Transcranial Sonography In Parkinson’s Disease Patients And A Part Of Non-motor Symptoms’s Related Research

Background: Parkinson’s disease (PD) is a common neurodegenerative disease.Recently, many studies have been described in PD patients with non-motor symptoms inaddition to motor symptoms, and many of these had already appeared before the onset ofmotor symptoms, but because of the incidence of occult,mild symptoms and common, soit’s easily ignored or misdiagnosed.These non-motor symptoms may first appear inParkinson’s disease or to coexist with Parkinson’s disease.And many studies suggest thatrapid eye movement sleep behavior disorder(RBD) and Olfactory dysfunction is animportant precursor symptoms for the PD.For the early diagnosis of Parkinson，TCS(transcranial ultrasound) have the feature that no injury and convenient as a helpfuldiagnose tool has gradually more and more important location. TCS and it diagnose bythere is a specific strong simultaneous of the substantia nigra in PD patients. Thecorrelation between the three relations in PD patients is unclear.Objective: To study in patients with Parkinson’s disease (PD), the transcranialsonography (TCS) with or without RBD and/or olfactory obstacle’s difference betweenthe positive diagnosis rate, the substantia nigra unilateral area, the S/M.To research thediseased’s parts and process’s contaction,helping the early diagosis of PD.Methods: Collected94patients’s data are diagnosed with Parkinson’s disease in thedepartment of the Second Affiliated Hospital of Suzhou University which from October2010to July2012.The patients all were completed the PSG and TCS examination,the datacontain demographic data, clinical characteristics including H-Y stage, disease duration,UPDRS, the olfactory data and so on.According to the PSG results and related clinicaldiagnostic criteria of PD patients is associated with RBD and hyposmia, first patients weredivided into PD+RBD group and PD-RBD group, and then further subdivided into PD+RBD+hyposmia group, PD+RBD-hyposmia group, PD-RBD+hyposmia, PD-RBD-hyposmiagroup. Collecting TCS’s examing result information, using SPSS17.0software packages, the measurement data with x±s, t test was used; using two independent sampleKruskal.Wallis H examination and analysis between the two groups of data distributiondifferences, the chi-square test was used for the diagnostic efficiency, Spearmancorrelation analysis and pairwise comparisons between clinical featurea, TCS diagnosticratio, the substantia nigra area, echo intensity and differences.Results:94patients with PD,12patients with temporal window transparent soundbad, can not be observed in the substantia nigra to the exclusion,82cases enrolled.1、Bilateral substantia nigra hyperechoic area of the PD+RBD group (44cases) andPD-RBD group (38cases)(0.62±2.44cm~2),(0.53±0.17cm~2); two groups’ S/M ratiowere (13.34±7.72),(17.40±8.70). Between the two groups compared to the index factorswere not statistically different (P>0.05). PD+RBD group with PD-RBD group betweenthe two groups TCS positive diagnostic rate was61.36%,60.52%, PD+RBD group TCSpositive rate is slightly higher, but the difference was not had statistically significant.2、prior to the onset of the group in PD (preRBD) and after the onset of the group PD(aftRBD,), TCS substantia nigra hyperechoic area and S/M was no significant statisticaldifference. Group PD (aftRBD) substantia nigra hyperechoic≥grade III positive ratio isgreater than PD (preRBD,) group, but there was no significant difference.3、 PD+RBD+hyposmia group, PD+RBD-hyposmia group, PD-RBD+hyposmia,PD-RBD-hyposmia group,TCS results of four groups of data two comparison among thegroups were no significant statistical difference about gender, age, TCS substantia nigrahyperechoic area and S/M between the TCS-positive diagnosis rate.4, PD patients’s Spearman correlation analysis showed that TCS bilateral thesubstantia nigra echo area was negative correlated with gender, positive correlated withage, the S/M ratio, UPDRS II scores. the severity of the disease, the axial symptoms, H-Ystage were not correlated.Conclusion:1, Though the RBD occurrence of lesions closed with the the substantianigra hyperechoic position in midbrain, but TCS detect the presence or absence ofhyperechoic and RBD poor correlation, with or without RBD TCS detection performancedifferences, time of onset of RBD has impact on the TCS results statistically insignificant.TCS may not be as clinicians determine whether the patient the RBD effective means ofauxiliary examination.2, TCS’s detection sites and the lesions part leading to earlynon-motor symptoms are different, but when with the more non-motor symptoms，the possibility of positive rate of TCS is more high than the individual.3, the substantia nigraecho’s intensity and area have not relationship with PD’s severity and clinicalmanifestations.