Transcranial Sonography Of Neuroimaging Characteristics In Parkinson’s Disease With Depression

Objective: to investigate the imaging characteristics of patients with Parkinson’s disease with depression(PDD+)by transcranial sonography,as well as the clinical value of auxiliary diagnosis and differential diagnosis of PDD+ and simple depression.Methods: From December 2016 to December 2018,50 cases of Parkinson’s disease with depression(PDD+),50 cases of Parkinson’s disease without depression(PDD-)and 49 cases of simple depression(SD)diagnosed by the department of mental health were selected from the special disease clinic of Parkinson’s disease of the first hospital of jilin university,the control group included 45 healthy adults from the physical examination center of the first hospital of jilin university.General demographic data of the four groups of subjects were collected,including gender,age,duration of PD,and initial symptoms,All subjects were examined by transcranial ultrasound physicians with more than 10 years of clinical experience in the first hospital of jilin university,to contrast analysis of the Substantia nigra(SN)echogenicity,Substantia nigra echogenicity area,Substantia nigra echo positive(nigra echo for level III or abovelevel III area increased and enhanced acuity 0.2 cm2),Brainstem raphe(BR)change and the third ventricle width of the echo,to summarize the characteristics of transcranial ultrasound in patients with Parkinson’s disease and depression.The severity of depression in PDD+ and SD patients was graded using the Hamilton depression scale(HAMD),and the correlation between the severity of depression and enhanced substantia nigra echo,enhanced area,nucleus raphe echo and the width of the third ventricle was evaluated.Results: 1.The SN echo positive rate of PDD+ group(66.0%,33/50)and PDD-group(64.0%,32/50)was much higher than that of SD group(8.2%,4/49)and control group(6.7%,3/45),the difference was statistically significant(c2=68.832,P < 0.05).2.The abnormal rate of median suture nucleus echo in PDD+ group(62.0%,31/50)and SD group(71.4%,35/49)was much higher than that in PDD-group(14.0%,7/50)and control group(11.1%,5/45),the difference was statistically significant(c2=59.876,P<0.05).3.The PDD+ group and SD group were divided into mild,moderate and severe sanya group according to HAMD score,and there were no statistical differences in BR echo anomaly rate(PDD+ group P=0.396,SD group P=0.954),SN enhancement rate(PDD+ group P=0.855,SD group P=0.664),SN enhancement area(PDD+ group P=0.740,SD groupP=0.908)and SN positive rate(PDD+ group P=0.944,SD group P=0.830).4.BR echo was not correlated with the patient’s age,gender,initial symptoms and disease severity,and the difference was not statistically significant.5.SN enhancement,SN enhancement area and SN positive rate were not correlated with BR echo changes,and the differences were not statistically significant.Conclusion: 1.The SN echo positive rate of PDD+ group and PDD-group was much higher than that of depression group and healthy control group.The presence of SN hyperechoic in TCS indicates that the patient is in the early stage of PD or has PD susceptibility.If the BR echo is decreased,interrupted or disappeared at the same time,it indicates that the patient has an increased risk of depression or is associated with depressive symptoms.2.The abnormal rate of BR echo in PDD+ group and depression group was much higher than that in PDD-group and healthy group.Abnormal BR echo found in TCS indicates that the patient is prone to depression.If SN echo is positive at the same time,it indicates that the patient is more likely to develop into PD.It is important to follow up these patients.3.The severity of depression in PDD+ group was not correlated with BR echo change,SN enhancement or not,and SN enhancement area.4.Age,gender,duration of PD,severity of PD,initial symptoms of PD and SN echo were not correlated with BR echo changes.