The ultra early diagnosis of Parkinson’s disease by the enhanced substantia nigra echo

J.-J. Zhuang, Y.-H. Zheng, X.-W. Xu, L. Zhou

Neurology Department, Weifang People’s Hospital, Weifang, Shandong, China. weifangzhou003@163.com

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• Neurology

OBJECTIVE: Our objective is to determine the value of enhanced substantia nigra echo in the diagnosis of Parkinson’s disease by analyzing the intensity and area of substantia nigra echo by transcranial Doppler sonography (TCS).

PATIENTS AND METHODS: 36 patients diagnosed as ultra early stage Parkinson’s disease between 2013 November and 2014 August were selected as the disease group, and 32 healthy people with the similar representation of age and gender were selected as the control group. TCS was used to detect the echo intensity and the echo intensity of the same location of bilateral hemicerebrum was used to evaluate the bilateral substantia nigra echo. The age and gender were also used for correlation analysis with the results of substantia nigra echo.

RESULTS: In the control group, there were 17 patients of substantia nigra echo grade I (53.1%), 13 cases of substantia nigra echo grade II (40.6%), 2 cases of substantia nigra echo grade III (6.3%). While in the disease group, there were 4 cases of substantia nigra echo grade II (11.1%), 13 cases of substantia nigra echo grade III (36.1%), 12 cases of substantia nigra echo grade IV (33.3%) and 7 cases of substantia nigra echo grade V (19.4%). The ratio of enhanced substantia nigra echo in Parkinson’s disease patients was significantly higher than the control group. The analysis of the factors related to motor symptoms in Parkinson’s disease patients revealed that the area of bilateral substantia nigra echo was negatively correlated with gender, but positively correlated with age, S/M ratio and UPDRS II score. However, there was no correlation with H-Y stage. The sensitivity of substantia nigra echo in diagnosing Parkinson’s disease was 32/36=88.89% and the specificity was 30/32 = 93.75%.

CONCLUSIONS: Analysis of substantia nigra echo is practically useful for the diagnosis of the ultra early stage Parkinson’s disease, which can potentially improve the accuracy of clinical diagnosis to significantly enhance the early clinical prevention and reduce later disability.

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