Neurosonological Findings Related to Non-Motor Features of Parkinson’s Disease: A Systematic Review

Abstract

Non-motor symptoms (NMS) in Parkinson’s disease (PD), including neuropsychiatric or dysautonomic complaints, fatigue, or pain, are frequent and have a high impact on the patient’s quality of life. They are often poorly recognized and inadequately treated. In the recent years, the growing awareness of NMS has favored the development of techniques that complement the clinician’s diagnosis. This review provides an overview of the most important ultrasonographic findings related to the presence of various NMS. Literature research was conducted in PubMed, Scopus, and Web of Science from inception until January 2021, retrieving 23 prospective observational studies evaluating transcranial and cervical ultrasound in depression, dementia, dysautonomic symptoms, psychosis, and restless leg syndrome. Overall, the eligible articles showed good or fair quality according to the QUADAS-2 assessment. Brainstem raphe hypoechogenicity was related to the presence of depression in PD and also in depressed patients without PD, as well as to overactive bladder. Substantia nigra hyperechogenicity was frequent in patients with visual hallucinations, and larger intracranial ventricles correlated with dementia. Evaluation of the vagus nerve showed contradictory findings. The results of this systematic review demonstrated that transcranial ultrasound can be a useful complementary tool in the evaluation of NMS in PD.

Clinical Features in Parkinson’s Disease Patients with Hyperechogenicity in Substantia Nigra: A Cross-Sectional Study

“…Several studies have shown that urinary incontinence, depression, UPDRS II scores, cognition, and visual hallucinations are associated with SNH. 5,[20][21][22][23] In our clinical scale assessment, we found that SNH was significantly and positively correlated with the UPDRS II scores, but no correlation was found between SNH and depression. A similar conclusion was drawn in a recent Chinese population-based study.…”

Unveiling the Hidden Challenges: Non-Motor Disorders in Parkinson’s Disease

“…In recent years, transcranial sonography (TCS) has seen increased use as a supplementary tool for diagnosing PD by examining brainstem and subcortical structures [12]. Del Toro-Perez et al's [13] systematic review delves into ultrasound findings related to NMS in PD patients. The authors emphasize a link between brainstem raphe (BR) hypoechogenicity and depressive states in PD, potentially indicating structural BR disruption.…”

“…Clinical and sociodemographic factors related to psychiatric disturbances are discussed [11]. Del Toro-Pérez et al [13] show how the advancements in diagnostics like transcranial sonography provide valuable insights, whereas innovative approaches such as virtual reality demonstrate potential benefits [18]. Additionally, the articles by Soliman et al [21], De Waele et al [24], and Lauretani et al [15] describe clinical and neurobiological characteristics of gastrointestinal, emotional, and sleep-related issues, respectively, proposing tailored therapies for each case.…”