Relationship Between The High Echo Of Substantia Nigra By Transcranial Sonography And The Clinical Features In Patients With Parkinson’s Disease

Objectives To investigate the relationship between the high echo of substantia nigra by transcranial sonography and the clinical features in patients with Parkinson’s Disease(PD).Methods 1 81 PD patients in Department of Neurology,First Hospital of Hebei Medical University were recruited from October 2015 to October 2016,collected the general informations,including sex,age,age of onset,course of disease and education.2 Collected the clinical features of patients:1)PD family history,smoking history and toxicant exposure history.2)Non-motor symptoms:By interrogation collected patient’s olfactory disorders,sleep disorder(Rapid eye movement sleep behavior disorder(RBD)and excessive daytime sleepiness),autonomic dysfunction(orthostatic hypotension,constipation and voiding dysfunction),by Hamilton Anxiety Depression Scale and Montreal Cognitive Assessment assessed patient’s neuropsychiatric disorders(anxiety,depression and cognitive function).3)Motor symptoms:By Hoehn-Yahr Stage and Unified Parkinson’s Disease Rating ScaleⅢ assessed patient’s motor symptoms.3 PD patient’s echo intensity and hyperechogenicity area of substantia nigra and ratio of hyper-substantia nigra over ipsilateral midbrain(S/M)were detected by Transcranial sonography(TCS),The patients were divided into case group(high echo group)and control group(normal echo group)according to the intensity of echo.4 The relationship between the high echo of substantia nigra and the clinical features in patients with PD were analyzed.Results 1 In 73 PD patients(8 cases were not detected due to poor temporal window condition),there(was)were 0,28,35,8 and 2case(s)for gradeⅠ-Ⅴof substantia nigra echogenicity,respectively;45 cases(61.6%)and 28 cases(38.4%)were in case group and control group,respectively.2 Serious motor symptoms side in 31 cases(68.9%)in case group were in the opposite side of substantia nigra hyperechogenicity,5 cases(11.1%)was in the same side with substantia nigra hyperechogenicity,and 9 cases(20.0%)was both sides with substantia nigra hyperechogenicity.3 The hyperechogenicity area of substantia nigra and S/M ratio in PD patients with different grade of echogenicity were all significantly difference(P<0.05).4 Univariate analysis showed that PD patients who smoke were significantly lower than those who without smoking(0R=0.375,P<0.05),PD patients with olfactory dysfunction were significantly higher than those who without olfactory dysfunction(0R=4.531,P<0.05),PD patients with RBD were significantly higher than those who without RBD(0R=3.422,P<0.05).5 Multivariate analysis showed that male and olfactory dysfunction were the risk factors for PD patients with high echo(OR=17.594 / 8.949,P<0.05).Conclusions 1 PD patients’ serious symptoms in the opposite side of substantia nigra.2 The echo intensity grade,high echo area and S/M ratio of the substantia nigra in the patients with PD can reflect the intensity of echo.3 The risk of high echo in smoking patients with PD was low,and the risk of high echo was higher in men,with olfactory disorders or RBD than in women,without olfactory disorders or RBD.