Objective To investigate the prevalence of substantia nigra(SN)hyperechogenicity in patients with Parkinson's disease(PD)using transcranial ultrasound(TCS),identify the associated influencing factors,and construct a predictive model.Methods A retrospective analysis was conducted on 101 PD patients admitted to Chengde City Central Hospital between August 2022 and July 2024.All patients underwent TCS examination to detect SN hyperechogenicity.Based on TCS findings,patients were categorized into case group(SN hyperechogenicity,stagesⅢ-V)and control group(normal SN echogenicity,stagesⅠ-Ⅱ).The prevalence of TCS-detected SN hyperechogenicity in PD patients was evaluated,and the clinical and laboratory data between two groups were compared.The risk factors for SN hyperechogenicity in PD patients were identified using multivariate Logistic regression,and a regression equation model of Logit(P)was established based on the results of multivariate analysis.The established model was validated by the Hosmer-Lemeshow goodness-of-fit test and the likelihood ratioχ2 test.Receiver operating characteristic(ROC)curve was constructed to evaluate the predictive accuracy of the model for SN hyperechogenicity in PD patients,and the area under the curve(AUC)was calculated.Results Among 101 PD patients,34(33.66%)exhibited SN hyperechogenicity.Compared with control group,case group had higher percentages of olfactory dysfunction,sleep disorders and H-Y stage≥Ⅲ(P<0.05),and lower levels of serum copper and ceruloplasmin(P<0.05).Multivariate Logistic regression analysis identified olfactory dysfunction,sleep disorders,H-Y stage≥Ⅲ,decreased serum copper and reduced ceruloplasmin as independent risk factors for SN hyperechoicity in PD patients(OR=2.168,2.008,2.063,2.300,1.921,respectively;P<0.05).The predictive model was formalized as Logit(P)=-9.233+olfactory dysfunction×0.774+sleep disorders×0.697+H-Y stage≥Ⅲ×0.724+decreased serum copper×0.833+reduced ceruloplasmin×0.653.ROC analysis showed that when Logit(P)>13.00,the AUC value was 0.876(95%CI:0.795-0.933),with a sensitivity of 73.53%and a specificity of 82.09%.Conclusion The phenomenon of TCS-detected SN hyperechogenicity is severe in PD patients,and its occurrence was associated with olfactory dysfunction,sleep disorders,H-Y stage≥Ⅲ,decreased serum copper and reduced ceruloplasmin,and the predictive model incorporating these factors demonstrated excellent predictive value.

Objective To investigate the prevalence of substantia nigra(SN)hyperechogenicity in patients with Parkinson's disease(PD)using transcranial ultrasound(TCS),identify the associated influencing factors,and construct a predictive model.Methods A retrospective analysis was conducted on 101 PD patients admitted to Chengde City Central Hospital between August 2022 and July 2024.All patients underwent TCS examination to detect SN hyperechogenicity.Based on TCS findings,patients were categorized into case group(SN hyperechogenicity,stagesⅢ-V)and control group(normal SN echogenicity,stagesⅠ-Ⅱ).The prevalence of TCS-detected SN hyperechogenicity in PD patients was evaluated,and the clinical and laboratory data between two groups were compared.The risk factors for SN hyperechogenicity in PD patients were identified using multivariate Logistic regression,and a regression equation model of Logit(P)was established based on the results of multivariate analysis.The established model was validated by the Hosmer-Lemeshow goodness-of-fit test and the likelihood ratioχ2 test.Receiver operating characteristic(ROC)curve was constructed to evaluate the predictive accuracy of the model for SN hyperechogenicity in PD patients,and the area under the curve(AUC)was calculated.Results Among 101 PD patients,34(33.66%)exhibited SN hyperechogenicity.Compared with control group,case group had higher percentages of olfactory dysfunction,sleep disorders and H-Y stage≥Ⅲ(P<0.05),and lower levels of serum copper and ceruloplasmin(P<0.05).Multivariate Logistic regression analysis identified olfactory dysfunction,sleep disorders,H-Y stage≥Ⅲ,decreased serum copper and reduced ceruloplasmin as independent risk factors for SN hyperechoicity in PD patients(OR=2.168,2.008,2.063,2.300,1.921,respectively;P<0.05).The predictive model was formalized as Logit(P)=-9.233+olfactory dysfunction×0.774+sleep disorders×0.697+H-Y stage≥Ⅲ×0.724+decreased serum copper×0.833+reduced ceruloplasmin×0.653.ROC analysis showed that when Logit(P)>13.00,the AUC value was 0.876(95%CI:0.795-0.933),with a sensitivity of 73.53%and a specificity of 82.09%.Conclusion The phenomenon of TCS-detected SN hyperechogenicity is severe in PD patients,and its occurrence was associated with olfactory dysfunction,sleep disorders,H-Y stage≥Ⅲ,decreased serum copper and reduced ceruloplasmin,and the predictive model incorporating these factors demonstrated excellent predictive value.