Table 1_The clinical value of combined assessment of substantia nigra morphology and intracranial hemodynamics via transcranial ultrasound in the diagnosis and differentiation of Parkinson’s disease.docx

All subjects underwent Transcranial Sonography (TCS) to measure the area of SN+ and Transcranial Color Doppler (TCCD) to measure intracranial vascular hemodynamic parameters. Intergroup differences were analyzed, and receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of individual parameters and their combination.</p>Results<p>Ultrasound parameters of the substantia nigra, including unilateral and bilateral hyperechogenicity, were markedly elevated in PD patients compared to PPS and control groups (p < 0.05).

Additionally, the PD group exhibited altered hemodynamic profiles, with significant differences in resistance index and diastolic flow velocity of the middle cerebral artery (MCA Vd) relative to controls. ROC curve analyses indicated that the diagnostic accuracy for PD using the SN+ area was high (AUC = 0.918), while a combined model incorporating TCS and TCCD parameters achieved a superior AUC of 0.945, with a sensitivity of 91.2% and specificity of 95.0%.</p>Conclusion<p>TCS-detected SN+ is an effective imaging biomarker for PD.

Combining SN+ with MCA Vd demonstrated superior diagnostic efficacy (AUC = 0.945) compared with either parameter alone, providing a non-invasive multimodality tool for distinguishing PD from non-PD individuals (including PPS and healthy controls).</p>