Objective: This study aims to investigate ultrasonography markers  as a potential imaging marker in prodromal Parkinson’s disease, with the goal of identifying individuals at higher risk of developing Parkinson’s disease.

Background: Parkinson’s disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms. Early detection of prodromal PD is crucial for implementing preventive strategies and improving patient outcomes. Ultrasonography has shown promise as a non-invasive imaging modality, offering the potential to identify specific markers associated with prodromal PD.

Method: We conducted a prospective study to select 100 patients at risk of prodromal Parkinson’s disease based on the following criteria: a mandatory criterion of being a direct family member of a Parkinson’s patient; at least one major criterion: hyposmia or abnormal REM sleep behavior; or at least three minor criteria: depression, constipation, male gender, and/or no caffeine consumption. Additionally, 30 patients with a confirmed diagnosis of Parkinson’s disease with less than 5 years of evolution and 30 healthy controls were included. All participants underwent transcranial ultrasound to study the substantia nigra (SN). Kruskal-Wallis method was employed to analyze ultrasound data, comparing SN hyperechogenicity across prodromal PD patients, controls, and PD patients.

Results: Analysis revealed that the area of hyperechogenicity in SN among prodromal PD patients was slightly higher compared to controls but significantly lower compared to PD patients. Statistically significant differences were primarily observed in comparisons between PD vs. prodromal PD and PD vs. controls, with no significant differences between prodromal PD and controls. 20% Outliers, indicated prodromal PD patients with SN hyperechogenicity levels comparable to or higher than those of PD patients. These outliers suggest a subgroup within prodromal PD patients where ultrasound imaging could potentially aid in diagnosis without invasive methods.

Conclusion: Overall, isolated ultrasound imaging may not be significantly useful in diagnosing prodromal PD based on the current sample. However, a subgroup of prodromal PD patients exhibiting high SN hyperechogenicity levels similar to PD patients could benefit from early diagnosis through ultrasound imaging. Further exploration is warranted to identify specific characteristics associated with these outliers.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/ultrasonography-markers-in-prodromal-parkinsons-disease/