Del Toro Pérez Cristina, Amaya Pascasio Laura, Arjona Padillo Antonio, Olivares Romero Jesús, Mejías Olmedo María Victoria, Fernández Pérez Javier, Payán Ortiz Manuel, Martínez-Sánchez Patricia
Neurosonology Laboratory, Department of Neurology, Torrecárdenas University Hospital, 04009 Almería, Spain.
Faculty of Health Sciences, CEINSA (Center of Health Research), University of Almería, La Cañada, 04120 Almería, Spain.
Brain Sci. 2021 Jun 11;11(6):776. doi: 10.3390/brainsci11060776.
Non-motor symptoms (NMS) in Parkinson's disease (PD), including neuropsychiatric or dysautonomic complaints, fatigue, or pain, are frequent and have a high impact on the patient's quality of life. They are often poorly recognized and inadequately treated. In the recent years, the growing awareness of NMS has favored the development of techniques that complement the clinician's diagnosis. This review provides an overview of the most important ultrasonographic findings related to the presence of various NMS. Literature research was conducted in PubMed, Scopus, and Web of Science from inception until January 2021, retrieving 23 prospective observational studies evaluating transcranial and cervical ultrasound in depression, dementia, dysautonomic symptoms, psychosis, and restless leg syndrome. Overall, the eligible articles showed good or fair quality according to the QUADAS-2 assessment. Brainstem raphe hypoechogenicity was related to the presence of depression in PD and also in depressed patients without PD, as well as to overactive bladder. Substantia nigra hyperechogenicity was frequent in patients with visual hallucinations, and larger intracranial ventricles correlated with dementia. Evaluation of the vagus nerve showed contradictory findings. The results of this systematic review demonstrated that transcranial ultrasound can be a useful complementary tool in the evaluation of NMS in PD.
帕金森病（PD）中的非运动症状（NMS），包括神经精神或自主神经功能障碍、疲劳或疼痛，很常见且对患者的生活质量有很大影响。这些症状往往未得到充分认识和治疗。近年来，对非运动症状认识的不断提高促进了补充临床医生诊断的技术的发展。本综述概述了与各种非运动症状相关的最重要的超声检查结果。从创刊至2021年1月在PubMed、Scopus和Web of Science上进行了文献研究，检索到23项评估经颅和颈部超声在抑郁症、痴呆、自主神经症状、精神病和不宁腿综合征中的前瞻性观察性研究。总体而言，根据QUADAS - 2评估，符合条件的文章显示出良好或中等质量。脑干中缝低回声与帕金森病患者及无帕金森病的抑郁症患者的抑郁症存在有关，也与膀胱过度活动有关。黑质高回声在有视幻觉的患者中很常见，较大的颅内脑室与痴呆相关。迷走神经评估结果相互矛盾。该系统评价的结果表明，经颅超声可作为评估帕金森病非运动症状的有用辅助工具。
