背景:经颅超声(TCS)中黑质高回声性(SN)的面积是否与帕金森病(PD)的严重程度有关尚有争议。铁沉积,这与SN+的形成有关,随着PD的进展,可能对多巴胺神经功能有不同的影响。然而,很少有研究探讨SN+区域与PD分期疾病严重程度之间的关系。
方法:从PD数据库中回顾性地纳入了612名具有足够骨窗的PD患者,疾病的严重程度通过统一帕金森病评定量表(UPDRS)评分进行评估。根据Hoehn和Yahr(H-Y)量表,我们将患者分为7组(H-Y阶段1,1.5,2,2.5,3,4和5),然后分别分析SN+面积和UPDRS评分之间的相关性.
结果:我们的结果表明,PD的初始SN面积与疾病严重程度之间存在U形关系:在H-Y1期组中,初始SN+面积与UPDRS总分(r=-0.456,p<0.001)和UPDRS-III评分(r=-0.497,p<0.001)呈负相关.在H-Y阶段1.5、2和2.5的组中没有观察到相关性。H-Y分期≥3组,初始-SN+面积与UPDRS总分和UPDRS-Ⅲ评分呈正相关,在H-Y5期组具有最强的相关性(所有p值<0.05)。此外,较大的SN+面积和平均SN+面积与UPDRS总分和UPDRS-Ⅲ分的相关演化趋势相似.
结论:我们的研究表明,随着H-Y阶段的进展,SN+面积与UPDRS总分和UPDRS-III评分之间呈U形相关。相关性的演变可能反映了与黑质中铁沉积有关的潜在病理机制的演变。
BACKGROUND: It is debatable whether the area of substantia nigra hyperechogenicity (SN+) in transcranial sonography (TCS) is related to Parkinson\'s disease (PD) severity. Iron deposition, which is associated with the formation of SN+, may have different effects on dopamine nerve function as PD progresses. However, little research has explored the association between the SN + area and disease severity of PD in stages.
METHODS: 612 PD patients with sufficient bone window were retrospectively included from a PD database, and disease severity was assessed by the Unified Parkinson\'s Disease Rating Scale (UPDRS) scores. Based on the Hoehn and Yahr (H-Y) scale, we classified the patients into seven groups (H-Y stage 1, 1.5, 2, 2.5, 3, 4, and 5) and then analyzed the correlations between the SN + area and the UPDRS scores separately.
RESULTS: Our results indicated a U-shaped relationship between the initial-SN + area and disease severity in PD: In the H-Y stage 1 group, the initial-SN + area was negatively correlated with the UPDRS total score (r = - 0.456, p < 0.001) and UPDRS-III score (r = - 0.497, p < 0.001). No correlation was observed in the groups of H-Y stages 1.5, 2, and 2.5. In the groups of H-Y stage ≥ 3, the initial-SN + area was positively correlated with the UPDRS total score and UPDRS-III score, with strongest correlation in the H-Y stage 5 group (all p values < 0.05). Moreover, the larger SN + area and average SN + area showed a similar evolutionary trend of correlation with UPDRS total score and UPDRS-III score.
CONCLUSIONS: Our study indicated a U-shaped correlation between the SN + area with the UPDRS total score and UPDRS-III score as H-Y stage progressed. The evolution of the correlation may reflect the evolution of underlying pathological mechanisms related to iron deposition in the substantia nigra.