostatus of the SN was assessed by TCS, motor performance by the Unified Parkinson's Disease Rating Scale (UPDRS) motor score, and olfactory function with Sniffin' Sticks. From the 1,603 subjects included in the analysis, 16.2% were SN+, 23.0% scored above zero in the UPDRS motor section, and 28.0% were hyposmic as defined by less than 75% correctly classified Sniffin' Sticks. SN+ was associated with a UPDRS motor score above zero (OR 1.45, 95% CI 1.08-1.96) and with a lower odor identification capability (OR 1.48, 95% CI 1.12-1.96). The combination of these two features (OR 1.98, 95% CI 1.25-3.15) and UPDRS motor scores >or=3 lead to higher OR. It is concluded that SN+, impaired motor performance, and hyposmia are frequently observed in the elderly and in isolation are unspecific and of limited use to predict a subject's risk for PD. Whether the association of SN+ with both impaired motor performance and hyposmia as seen in this study predicts an increased risk for the development of PD needs to be evaluated in the follow-up investigations.
经颅超声（TCS）评估的黑质回声增强（SN+）可能与帕金森病（PD）风险标志物相关，如运动表现受损和嗅觉减退。本多中心横断面研究的目的是在无 PD 诊断的 50 岁以上人群中定义 SN+与这些风险标志物之间的关联。在三个中心（图宾根、洪堡和因斯布鲁克），共检查了 1839 人。通过 TCS 评估 SN 的回声状态，使用统一帕金森病评定量表（UPDRS）运动评分评估运动表现，使用 Sniffin' Sticks 评估嗅觉功能。在纳入分析的 1603 名受试者中，16.2%为 SN+，23.0%的 UPDRS 运动评分大于零，28.0%的嗅觉功能定义为 Sniffin' Sticks 正确分类少于 75%。SN+与 UPDRS 运动评分大于零（OR 1.45，95%CI 1.08-1.96）和嗅觉识别能力降低（OR 1.48，95%CI 1.12-1.96）相关。这两种特征的组合（OR 1.98，95%CI 1.25-3.15）和 UPDRS 运动评分>或=3 导致更高的 OR。结论是，SN+、运动表现受损和嗅觉减退在老年人中经常观察到，并且单独使用时不具有特异性，对预测个体患 PD 的风险有限。在后续研究中需要评估本研究中观察到的 SN+与运动表现受损和嗅觉减退的关联是否预测 PD 发展的风险增加。
