engleski

Nigral substance hyperechogenicity correlates with Parkinson's diseae duration and disease severity

Aims: Transcranial ultrasound (TCS) displays hyperechogenic nigral substance (NS) in patients with Parkinson disease (PD). The aim of the study was to assess correlation of NS hyperechogenicity with the disease severity and characteristics. Patients and methods: Thirty six PD patients were analysed. History was taken and thourough neurologic examination. Assessment of disease stage was made according to Unified Parkinson's Disease rating Scale motor part (UPDRS), Mini-mental State Examination (MMSE) and Hoehn and Yahr (H&Y) rating scale. TCS was applied by standardized protocol ; SN was displayed, encircled, and measured two times. Mean area was calculated. Mann Whitney U test for inter-group comparison was used and Spearman rank correlation for correlation analysis. Results: TCS was possible in 28 patients (78%). Twenty-five of 28 (89%) displayed hyperechogenic NS. Median NS size was 0.32 cm2 (0.27:0.39). A positive correlation of disease duration and hyperechogenic NS was found (r=0.39, p<0.047), as well as UPDRS and NS area (r=0.39, p<0.043). Subgroup of patients with late motor complication exhibited larger median NS size than those without complications: 0.34 cm2 (0.24:0.48) versus 0.29 cm2 (0.10:0.41) (Mann Whiney p=0.012). None of other clinical or epidemiological characteristics correlated with TCS findings. Discussion: Patients with longer disease duration and more severe disease, including complications, exhibited larger NS. A positive correlation of disease severity and symptoms with NS area was observed in one previous study by means of TCS. Neither imaging method displayed pathological finding of NS in these patients. Conclusion: NS hyperechogenicity correlates with PD duration, severity and late motor complications.

transcranial color coded duplex; Parkinson's disease; disease severity

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