Department of Neurology and Institute of Neurology, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Ultrasonography, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Parkinsons Dis. 2018;8(2):333-340. doi: 10.3233/JPD-171264.
It is debatable whether transcranial sonography (TCS) could be a biomarker for monitoring disease progression. Various phenotypes of Parkinson's disease (PD) may be a major reason contributing to the inconsistency.
We classified PD patients into different subtypes and evaluated the correlation between SN echogenicity and disease progression.
A total of 411 PD patients were included in this study. TCS evaluations of the substantia nigra (SN) were performed, and motor and non-motor symptoms were assessed by a series of rating scales in all PD patients.
Three hundred and thirteen patients had appropriate temporal acoustic bone windows, and they were divided into three subgroups according to disease onset age. SN hyperechogenicity (SN+) was found to be associated with age, gender, disease duration, H-Y stage and UPDRS-II scores in 220 middle-age onset patients. Regression analysis identified both disease duration and gender as independent predictors for SN+. When this distinct group was separated into male and female subgroups, the correlation between larger SN echogenicity (SNL) and disease duration was positive in males rather than females. When these middle-age onset male patients were classified as tremor dominant (TD) and non-TD subtypes, it turned out that correlation between disease duration and SNL only existed in male non-TD PD patients.
Our study demonstrated correlation between the size of SN echogenicity and disease duration in Chinese patients with PD who were male non-TD subtypes with middle-age onset, suggesting the formation of SN echogenicity might be a dynamic process following disease progression in this distinct subtype.
经颅超声（TCS）是否可以作为监测疾病进展的生物标志物存在争议。帕金森病（PD）的各种表型可能是导致这种不一致的主要原因。
我们将 PD 患者分为不同亚型，并评估 SN 回声强度与疾病进展之间的相关性。
本研究共纳入 411 例 PD 患者。对所有 PD 患者进行 TCS 评估黑质（SN），并通过一系列评定量表评估运动和非运动症状。
313 例患者具有适当的颞骨声窗，根据发病年龄将其分为三组。在 220 例中年发病患者中，SN 高回声（SN+）与年龄、性别、病程、H-Y 分期和 UPDRS-II 评分相关。回归分析发现病程和性别均为 SN+的独立预测因素。当将这一明显的亚组分为男性和女性亚组时，SN 回声强度（SNL）与病程之间的相关性在男性中呈正相关，而在女性中则无相关性。当这些中年发病的男性患者被分为震颤为主（TD）和非 TD 亚型时，结果表明，只有男性非 TD PD 患者的病程与 SNL 之间存在相关性。
本研究表明，在中国中年发病的男性非 TD 亚型 PD 患者中，SN 回声强度的大小与疾病持续时间存在相关性，提示在这种特定亚型中，SN 回声强度的形成可能是疾病进展后的一个动态过程。
