Abstract：
BACKGROUND: According to the current Parkinson\'s Disease (PD) pathogenesis hypotheses, the vagus nerve (VN) is essential for disease development. It has been identified as a main entry point for misfolded α-synuclein to the central nervous system, and surgical vagotomy appears to limit disease progress both in animal models and in humans. A recent approach tried to assess VN size in PD patients via neck ultrasonography, but the clinical value of this method is yet to be established.
BACKGROUND: A systematic search of the MEDLINE, Scopus, and Web of Science databases was conducted, and 12 case- -control studies were included. Meta-analysis revealed a modest reduction in VN size in PD (effect size - 0.79 SD (95%CI [-1.34, -0.25] p = 0.004)). The atrophy was more pronounced on the right side, and the nerve was smaller in females. In PD patients, VN reduction correlated with cardiac parasympathetic function decline and with advances in motor ratings. The discrimination potential for PD diagnosis, and any association with other non-motor domains, remains unclear.
CONCLUSIONS: VN atrophy in PD could be detected by ultrasound imaging. However, the clinical significance of this phenomenon has yet to be clarified. Size reduction is not readily apparent and is individually variable. However, it may be considered a promising means to improve early PD diagnosis and the recognition of autonomic dysfunction.
CONCLUSIONS: With more extensive research, VN sonography could provide useful evidence regarding disease origins. Imaging should be performed together with a profound clinical assessment and biomarker testing to establish the role to be played by this method in future practice.
BACKGROUND: A systematic search of the MEDLINE, Scopus, and Web of Science databases was conducted, and 12 case- -control studies were included. Meta-analysis revealed a modest reduction in VN size in PD (effect size - 0.79 SD (95%CI [-1.34, -0.25] p = 0.004)). The atrophy was more pronounced on the right side, and the nerve was smaller in females. In PD patients, VN reduction correlated with cardiac parasympathetic function decline and with advances in motor ratings. The discrimination potential for PD diagnosis, and any association with other non-motor domains, remains unclear.
CONCLUSIONS: VN atrophy in PD could be detected by ultrasound imaging. However, the clinical significance of this phenomenon has yet to be clarified. Size reduction is not readily apparent and is individually variable. However, it may be considered a promising means to improve early PD diagnosis and the recognition of autonomic dysfunction.
CONCLUSIONS: With more extensive research, VN sonography could provide useful evidence regarding disease origins. Imaging should be performed together with a profound clinical assessment and biomarker testing to establish the role to be played by this method in future practice.
摘要：
背景：根据当前的帕金森病（PD）发病机制假设，迷走神经(VN)对疾病的发展至关重要。它已被确定为错误折叠的α-突触核蛋白进入中枢神经系统的主要切入点，手术迷走神经切断术似乎限制了动物模型和人类疾病的进展。最近的一种方法试图通过颈部超声检查评估PD患者的VN大小，但这种方法的临床价值尚未确定。
背景：对MEDLINE的系统搜索，Scopus,进行了WebofScience数据库，并纳入12项病例对照研究。荟萃分析显示PD患者VN大小适度减少（效应大小-0.79SD（95CI[-1.34，-0.25]p=0.004））。右侧萎缩更明显,女性的神经更小。在PD患者中，VN降低与心脏副交感神经功能下降和运动评分的提高相关。PD诊断的辨别潜力，以及与其他非运动领域的任何关联，尚不清楚。
结论：通过超声成像可以检测到PD中的VN萎缩。然而,这种现象的临床意义还有待澄清。尺寸减小不是显而易见的,并且是单独可变的。然而,它可能被认为是改善早期PD诊断和自主神经功能障碍识别的有希望的手段。
结论：随着更广泛的研究，VN超声检查可以提供有关疾病起源的有用证据。成像应与深刻的临床评估和生物标志物测试一起进行，以确定该方法在未来实践中的作用。
背景：对MEDLINE的系统搜索，Scopus,进行了WebofScience数据库，并纳入12项病例对照研究。荟萃分析显示PD患者VN大小适度减少（效应大小-0.79SD（95CI[-1.34，-0.25]p=0.004））。右侧萎缩更明显,女性的神经更小。在PD患者中，VN降低与心脏副交感神经功能下降和运动评分的提高相关。PD诊断的辨别潜力，以及与其他非运动领域的任何关联，尚不清楚。
结论：通过超声成像可以检测到PD中的VN萎缩。然而,这种现象的临床意义还有待澄清。尺寸减小不是显而易见的,并且是单独可变的。然而,它可能被认为是改善早期PD诊断和自主神经功能障碍识别的有希望的手段。
结论：随着更广泛的研究，VN超声检查可以提供有关疾病起源的有用证据。成像应与深刻的临床评估和生物标志物测试一起进行，以确定该方法在未来实践中的作用。
