Analysis Of The Correlation Between Parkinson's Depression And The Echogenicity Of Raphe Nucleus

Objective:The purpose of our study was to further assess the association between the echogenicity of raphe nuclei(RN)and the depressed symptom with Parkinson's disease;2?Explore the correlation between the RN changes and depression severity using the HAMD scales;The staging of Parkinson's disease in patients with or without depression by H-Y staging scales;3 ? We assess the relationship between the SN hyperechogenicity and the reduced RN echogenicity;4 ? Besides,evaluation of the relationship between platelet 5-HT concentration and Parkinson's disease depression has been put into this research.Methods:1?The subjects were either inpatients or outpatients who registered in our hospital from November 2015 to December 2017.TCS was performed in patients with PD,depression with PD(PDD+),depression only and controls using the red nucleus as an internal stander,the echo of brainstem raphe(BR)was rated on a two-point(grade 0: invisible,slightly echogenic or interrupted BR;grade 1: hyperechogenicity BR as a continuous line).The differences of the neuroimaging characteristics of TCS in brainstem raphe(BR)in four groups were analyzed;2?In terms of the depression,PDD+ and D groups were divided into three subgroups using the HAMD scales : mild,moderate and severe depression,the differences of BR echogenicity were analyzed among the subgroup;The H-Y stage(hoehn and yahr hoehn,HY stage)was used to divide patients in the PDD+ and PD groups into 5 stages(stage I :unilateral lesions;stage II :bilateral mild lesions;stage III bilateral lesions with early balance disorders;IV Severe lesions require a lot of help;V: Life is confined to bed or wheelchair and cannot take care of themselves),Analysis of abnormalities in the RN echogenicity in patients with PD at different stages.3 ? TCS was used to observe the changes in the hyperechogenicity of SN among the four groups,and to assess the correlation between the SN hyperechogenicity and the echo changes in the RN.The criteria of the SN hyperechogenicity in the PDD+ and PD groups are grade III or higher and the hyperechogenicity area is?0.2cm2;4?The concentration of platelet serotonin in each subject was detected by Elisa and the differences among the four groups were analyzed.Results:1?The rate of abnormal RN(grade 0)was found to be only 16.67%in patients with PD(5/30)and 14.29% in controls(4/28).The rate of abnormal RN was significantly higher(x2=15.983,P<0.05)in patients with depressed PD(40%,12/30)or patients with depression only(58.33%,14/24);2?No correlation was found between RN changes and depression severity(x2=0.295,P>0.05),either between the RN changes and the staging of Parkinson's disease;3?We were not able to found the significant difference between the SN hyperechogenicity and the abnormal RN echogenicity(P>0.05);4?We found that there was no significant difference in concentration of platelet 5-HT among four groups(F=3.275,P>0.05).Condlusion:1?The rate of abnormal RN echogenicity in depressed PD patients was much higher than that in the control groups.The abnormal echo of the RN in patients with Parkinson's disease suggests that the patient may have a depressive tendency.Patients with depressive symptoms who have passive RN echogenicity and enhanced SN echogenicity may suggest the possibility of developing PD.Follow-up study will be helpful to the diagnosis of PD in this group of patients.2?The severity of depression in the depressed PD and depression groups was not related to the RN hypoechogenicity.3?There was no correlation between the SN hyperechogenicity in depressed PD?PD groups and hypoechogenicity.4?Concerning the theory that platelet 5-HT in peripheral blood can be as a peripheral model of 5-HT in central nervous system,caution should be displayed in clinical application.5?By observing changes of RN echogenicity,TCS might provide neuroimaging information for the diagnosis of depressed PD and differential diagnosis of PD.