ArticleFrontiers in neurology2026
The clinical value of combined assessment of substantia nigra morphology and intracranial hemodynamics via transcranial ultrasound in the diagnosis and differentiation of Parkinson's disease.
Article in Frontiers in neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Parkinson's disease (PD) is a common neurodegenerative disease, and its clinical differentiation from Parkinson-plus syndromes (PPS) remains challenging due to the lack of highly specific biomarkers. Although dopamine transporter single-photon emission computed tomography (DAT-SPECT) provides objective evidence of dopaminergic denervation, its limited value in distinguishing PD from PPS and restricted availability underscore the need for accessible and reliable diagnostic tools. This study aimed to evaluate a novel, non-invasive, and convenient auxiliary diagnostic approach for the diagnosis and differentiation of PD by integrating the assessment of substantia nigra hyperechogenicity (SN+) and intracranial hemodynamics using transcranial ultrasound. Methods: A total of 68 PD patients (PD group), 30 PPS patients (PPS group), and 80 healthy controls (NC group) were enrolled between June 2023 and December 2025. All subjects underwent Transcranial Sonography (TCS) to measure the area of SN+ and Transcranial Color Doppler (TCCD) to measure intracranial vascular hemodynamic parameters. Intergroup differences were analyzed, and receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of individual parameters and their combination. Results: Ultrasound parameters of the substantia nigra, including unilateral and bilateral hyperechogenicity, were markedly elevated in PD patients compared to PPS and control groups ( Conclusion: TCS-detected SN+ is an effective imaging biomarker for PD. Combining SN+ with MCA Vd demonstrated superior diagnostic efficacy (AUC = 0.945) compared with either parameter alone, providing a non-invasive multimodality tool for distinguishing PD from non-PD individuals (including PPS and healthy controls).
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