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Integrating Substantia Nigra Hyperechogenicity and Inflammation-Associated Biomarkers: A Classification Model for Staging Cognitive Impairment in Parkinson's Disease.

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Τίτλος: Integrating Substantia Nigra Hyperechogenicity and Inflammation-Associated Biomarkers: A Classification Model for Staging Cognitive Impairment in Parkinson's Disease.
Συγγραφείς: Zhao J; Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China., Hou C; Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China.; Department of Ultrasound, The Affiliated Hospital of Southwest Medical University, 646000 Luzhou, Sichuan, China., Wang S; Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China., Lin Y; Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China., Xu L; Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China., He W; Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China., Zhang W; Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China.
Πηγή: Journal of integrative neuroscience [J Integr Neurosci] 2026 Mar 09; Vol. 25 (3), pp. 46585.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: IMR Press Country of Publication: Singapore NLM ID: 101156357 Publication Model: Print Cited Medium: Internet ISSN: 0219-6352 (Print) Linking ISSN: 02196352 NLM ISO Abbreviation: J Integr Neurosci Subsets: MEDLINE
Imprint Name(s): Publication: 2021-: Singapore : IMR Press
Original Publication: London : Imperial College Press, c2002-
Ιατρικοί όροι (MeSH): Parkinson Disease*/complications , Parkinson Disease*/diagnostic imaging , Substantia Nigra*/diagnostic imaging , Cognitive Dysfunction*/etiology , Cognitive Dysfunction*/classification , Cognitive Dysfunction*/diagnostic imaging , Cognitive Dysfunction*/diagnosis , Inflammation*/diagnostic imaging, Humans ; Male ; Middle Aged ; Female ; Biomarkers ; Aged ; Ultrasonography, Doppler, Transcranial ; Prospective Studies
Περίληψη: Background: Cognitive impairment (CI) is recognized as a debilitating complication of Parkinson's disease (PD). This study was designed to develop a diagnostic classification model by integrating substantia nigra hyperechogenicity (SNH) and inflammationassociated biomarkers to evaluate its diagnostic performance in distinguishing PD CI stages.
Methods: Between January, 2023 and May, 2024, 184 patients with PD who underwent transcranial sonography were prospectively enrolled. Based on Montreal Cognitive Assessment (MoCA) scores, participants were categorized into three groups: cognitive impairment (PD-CI, MoCA <26), mild cognitive impairment (PD-MCI, MoCA 22-25), and dementia (PD-dementia, MoCA ≤21). Ultrasound features and inflammationassociated biomarkers were screened with univariate analyses. Multivariate logistic regression was used to identify independent diagnostic factors, and receiver operating characteristic (ROC) curve analysis was used to assess model discrimination.
Results: Multivariate regression analysis indicated that age <50 years and more years of education were significantly associated factors for CI (OR = 0.170, p = 0.0350; OR = 0.8780, p = 0.0020, respectively), whereas Unified Parkinson's Disease Rating Scale Part III (UPDRSIII) score (OR = 1.024, p = 0.0270), SNH (OR = 2.550, p = 0.0030), elevated C-reactive protein (CRP) (OR = 2.038, p = 0.0350), and elevated homocysteine (Hcy) (OR = 2.830, p = 0.0020) were independent risk factors. The area uinder the curves (AUCs) for the combined SNH+CRP+Hcy model in predicting PD-CI, PD-MCI, and PD-dementia were 0.783, 0.729, and 0.823, respectively; these values were significantly superior to those for single or dual marker combinations (p < 0.05), with the strongest performance for distinguishing PD-dementia.
Conclusion: An SNH and inflammationassociated biomarkerbased model was developed for predicting the stage of cognitive impairment in PD. Clinical targets for individualized intervention can be provided, and clinical risk stratification and care pathways can be optimized. Furthermore, the model supports the iron deposition-neuroinflammation-CI pathway hypothesis, providing a mechanistic rationale for ultrasoundbased PD-CI diagnosis.
(© Copyright: © 2026 The Author(s). Published by IMR Press.)
Grant Information: 82271995 National Natural Science Foundation of China; 81730050 National Natural Science Foundation of China
Contributed Indexing: Keywords: Parkinson’s disease; cognitive impairment; inflammation; substantia nigra; ultrasonography
Substance Nomenclature: 0 (Biomarkers)
Entry Date(s): Date Created: 20260331 Date Completed: 20260714 Latest Revision: 20260714
Update Code: 20260714
DOI: 10.31083/JIN46585
PMID: 41914259
Βάση Δεδομένων: MEDLINE
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  Data: Integrating Substantia Nigra Hyperechogenicity and Inflammation-Associated Biomarkers: A Classification Model for Staging Cognitive Impairment in Parkinson&#39;s Disease.
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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Zhao+J%22&quot;&gt;Zhao J&lt;/searchLink&gt;; Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Hou+C%22&quot;&gt;Hou C&lt;/searchLink&gt;; Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China.; Department of Ultrasound, The Affiliated Hospital of Southwest Medical University, 646000 Luzhou, Sichuan, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Wang+S%22&quot;&gt;Wang S&lt;/searchLink&gt;; Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Lin+Y%22&quot;&gt;Lin Y&lt;/searchLink&gt;; Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Xu+L%22&quot;&gt;Xu L&lt;/searchLink&gt;; Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22He+W%22&quot;&gt;He W&lt;/searchLink&gt;; Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Zhang+W%22&quot;&gt;Zhang W&lt;/searchLink&gt;; Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, 100070 Beijing, China.
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  Data: &lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Parkinson+Disease%22&quot;&gt;Parkinson Disease*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Parkinson+Disease+complications%22&quot;&gt;complications&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Parkinson+Disease%22&quot;&gt;Parkinson Disease*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Parkinson+Disease+diagnostic+imaging%22&quot;&gt;diagnostic imaging&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Substantia+Nigra%22&quot;&gt;Substantia Nigra*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Substantia+Nigra+diagnostic+imaging%22&quot;&gt;diagnostic imaging&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Cognitive+Dysfunction%22&quot;&gt;Cognitive Dysfunction*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Cognitive+Dysfunction+etiology%22&quot;&gt;etiology&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Cognitive+Dysfunction%22&quot;&gt;Cognitive Dysfunction*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Cognitive+Dysfunction+classification%22&quot;&gt;classification&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Cognitive+Dysfunction%22&quot;&gt;Cognitive Dysfunction*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Cognitive+Dysfunction+diagnostic+imaging%22&quot;&gt;diagnostic imaging&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Cognitive+Dysfunction%22&quot;&gt;Cognitive Dysfunction*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Cognitive+Dysfunction+diagnosis%22&quot;&gt;diagnosis&lt;/searchLink&gt; &lt;br /&gt;&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Inflammation%22&quot;&gt;Inflammation*&lt;/searchLink&gt;/&lt;searchLink fieldCode=&quot;MM&quot; term=&quot;%22Inflammation+diagnostic+imaging%22&quot;&gt;diagnostic imaging&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Humans%22&quot;&gt;Humans&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Male%22&quot;&gt;Male&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Middle+Aged%22&quot;&gt;Middle Aged&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Female%22&quot;&gt;Female&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Biomarkers%22&quot;&gt;Biomarkers&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Aged%22&quot;&gt;Aged&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Ultrasonography%2C+Doppler%2C+Transcranial%22&quot;&gt;Ultrasonography, Doppler, Transcranial&lt;/searchLink&gt; ; &lt;searchLink fieldCode=&quot;MH&quot; term=&quot;%22Prospective+Studies%22&quot;&gt;Prospective Studies&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Cognitive impairment (CI) is recognized as a debilitating complication of Parkinson&#39;s disease (PD). This study was designed to develop a diagnostic classification model by integrating substantia nigra hyperechogenicity (SNH) and inflammationassociated biomarkers to evaluate its diagnostic performance in distinguishing PD CI stages.&lt;br /&gt;Methods: Between January, 2023 and May, 2024, 184 patients with PD who underwent transcranial sonography were prospectively enrolled. Based on Montreal Cognitive Assessment (MoCA) scores, participants were categorized into three groups: cognitive impairment (PD-CI, MoCA &amp;lt;26), mild cognitive impairment (PD-MCI, MoCA 22-25), and dementia (PD-dementia, MoCA ≤21). Ultrasound features and inflammationassociated biomarkers were screened with univariate analyses. Multivariate logistic regression was used to identify independent diagnostic factors, and receiver operating characteristic (ROC) curve analysis was used to assess model discrimination.&lt;br /&gt;Results: Multivariate regression analysis indicated that age &amp;lt;50 years and more years of education were significantly associated factors for CI (OR = 0.170, p = 0.0350; OR = 0.8780, p = 0.0020, respectively), whereas Unified Parkinson&#39;s Disease Rating Scale Part III (UPDRSIII) score (OR = 1.024, p = 0.0270), SNH (OR = 2.550, p = 0.0030), elevated C-reactive protein (CRP) (OR = 2.038, p = 0.0350), and elevated homocysteine (Hcy) (OR = 2.830, p = 0.0020) were independent risk factors. The area uinder the curves (AUCs) for the combined SNH+CRP+Hcy model in predicting PD-CI, PD-MCI, and PD-dementia were 0.783, 0.729, and 0.823, respectively; these values were significantly superior to those for single or dual marker combinations (p &amp;lt; 0.05), with the strongest performance for distinguishing PD-dementia.&lt;br /&gt;Conclusion: An SNH and inflammationassociated biomarkerbased model was developed for predicting the stage of cognitive impairment in PD. Clinical targets for individualized intervention can be provided, and clinical risk stratification and care pathways can be optimized. Furthermore, the model supports the iron deposition-neuroinflammation-CI pathway hypothesis, providing a mechanistic rationale for ultrasoundbased PD-CI diagnosis.&lt;br /&gt; (&#169; Copyright: &#169; 2026 The Author(s). Published by IMR Press.)
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  Data: 82271995 National Natural Science Foundation of China; 81730050 National Natural Science Foundation of China
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  Data: &lt;i&gt;Keywords: &lt;/i&gt;Parkinson’s disease; cognitive impairment; inflammation; substantia nigra; ultrasonography
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        StartPage: 46585
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        Type: general
      – SubjectFull: Male
        Type: general
      – SubjectFull: Middle Aged
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      – SubjectFull: Parkinson Disease complications
        Type: general
      – SubjectFull: Parkinson Disease diagnostic imaging
        Type: general
      – SubjectFull: Substantia Nigra diagnostic imaging
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      – SubjectFull: Cognitive Dysfunction etiology
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      – SubjectFull: Inflammation diagnostic imaging
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      – TitleFull: Integrating Substantia Nigra Hyperechogenicity and Inflammation-Associated Biomarkers: A Classification Model for Staging Cognitive Impairment in Parkinson's Disease.
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              Text: 2026 Mar 09
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