A Follow-up Study With Quantitative Changes Of Substantia Nigra Hyperechogenicity Detected By Transcranial Sonography In Patients With Parkinson's Disease

Objective: Using Transcranial Sonography(TCS)technology,to detect the Substantia Nigra(SN)hyperechogenicity of midbrain at the first visit and the follow-up in patients with Parkinson's Disease(PD).The quantitative and semi-quantitative results were collected to explore the relationship between the SN hyperechogenicity and disease progression.Methods: We collected all the clinical data of PD patients who came to the clinic and ward of Neurology Department in the Second Affiliated Hospital of Soochow University from June 2016 to September 2017,including age,gender,disease duration,Unified Parkinson's Disease Rating Scale(UPDRS),Hoehn and Yahr(H&Y)Scale,etc.All the patients had repeated TCS examinations.We collected the SN echo area,intensity and the ratio of S/M(Substantia nigra hyperechoic area / Midbrain area).The echo intensity?or? were defined as the “negative” group,greater than or equal to? was defined as the “positive” group.The clinical factors affecting S/M and ?S/M were evaluated by single factor and multifactor regression analysis.Results:45 of total 140 patients who met the criteria of entry had twice positive results by TCS,and the average follow-up period was 52.53±29.18 months(mean ±Standard Deviation).There were no significant differences in SN echo area and S/M of 45 patients in the comparison of themselves at the first visit,while UPDRS?,?,?,H&Y Scale and the myotonia score were significantly higher in the follow-up(P1=0.020?P2 < 0.001 ? P3=0.002 ? P4=0.016 ? P5=0.025).Also,single factor and multivariate regression analysis found that S/M was not changed with the clinical characteristics during the two visits.In the follow-up study,there was a significant positive correlation between the ?S/M and the disease duration(P=0.014<0.05,the regression coefficient was 0.365).Conclusions:The change of S/M ratio detected by TCS was only related to the disease duration,showing that TCS detection can not reflect the severity of the disease or predict disease progression.