Transcranial sonography image characteristics in different Parkinson's disease subtypes

Area of Science:

• Neurology
• Medical Imaging
• Neurodegenerative Diseases

Background:

• Parkinson's disease (PD) is increasingly classified into subtypes: postural instability gait difficulty (PIGD), tremor-dominant (TD), and indeterminate.
• Transcranial sonography (TCS) is a valuable tool for PD diagnosis.
• Differences in TCS characteristics among PD subtypes remain unclear.

Purpose of the Study:

• To investigate variations in TCS image characteristics across different idiopathic PD subtypes.
• To analyze the association between clinical features and TCS findings within these subtypes.

Main Methods:

• 373 idiopathic PD patients (188 PIGD, 108 TD, 77 indeterminate) underwent TCS.
• Substantia nigra (SN) and brainstem raphe signals were assessed via TCS.
• Correlation analysis between TCS results and clinical data (disease duration, severity) was performed.

Main Results:

• Substantia nigra (SN) hyperechogenicity was detected in 85.4% of PD patients via TCS.
• PIGD patients demonstrated significantly more severe disease compared to TD and indeterminate groups (p < 0.05).
• Larger SN hyperechogenicity areas on TCS were observed in the PIGD group (p < 0.05).
• Abnormal brainstem raphe signals were more frequent in the PIGD group (p < 0.05).
• No correlation was found between SN hyperechogenicity and disease duration or severity (p > 0.05).

Conclusions:

• TCS reveals distinct imaging patterns correlating with PD subtypes.
• PIGD patients exhibit more severe disease and altered SN echogenicity on TCS.
• Increased prevalence of abnormal brainstem raphe signals in PIGD may indicate future vulnerability to depression.