Horsager Jacob, Walter Uwe, Fedorova Tatyana D, Andersen Katrine B, Skjærbæk Casper, Knudsen Karoline, Okkels Niels, von Weitzel-Mudersbach Paul, Dyrskog Stig Eric, Bergholt Bo, Borghammer Per
Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus, Denmark.
Department of Neurology, Rostock University, Rostock, Germany.
Front Neurol. 2021 Jun 22;12:681413. doi: 10.3389/fneur.2021.681413. eCollection 2021.
Vagal parasympathetic neurons are prone to degeneration in Parkinson's disease (PD). High-resolution ultrasound can precisely estimate the cross-sectional (CSA) area of peripheral nerves. Here, we tested the hypothesis that vagus CSA is reduced in PD. We included 56 healthy controls (HCs) and 63 patients with PD. Using a high-end ultrasound system equipped with a high-frequency transducer, five images were obtained of each nerve. The hypoechoic neuronal tissue was delineated offline with dedicated software and the CSA extracted. In the initial PD vs. HC comparison, no statistically significant differences were observed in mean left vagus CSA (HC: 1.97 mm, PD: 1.89 mm, = 0.36) nor in mean right vagus CSA (HC: 2.37 mm, PD: 2.23 mm, = 0.17). The right vagus CSA was significantly larger than the left vagus CSA in both groups ( < 0.0001). Females were overrepresented in the HC group and presented with generally smaller vagus CSAs. Consequently, sex-adjusted CSA was significantly smaller for the right vagus nerve of the PD group ( = 0.041), but not for the left. A small but significant reduction in sex-adjusted right vagus CSA was observed in patients with PD. The left vagus CSA was not significantly reduced in patients with PD. Ultrasound may not be a suitable method to detecting vagal axonal loss in individual patients.
迷走神经副交感神经元在帕金森病（PD）中易于发生变性。高分辨率超声能够精确估计周围神经的横截面积（CSA）。在此，我们检验了PD患者迷走神经CSA减小这一假设。我们纳入了56名健康对照者（HC）和63名PD患者。使用配备高频探头的高端超声系统，对每条神经获取5张图像。利用专用软件在离线状态下勾勒出低回声神经元组织，并提取CSA。在最初的PD与HC对比中，左迷走神经平均CSA未观察到统计学显著差异（HC：1.97平方毫米，PD：1.89平方毫米，P = 0.36），右迷走神经平均CSA也未观察到统计学显著差异（HC：2.37平方毫米，PD：2.23平方毫米，P = 0.17）。两组中右迷走神经CSA均显著大于左迷走神经CSA（P < 0.0001）。HC组中女性占比过高，且迷走神经CSA总体较小。因此，PD组右迷走神经经性别调整后的CSA显著更小（P = 0.041），但左迷走神经并非如此。在PD患者中观察到经性别调整后的右迷走神经CSA有小幅但显著的减小。PD患者左迷走神经CSA未显著减小。超声可能不是检测个体患者迷走神经轴突丢失的合适方法。
