{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:27:44Z","timestamp":1790267264133,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007847","name":"Natural Science Foundation of Jilin Province","doi-asserted-by":"publisher","award":["YDZJ202501ZYTS019"],"award-info":[{"award-number":["YDZJ202501ZYTS019"]}],"id":[{"id":"10.13039\/100007847","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Transcranial sonography (TCS)\u2010detected substantia nigra hyperechogenicity (SN+) is a potential biomarker for Parkinson's disease (PD). While SN+ may indicate PD risk in essential tremor (ET), longitudinal undetermined tremor (UT) data are lacking; insufficient cross\u2010cohort validation hinders clinical translation. This study aimed to evaluate the predictive efficacy of SN+ for 8\u2010year PD risk and its subtype\u2010specific differences in ET\/UT populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>180 patients with tremors who underwent TCS were enrolled and categorized based on the tremor type (ET\/UT) and SN echogenicity grade (SN+\/SN\u2212). 127 patients (59 with ET, 68 with UT) completed a mean follow\u2010up period of 8.01\u2009years (range: 7.41\u20138.67; median: 7.92), during which new\u2010onset PD was documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the ET cohort, 52.4% of SN+ individuals developed PD, compared to 7.9% in the SN\u2212 group. For UT, the PD incidence was 91.2% in SN+ individuals and 50.0% in SN\u2212 individuals. Multivariable\u2010adjusted Firth logistic regression revealed significant associations between SN+ and PD in the ET and UT groups. Moreover, Bayesian logistic regression confirmed SN+ was significantly associated with PD risk in both groups. The posterior probability of an odds ratio exceeding 5 for SN+ was greater than 80% in both cohorts. Subgroup interaction analysis demonstrated no evidence of effect modification by tremor subtype, indicating consistent SN+ effects across cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TCS\u2010detected SN+ is a predictor of PD progression over 8\u2009years in both ET and UT cohorts. The consistent risk association across tremor subtypes in SN+ subgroups supports its clinical potential as a cross\u2010tremor subtype biomarker.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70326","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T10:30:26Z","timestamp":1754908226000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Substantia Nigra Hyperechogenicity Predicts Parkinson's Disease Risk in Patients With Essential Tremor and Undetermined Tremor: Dual\u2010Cohort Longitudinal Evidence With 8\u2010Year Follow\u2010Up and Bayesian Validation"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1997-2026","authenticated-orcid":false,"given":"Xin","family":"Qu","sequence":"first","affiliation":[{"name":"Department of Neurology, The Neuroscience Center The First Hospital of Jilin University, Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Neuroscience Center The First Hospital of Jilin University, Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8719-698X","authenticated-orcid":false,"given":"Jie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Neuroscience Center The First Hospital of Jilin University, Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan\u2010Li","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Pediatric Ultrasound, Ultrasound Diagnostic Center The First Hospital of Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5439-8988","authenticated-orcid":false,"given":"Li\u2010Juan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Neuroscience Center The First Hospital of Jilin University, Jilin University  Changchun China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00030-2"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.7475"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-021-00314-w"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-78794-1"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0404.2002.1o040.x"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2018.11.010"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep20863"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26515"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13988"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26424"},{"issue":"3","key":"e_1_2_12_12_1","first-page":"2","article-title":"Consensus Statement of the Movement Disorder Society on Tremor","volume":"13","author":"Deuschl G.","year":"1998","journal-title":"Movement Disorders"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.56.8.868"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22340"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21740"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21054"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/17562864211007708"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01419-8"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-023-11803-1"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27941"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awaa262"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2020-323646"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(19)30320-5"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26898"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41531-021-00176-9"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-018-9006-5"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.3233\/JPD-213012"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000020028"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmb.2022.167680"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1407860"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1047"},{"key":"e_1_2_12_32_1","unstructured":"G.Heinze M.Ploner D.Dunkler H.Southworth andL.Jiricka \u201clogistf: Firth's Bias\u2010Reduced Logistic Regression.\u201d(2020) https:\/\/CRAN.R\u2010project.org\/package=logist."},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocab280"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsr077003"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.70326","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:51:32Z","timestamp":1756363892000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.70326"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":33,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1111\/ene.70326"],"URL":"https:\/\/doi.org\/10.1111\/ene.70326","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]},"assertion":[{"value":"2025-05-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70326"}}