Value of cervical vagus cross-sectional area in diagnosis of Parkinson's disease
10.7683/xxyxyxb.2023.12.006
- VernacularTitle:颈部迷走神经横截面面积在帕金森病诊断中的价值
- Author:
Siyuan CHEN
1
;
Yinlong LIU
;
Qi GU
;
Limin ZHU
;
Shaopu WU
;
Dongsheng LI
;
Jianjun MA
;
Xue LI
Author Information
1. 郑州大学人民医院/河南省人民医院/河南大学人民医院神经内科,河南 郑州 450003
- Keywords:
Parkinson's disease;
multiple system atrophy;
vagus nerve;
cross-sectional area;
autonomic dysfunction
- From:
Journal of Xinxiang Medical College
2023;40(12):1131-1135
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the diagnostic value of cervical vagus nerve cross-sectional area(CAS)for Parkinson's disease(PD).Methods Thirty patients with PD admitted to the People's Hospital of Zhengzhou University from October 2019 to October 2022 were selected as PD group,25 patients with multiple system atrophy(MSA)admitted to the People's Hospital of Zhengzhou University during the same period were selected as the MSA group,and 30 healthy individuals who underwent physical examination in the People's Hospital of Zhengzhou University during the same period were selected as healthy control group.Cervical vagus CAS of subjects in the three groups were measured by high-resolution ultrasound,and the difference of CAS of cervical vagus nerve was compared among the three groups.The degree of impairment of autonomic nervous function of subjects in the three groups was evaluated by PD autonomic symptom scale(SCOPA-AUT).The diagnostic value of cervical vagus nerve CAS for PD was analyzed by receiver operating characteristic(ROC)curve.Results The CAS of the right cervical vagus nerve of subjects was significantly larger than that of the left in the healthy control group and PD group(P<0.05);there was no significant difference in CAS of bilateral cervical vagus nerve of subjects in the MSA group(P>0.05).The CAS and average CAS of bilateral cervical vagus nerve of subjects in the PD group and MSA group were significantly lower than those in the healthy control group(P<0.01).The CAS of the right vagus nerve of subjects in the MSA group was significantly lower than that in the PD group(P<0.05);there was no significant difference in CAS and the average CAS of the left vagus nerve between the MSA group and the PD group(P>0.05).The total score of SCOPA-AUT and gastrointestinal(GI),cardiovascular(CV),urinary(UR)and sexual(SX)scores of subjects in the PD group and MSA group were significantly higher than those in the healthy control group(P<0.01).The total score of SCOPA-AUT and UR,SX scores of subjects in the MSA group were significantly higher than those in the PD group(P<0.05).There was no significant difference in temperature(TH)and pupil(PU)of subjects among the three groups(P>0.05).Pearson correlation analysis showed that the CAS of cervical vagus nerve of PD patients was not correlated with the total score of SCOPA-AUT and the UR,TH,PU,SX scores(r=-0.143,0.281,0.297,0.265,0.312;P>0.05).The CAS of cervical vagus nerve of PD patients was negatively correlated with GI and CV scores(r=-0.683,-0.373;P<0.05).ROC curve analysis showed that the area under the curve of cervical vagus nerve for diagnosing PD was 0.870(95%confidence interval:0.773-0.966,P<0.05);the critical value was 3.064 mm2,the sensitivity was 96%,and the specificity was 67%.The area under the curve of CAS of cervical vagus nerve in differential diagnosis of PD,MSA was 0.680(95%confidence interval:0.537-0.823,P<0.05).The sensitivity and specificity for the diagnosis of MSA were 68%and 70%when the CAS of the cervical vagus nerve<2.709 mm2.Conclusion The CAS of cervical vagal nerve has high clinical diagnostic value for PD,and it provides a new way to improve the diagnosis rate of PD.