Objective: To measure the echogenicity of the substantia nigra (SN) by transcranial sonography (TCS) in PD patients and discuss its correlation with iron metabolism and c-reactive protein (CRP).

Background: TCS of the SN is a new and promising method to diagnose PD. Abnormal iron deposition and inflammation in the SN of PD patients have been demonstrated. However, whether SN echogenicity in PD patients is associated with clinical symptoms, drug treatment especially iron metabolism and CRP are unclear.

Methods: (1) All 132 PD patients underwent physical examinations, Unified Parkinson’s disease Rating Scale (UPDRS), Non-motor Symptoms Questionnaire (NMSQ), Hamilton Anxiety Scale (HAMA), Hamilton Rating Scale for Depression (HAMD) and Mini-mental state examination (MMSE) assessments. (2) TCS examination was performed using a color-coded phase array Ultrasound system with a 2.5 MHz phase array transducer. An area of echogenicity≤19 mm2 was considered normal (SN-), while an area of echogenicity>19 mm2 was defined as hyperechogenic (SN+). (3) Levels of serum iron, transferrin, ceruloplasmin and CRP were measured. (4) Statistical analysis were carried out to explore the relationship between SN echogenicity in PD patients and clinical symptoms, drug treatment, levels of serum iron, transferrin, ceruloplasmin and CRP.

Results: There were 97 cases involved in this study after excluding 35 subjects due to an insufficient temporal bone window. 49 cases had positive SN area (SN+) and 48 cases had negative results (SN-). Positive rate of SN+ was 50.52%. There were no correlation between the echogenic area of SN and patient’s age, age of onset, duration of disease, H-Y stage or drug treatment. There were also no correlation between SN echogenicity and UPDRS, HAMA, MMSE or NMS scores. Area of SN echogenicity contralaterally to the initial limb side showed some correlation with HAMD scores (r=0.20 ,P=0.067). Furthermore, no correlation was found between the SN echogenicity and serum iron, transferrin, ceruloplasmin or CRP.

Conclusions: We reported a higher temporal insufficiency rate in Chinese population. SN echogenicity is a stable marker have no correlation with iron metabolism or CRP, and is not changed over age, duration of illness in PD patients; the contralateral SN echogenicity may have a certain correlation with PD depression which need a further larger cohort study.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/transcranial-sonography-of-the-substantia-nigra-and-its-correlation-with-iron-metabolism-and-c-reactive-protein-in-parkinsons-disease/