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© 2010 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 29:37-42 • 0278-4297

Correlation Between Substantia Nigra Features Detected by Sonography and Parkinson Disease Symptoms

Petra Bártová, MD, PhD, David Skoloudík, MD, PhD, Pavel Ressner, MD, PhD, Katerina Langová, Roman Herzig, MD, PhD and Petr Kanovsky, MD, PhD

Department of Neurology, University Hospital Ostrava, Ostrava, Czech Republic (P.B., D.S.); Department of Neurology, Hospital Novy Jicín, Novy Jicín, Czech Republic (P.R.); and Institute of Biophysics (K.L.), and Department of Neurology (D.S., R.H., P.K.), Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic.

Address correspondence to David Skoloudík, MD, PhD, Department of Neurology, University Hospital Ostrava, Tr 17, Listopadu 1790, CZ-708 52 Ostrava, Czech Republic. E-mail: skoloudik{at}hotmail.com

Objective. The aim of this study was to assess the correlation between substantia nigra (SN) echogenic features and area and the clinical symptoms in patients with Parkinson disease (PD). Methods. Clinical examinations and transcranial sonographic evaluations of the SN were performed in 115 consecutive patients with PD. The presence of tremors, rigidity, bradykinesia, gait disorders, speech disorders, and hypomimia was evaluated according to the motor portion of the Unified Parkinson Disease Rating Scale. The Mann-Whitney U test, the Kruskal-Wallis test, analysis of variance, and multivariate analysis were applied when assessing statistical significance. Results. An enlarged and hyperechoic SN existed in 84.0% of patients with bilateral rigidity but in only 70.6% of patients with unilateral rigidity (P < .05). Similarly, 85.0% of patients with bilateral bradykinesia in comparison with 65.7% of patients with unilateral bradykinesia had an enlarged and hyperechoic SN (P < .05). A significant correlation was shown between the SN echogenicity and area (r = 0.705; P < .01). Conclusions. An enlarged and hyperechoic SN seems to be a marker of structural involvement of the SN in patients with PD. This structural involvement is expressed more in patients with bilateral rigidity and bradykinesia.

Key Words: bradykinesia • Parkinson disease • substantia nigra • transcranial sonography • tremor

Abbreviations: ANOVA, analysis of variance • HY, Hoehn-Yahr • L-DOPA, L-3,4-dihydroxyphenylalanine • PD, Parkinson disease • SN, substantia nigra • TCS, transcranial sonography • UPDRS, Unified Parkinson Disease Rating Scale

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Copyright © 2010 by the American Institute of Ultrasound in Medicine.