Relationship Between The Echo Changes Of Brainstem Raphe Detected By Transcranial Parenchymal Sonography And Clinical Characteristics In Parkinson's Disease

Objectives: To observe the relationship between the echogenicity changes of brainstem raphe(BR)structures detected by transcranial parenchymal sonography(TCS)and motor and non motor symptoms in Parkinson's disease(PD).Methods: Consecutive PD patients were enrolled from the outpatient clinic and inpatient in second affiliated hospital of Soochow University.Demographic information of all subjects were collected.Motor and non-motor symptoms were evaluated by the two specialists using Unified Parkinson's Disease Rating Scale(UPDRS),Montreal Cognitive Assessment(MoCA),Epworth Sleeping Scale(ESS),Pittsburgh Sleep Quality Index(PSQI),Hamilton Rating Scale for Depression(HRSD),Hamilton Anxiety Scale(HAMA),Fatigue Severity Scale(FSS),Non-motor Symptom Questionnaire(NMSQ),Scale For Outcomes in PD For Autonomic Symptoms(SCOPA-AUT),Parkinson's Disease Questionnaire 39-item(PDQ39)and REM sleep behavior disorder(RBD).TCS was used to detect the echogenicity changes of BR in patients.Results: There were sixty five(male 35,female 30)patients were found with abnormal echo of BR with mean age of 64.15±8.42 years old.Seventy(male 48,female 22)patients were found with normal echogenicity of BR with mean age of 63.13±9.36 years old.There were no statistically significant differences with respect to gender,age,age of onset,disease duration,education,onset location,onset symptoms,recent symptoms,score of UPDRS II?UPDRS III?UPDRS IV?Hoehn-Yahr(H-Y)stage,cognitive function,sleep quality,FSS,NMSQ,SCOPA-AUT,incidence of constipation,dyskinesia,olfactory dysfunction,RBD and width of third ventricle.Significant higher score of HRSD(Z=3.052,P=0.002),HAMA(t=2.472,P=0.017)and PDQ-39(Z=2.117,P=0.034)were found in patients with abnormal BR echogenicity than in patients normal BR echogenicity.Spearman correlation analysis showed that score of HRSD(r=0.274,P=0.002),HAMA(r=0.201,P=0.047)and PDQ-39(r=0.208,P=0.034)were positively correlated with abnormal BR echogenicity.Conclusion: Changes of BR echogenicity detected by TCS can reveal the condition of depression,anxiety and quality of life in PD patients.Detection of BR echogenicity by TCS is a kind of fast and effective tool for investing depression and anxiety in PD patients which is and beneficial to early intervention and treatment so as to improve the patients' quality of life.