Objective: To detect by the ultrasound (US) the possible presence of vagus nerve atrophy in patients with PD and its relation to severity of motor, non-motor, cognitive symptoms and echogenicity of substantia nigra (SN).

Background: There is strong evidence that gastrointestinal tract could be the starting point of Parkinson’s disease (PD) and the aberrant alpha synclein bodies may travel in a prion like manner through vagus nerve.

Method: We recruited 32 patients fulfilled the criteria for diagnosis of idiopathic PD and 25 healthy controls. We used Unified Parkinson’s disease Rating Scale (UPDRS), Montreal Cognitive Assessment (MOCA) and Non-Motor symptom Scale (NMS) to assess severity of motor, cognitive and non-motor symptoms respectively. High resolution US was used to assess cervical parts both vagus nerves and transcranial parenchymal US was used to assess echogenicity of SN.

Results: PD patients were found to have significantly reduced vagus nerve Cross Sectional Area (CSA) (mm²) than age matched controls (right: 1.21± 0.41 vs. 2.39 ± 0.67; left: 1.09 ± 0.39 vs. 2.23 ± 0.63; p < 0.001).PD patients were found to have significantly increased echogenicity of SN than age matched controls P-value < 0.001 .The CSA of right vagus nerve was negatively correlated with motor part of UPDRS, bradykinesia and tremors scores (P-value 0.037,0.017, 0.004 respectively). The CSA of vagus nerve both sides didn’t correlate with total NMS, total UPDRS, MOCA or with echogenicity of SN.

Conclusion: PD patients were found to have significantly reduced vagus nerve CSA in comparison to controls. The CSA of right vagus nerve was correlated with the severity of motor symptoms especially tremor and bradykinesia.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/diagnostic-value-of-vagus-nerve-ultrasound-in-parkinsons-disease/