https://orcid.org/0000-0003-3178-1981
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Abstract
Background
Transcranial ultrasound (TCS) can be used to reveal structural changes in the substantia nigra (SN) and is a potential tool for the early diagnosis of Parkinson’s disease (PD). This study aimed to explore the relationship between substantia nigra hyperechogenicity (SNH) and the clinical features of PD patients.
Methods
A total of 96 PD patients were included in our study. All patients were detected by TCS and divided into two groups: PD patients with SNH (PDSN+) and those with normal SN echogenicity (PDSN-). The Unified Parkinson’s Disease Rating Scale (UPDRS) and the Hoehn & Yahr stage were used to assess the extent of disease-related disability of the PD patients. Non-motor symptoms were evaluated by using several scales. The instrumented stand and walk test was performed on all subjects, and gait data were gathered using a JiBuEn gait analysis system.
Results
Seventy-five PD patients were successfully assessed by TCS. We found that SNH was associated with a higher UPDRS II scores (p = 0.028). In addition, compared with PDSN- group, the PDSN+ group exhibited more severe gait impairment, including increased variability in stride length (p = 0.042), decreased heel strike angle (p = 0.017), decreased range of motion of hip joints (p = 0.031), and a more asymmetrical walking pattern (p = 0.028).
Conclusion
Our study demonstrated that SNH significantly correlated with activities of daily living and gait impairment in Chinese patients with PD, suggesting the formation of SNH might be a dynamic biomarker reflecting disease severity.
Data Sharing Statement
The data supporting the result of this study are included in the article, and further inquiries can be directed to the corresponding author/s.
Statement of Ethics
The study was approved by the Ethics committee of Nanjing Brain Hospital Affiliated to Nanjing Medical University. All participants signed a written informed consent before the study. All procedures followed the declaration of Helsinki.
Acknowledgments
This research was funded by the National Natural Science Foundation of China [grant numbers 82171249], the Jiangsu Provincial Cadre Health Projects [grant number BJ20005], the Special Funds of the Jiangsu Provincial Key Research and Development Program [grant numbers BE2019612], the Jiangsu Province Elderly Health Project[grant numbers LD2021013], the Nanjng Medical University School Fund Project[grant numbers NMUB20210223], the Nanjing Medical Science and Technology Development Foundation [grant number QRX17026] and the Nanjing Rehabilitation Medicine Center Project [grant number is not available]. We acknowledge all the researchers of JiBuEn gait analysis system for their technical support.
Author Contributions
All authors contributed to the article, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in writing, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work. All authors approved the submitted version.
Disclosure
The authors report no conflicts of interest in relation to this work and declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.