Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China.
Department of Psychiatry, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Neurol Sci. 2017 Oct;38(10):1805-1810. doi: 10.1007/s10072-017-3059-6. Epub 2017 Jul 19.
Recently, Parkinson's disease (PD) has been classified into three subtypes: postural instability gait difficulty (PIGD), tremor dominate (TD), and indeterminate PD. Transcranial sonography (TCS) is considered to be an important tool to diagnose PD. However, it is uncertain that whether there are differences in TCS image characteristics in different PD subtypes, so 373 idiopathic PD (188 PIGD, 108 TD, 77 indeterminate PD) were registered and received TCS in our investigation; also, the association between clinical characteristics and TCS results in different PD subtypes was analyzed. In accordance with several previous studies, we detected substantia nigra (SN) by TCS in 85.4% of patients with idiopathic PD; we concluded that PIGD patients had more serious disease than TD and indeterminate PD group (p < 0.05). They always had larger SN hyperechogenicity areas on TCS (p < 0.05), and we found that there was no correlation between SN hyperechogenicity and disease duration or severity (p > 0.05). Similarly, abnormal brainstem raphe signal was also more often in PIGD group than in TD and indeterminate PD group (p < 0.05), which might imply that PIGD group was vulnerable to suffer from depression in the future.
最近，帕金森病（PD）已被分为三种亚型：姿势不稳步态困难（PIGD）、震颤为主（TD）和不确定 PD。经颅超声（TCS）被认为是诊断 PD 的重要工具。然而，不同 PD 亚型的 TCS 图像特征是否存在差异尚不确定，因此我们对 373 例特发性 PD（188 例 PIGD、108 例 TD、77 例不确定 PD）进行了登记并接受了 TCS 检查；此外，还分析了不同 PD 亚型的临床特征与 TCS 结果之间的关系。根据几项先前的研究，我们在 85.4%的特发性 PD 患者中通过 TCS 检测到黑质（SN）；我们得出结论，PIGD 患者的疾病比 TD 和不确定 PD 组更严重（p<0.05）。他们在 TCS 上的 SN 高回声区域总是更大（p<0.05），并且我们发现 SN 高回声与疾病持续时间或严重程度之间没有相关性（p>0.05）。同样，异常脑桥中缝信号在 PIGD 组中也比 TD 和不确定 PD 组更常见（p<0.05），这可能意味着 PIGD 组将来更容易患抑郁症。
