Oppold Julia, Breu Maria-Sophie, Gharabaghi Alireza, Grimm Alexander, Del Grosso Nicholas A, Hormozi Mohammad, Kleiser Benedict, Klocke Philipp, Kronlage Cornelius, Weiß Daniel, Marquetand Justus
Department of Epileptology, Hertie-Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany.
MEG-Center, University of Tübingen, 72076 Tübingen, Germany.
Diagnostics (Basel). 2023 Jan 6;13(2):213. doi: 10.3390/diagnostics13020213.
Rigidity in Parkinson’s disease (PD) is assessed by clinical scales, mostly the Unified Parkinson’s Disease Rating Scale of the Movement Disorders Society (MDS-UPDRS). While the MDS-UPDRS-III ranges on an integer from 0 to 4, we investigated whether muscle ultrasound shear wave elastography (SWE) offers a refined assessment. Ten PD patients (five treated with deep brain stimulation (DBS) and levodopa, five with levodopa only) and ten healthy controls were included. Over a period of 80 min, both the SWE value and the item 22b-c of the MDS-UPDRS-III were measured at 5 min intervals. The measurements were performed bilaterally at the biceps brachii muscle (BB) and flexor digitorum profundus muscle in flexion and passive extension. Rigidity was modified and tracked under various therapeutic conditions (with and without medication/DBS). The feasibility of SWE for objective quantification was evaluated by correlation with the UPDRS-III: considering all positions and muscles, there was already a weak correlation (r = 0.01, p < 0.001)—in a targeted analysis, the BB in passive extension showed a markedly higher correlation (r = 0.494, p < 0.001). The application of dopaminergic medication and DBS resulted in statistically significant short-term changes in both clinical rigidity and SWE measurements in the BB (p < 0.001). We conclude that rigidity is reflected in the SWE measurements, indicating that SWE is a potential non-invasive quantitative assessment tool for PD.
帕金森病（PD）的僵硬程度通过临床量表进行评估，主要是运动障碍协会统一帕金森病评定量表（MDS-UPDRS）。虽然MDS-UPDRS-III的评分范围为0至4的整数，但我们研究了肌肉超声剪切波弹性成像（SWE）是否能提供更精确的评估。纳入了10名PD患者（5名接受深部脑刺激（DBS）和左旋多巴治疗，5名仅接受左旋多巴治疗）和10名健康对照者。在80分钟的时间段内，每隔5分钟测量一次SWE值和MDS-UPDRS-III的第22b - c项。测量在肱二头肌（BB）以及指深屈肌在屈曲和被动伸展时双侧进行。在各种治疗条件下（有或无药物/ DBS）改变并跟踪僵硬程度。通过与UPDRS-III的相关性评估SWE进行客观量化的可行性：考虑所有位置和肌肉，已经存在较弱的相关性（r = 0.01，p < 0.001）——在针对性分析中，被动伸展时的BB显示出明显更高的相关性（r = 0.494，p < 0.001）。多巴胺能药物和DBS的应用导致BB的临床僵硬程度和SWE测量值在统计学上有显著的短期变化（p < 0.001）。我们得出结论，僵硬程度在SWE测量中有所体现，这表明SWE是一种用于PD的潜在非侵入性定量评估工具。
