Analysis Of Correlation Between Depression Degree And Echo Changes Of Brainstem Raphe Detected By Transcranial Sonography In Patients Who Having Parkinson’s Disease With Depression

Objective:To explore the echo changes of brainstem raphe(BR)detected by transcranial sonography(TCS)and its correlation with depression degree in patients who having Parkinson’s disease with depression(PDD+),so as to provide certain diagnostic value for clinical work.Methods:1.From December 2017 to December 2019,139 cases of Parkinson’s disease with depression(PDD+)and 126 cases of Parkinson’s disease without depression(PDD-)diagnosed by the special disease clinic of Parkinson’s disease of the first hospital of Ji Lin university were collected the clinical data,including age,gender,duration,onset of the first symptoms and body,H-Y stage and UPDRS Ⅲ scores.At the same time,both groups underwent Transcranial sonography to assess general clinical,the characteristics of the echo in brainstem raphe and the risk factors for PD patients with depression.2.Patients with Parkinson’s disease with depression were divided into three subgroups,namely mild depression,moderate depression and severe depression,by Hamilton depression scale(HAMD)and Beck depression scale(BDI),and the characteristics of echo changes in brainstem raphe were analyzed.3.Under Transcranial sonography,265 cases of Parkinson’s disease patients(PD)were divided into two groups: normal or abnormal echo in the brainstem raphe to explore the correlation of clinical data between the two groups.Results:1.There was a statistical difference in gender(t = 9.216,P =0.002),H-Y stage(Z=3.027,P =0.002),the UPDRS Ⅲ score(Z =4.723,P <0.001)between the two groups of PDD+ and PDD-.2.The abnormal rate of brainstem raphe’s echo in the PDD+ group(41%57/82)was significantly higher than that in the PDD-group(8.7% 11/115),and the difference between the two groups was statistically significant(χ2=36.095,P<0.001).3.Gender,UPDRS Ⅲ score,H-Y stage and abnormal rate of brainstem raphe were included in Logistic regression analysis,results show the risk of depression was 1.788 times higher in women with PD than in men(P=0.039)after controlling for UPDRS Ⅲ score and brainstem raphe.After controlling for gender and UPDRS Ⅲ score,PD patients with abnormal brainstem raphe had a 6.790 times higher risk of depression than those with normal brainstem raphe(P<0.001).Finally,after controlling for gender and brainstem raphe,the higher the UPDRS Ⅲ score,the higher the risk of PD patients with depression(P<0.001).4.The difference of BR abnormal rate between the three subgroups of mild depression,moderate depression and severe depression was statistically significant(χ2=7.210,P<0.001).5.Spearman correlation analysis results showed that depression degree was negatively correlated with echo changes in the brainstem raphe under transcranial Sonography(r=-0.298,P<0.001).6.PDBR + and PDBR-groups in the gender(χ2= 13.173,P <0.001),the HAMD scores(Z=6.384,P<0.001),BDI Ⅱ score(Z=5.880,P <0.001)in statistical differences.7.Gender and HAMD score were included in the Logistic regression analysis,the results showed that the risk of abnormal brainstem raphe in female patients with PD was 2.412 times higher than that in male patients(P=0.006)after controlling HAMD score,the higher the HAMD score,the higher the risk of abnormal brainstem raphe in PD patients(P <0.001)after controlling for gender factors.Conclusion:1.women or those with high UPDRS Ⅲ score or abnormal BR echo under TCS in PD patients have a higher risk of accompanied by depression or developing into depression.2.The female or the higher HAMD score in PD patients is,the higher the probability of occurrence of abnormal brainstem raphe.3.There was a difference between the abnormal rate of BR among the three subgroups of mild depression,moderate depression and severe depression,and the BR echo level was negatively correlated with the degree of depression.Therefore,TCS could be considered to provide a quick and simple method for the diagnosis of clinical PDD+.