Enlarged substantia nigra hyperechogenicity and risk for Parkinson disease: a 37-month 3-center study of 1847 older persons

Arch Neurol. 2011 Jul;68(7):932-7. doi: 10.1001/archneurol.2011.141.


Objective: To evaluate whether enlarged substantia nigra hyperechogenicity (SN+) is associated with an increased risk for Parkinson disease (PD) in a healthy elderly population.

Design: Longitudinal 3-center observational study with 37 months of prospective follow-up.

Setting: Individuals 50 years or older without evidence of PD or any other neurodegenerative disease.

Participants: Of 1847 participants who underwent a full medical history, neurological assessment, and transcranial sonography at baseline, 1535 could undergo reassessment.

Main outcome measure: Incidence of new-onset PD in relation to baseline transcranial sonography status.

Results: There were 11 cases of incident PD during the follow-up period. In participants with SN+ at baseline, the relative risk for incident PD was 17.37 (95% confidence interval, 3.71-81.34) times higher compared with normoechogenic participants.

Conclusions: In this prospective study, we demonstrate for the first time a highly increased risk for PD in elderly individuals with SN+. Transcranial sonography of the midbrain may therefore be a promising primary screening procedure to define a risk population for imminent PD.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Mapping
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Neurologic Examination
  • Parkinson Disease / diagnostic imaging
  • Parkinson Disease / etiology
  • Parkinson Disease / pathology*
  • Risk Factors
  • Substantia Nigra / diagnostic imaging
  • Substantia Nigra / pathology*
  • Ultrasonography, Doppler, Transcranial / methods