Substantia nigra hyperechogenicity assessed by transcranial sonography is related to neuropsychological impairment in the elderly population

Abstract

Transcranial sonography (TCS) is a valuable tool in the diagnosis of Parkinson's disease (PD). However, substantia nigra hyperechogenicity (SN+) in TCS has been shown to be also evident in about 8-10% of healthy persons. Neuroimaging studies and slight motor deficits in subjects with SN+ indicate functional impairment of the nigrostriatal system associated with the ultrasound sign. We questioned, whether SN+ may also be associated with neuropsychological deficits and whether there is a relation to other PD premotor markers. Thirty-six subjects with SN+ and 34 control persons (SN-) older than 50 years were investigated. The delayed verbal memory recall (LogII) of subjects with SN+ was significantly reduced compared to the performance of the control group (P=0.02). Binary logistic regression analysis revealed that, besides UPDRS-III (P<0.001) and positive family history for PD (P<0.01), LogII (P<0.05) seems to be independently associated with SN+.

Sonographic basal ganglia alterations are related to non-motor symptoms in multiple sclerosis

“…MRI deep grey matter T2 hypointensity has been demonstrated to correlate with cognitive dysfunction [40]. This agrees with the finding of a correlation between increased echogenicity of LN and/or SN and impaired cognitive performance in MS as found in the present study, and resembles previous findings in other neurodegenerative diseases [41,42]. Also, in a hereditary iron storage disorder, affection of the LN was specifically associated with cognitive dysfunction [43].…”

Premotor cognitive status in a cohort of incident Parkinson disease patients (NEDICES)

“…Previous clinical, imaging and animal models of PD studies have reached inconclusive results regarding cognitive impairment in the premotor phase. [40][41][42][43] In addition, while executive dysfunction has been observed in investigations of first-degree relatives of patients with familial PD, [40] Ponsen et al [43] found that executive function was not predictive of later development of PD in 361 non-parkinsonian first-degree relatives of PD patients. In a recent study of aphakia mice, an animal model of PD, results suggested impairment in striatum-dependent cognitive tasks including rotarod learning, t-maze and inhibitory avoidance tasks, but not the striatum-independent social transmission of food preference task.…”

Place Value of Transcranial Sonography in Early Diagnosis of Parkinson’s Disease

“…According to these studies, subjects with SN hyperechogenicity but without the clinical picture of PD may show more often premotor symptoms, like (1) olfactory dysfunction [5,50] , (2) depression [51] , (3) specific neuropsychological deficits like visuospatial processing and sequential planning, known to be primarily affected in PD [52] , (4) unilateral motor slowing when performing demanding motor tasks [45,51] , and (5) REM sleep behavior disorder [53,54] than healthy subjects without this ultrasound signal.…”