Construction of a nomogram for predicting cognitive impairment in Parkinson's disease based on substantia nigra hyperechogenicity and clinical features
FAN Xiaolan
LIU Hailian
XIE Qiyan
TONG Ya
HOU Chao
Abstract：Objective To explore the correlation between substantia nigra hyperechogenicity(SNH),clinical data and cognitive function in Parkinson's disease(PD),as well as develop a nomogram to predict cognitive impairment(CI)in PD patients.Methods PD patients who underwent transcranial sonography in our hospital from January 2021 to December 2023 were included and randomly divided into the training set(n=246 cases,63.46±9.68 years old,65.9%male)and testing set(n=106,64.3±8.43 years old,60.4%male)in a 7:3 ratio.The echogenicity of SN,area of SNH,plasma neuron-specific enolase(NSE)and other clinical features were collected,and the cognitive level was scored according to the Montreal Cognitive Assessment(MoCA).Logistic regression analysis was used to screen potential risk factors and construct a nomogram,and the receiver operating characteristic curves and calibration curves were used to evaluate the predictive performance of the nomogram.Results Age,UPDRS-Ⅲ scores,Hoehn Yah stage,MoCA score,SNH proportion,NSE and homocysteine levels,and education level in the training set and test set were all significant different between PD patients with normal cognition and PD-CI.Gender,age,education level,UPDRS-Ⅲ scores,NSE concentration and SNH were identified as independent risk factors for PD-CI.The nomogram constructed using these six factors has good identification performance in both the training set and the test set(AUC were 0.867,95%CI:0.824-0.911,P<0.001;0.873,95%CI:0.805-0.941,P<0.001,respectively).The calibration curve demonstrated acceptable agreement between predicted outcomes and actual values.Conclusion Plasma NSE concentration and SNH are related to the cognitive function of PD patients,and the constructed nomogram may have the potential to predict cognitive impairment in Parkinson's disease.
Keywords：Parkinson's diseasecognition impairmentsubstantia nigratranscranial sonographyneuron-specific enolase
Publication Date：2025-03-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 302-308 )