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Purpose <p>Sarcopenia affects up to 27.5% of Parkinson’s disease (PD) patients, yet quantitative biomarkers for muscle deterioration remain undefined. This study aimed to characterize muscle stiffness patterns in PD patients with different sarcopenia stages using shear wave elastography (SWE) and establish clinically relevant diagnostic cutoffs.</p> Methods <p>We used shear wave elastography to evaluate muscle stiffness across sarcopenia stages in 102 PD patients (Hoehn-Yahr stages I-II) and 38 controls.SWE measurements of shear wave velocity (SWV) were performed on bilateral brachioradialis (BR), biceps brachii (BB), and medial gastrocnemius (MG) muscles in both resting and functional positions.</p> Results <p>We discovered a biphasic pattern in brachioradialis muscle stiffness: initial reduction during sarcopenia onset (2.85&#xa0;m/s) followed by paradoxical elevation in severe sarcopenia (3.70&#xa0;m/s) compared to PD alone (3.30&#xa0;m/s, p &lt; 0.001). This U-shaped relationship suggests distinct compensatory and decompensatory phases in PD-sarcopenia progression. Brachioradialis shear wave velocity accurately identified sarcopenia (cutoff 3.15&#xa0;m/s, AUC = 0.813, sensitivity = 81%, specificity = 83%) and severe sarcopenia (cutoff 3.45&#xa0;m/s, AUC = 0.823, sensitivity = 90%, specificity = 69%), while distinguishing PD from controls (cutoff 2.85&#xa0;m/s, AUC = 0.966, sensitivity = 87%, specificity = 97%). Biceps stiffness correlated with motor severity (r = 0.56, p = 0.001), whereas standing gastrocnemius stiffness inversely correlated with disease duration (r = -0.80, p &lt; 0.001) and UPDRS-III scores (r = -0.58, p &lt; 0.01). Measurement reliability was excellent (ICC: 0.880–0.953).</p> Conclusion <p>Our findings establish muscle elastography as a quantitative tool for sarcopenia staging in PD, potentially enabling early intervention during the critical 3.15–3.45&#xa0;m/s therapeutic window before irreversible muscle remodeling occurs.</p>

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Evaluation of Muscle Stiffness in Patients with Parkinson’s Disease with Different Stages of Sarcopenia by Shear Wave Elastography

  • 期刊论文

  • 发表日期：

    2026年1月29日

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  • Ping Zhao,
  • Changwei Ding,
  • Yingchun Zhang,
  • Jian Wu,
  • Min Yang,
  • Caishan Wang,
  • Chunfeng Liu

摘要

Purpose

Sarcopenia affects up to 27.5% of Parkinson’s disease (PD) patients, yet quantitative biomarkers for muscle deterioration remain undefined. This study aimed to characterize muscle stiffness patterns in PD patients with different sarcopenia stages using shear wave elastography (SWE) and establish clinically relevant diagnostic cutoffs.

Methods

We used shear wave elastography to evaluate muscle stiffness across sarcopenia stages in 102 PD patients (Hoehn-Yahr stages I-II) and 38 controls.SWE measurements of shear wave velocity (SWV) were performed on bilateral brachioradialis (BR), biceps brachii (BB), and medial gastrocnemius (MG) muscles in both resting and functional positions.

Results

We discovered a biphasic pattern in brachioradialis muscle stiffness: initial reduction during sarcopenia onset (2.85 m/s) followed by paradoxical elevation in severe sarcopenia (3.70 m/s) compared to PD alone (3.30 m/s, p < 0.001). This U-shaped relationship suggests distinct compensatory and decompensatory phases in PD-sarcopenia progression. Brachioradialis shear wave velocity accurately identified sarcopenia (cutoff 3.15 m/s, AUC = 0.813, sensitivity = 81%, specificity = 83%) and severe sarcopenia (cutoff 3.45 m/s, AUC = 0.823, sensitivity = 90%, specificity = 69%), while distinguishing PD from controls (cutoff 2.85 m/s, AUC = 0.966, sensitivity = 87%, specificity = 97%). Biceps stiffness correlated with motor severity (r = 0.56, p = 0.001), whereas standing gastrocnemius stiffness inversely correlated with disease duration (r = -0.80, p < 0.001) and UPDRS-III scores (r = -0.58, p < 0.01). Measurement reliability was excellent (ICC: 0.880–0.953).

Conclusion

Our findings establish muscle elastography as a quantitative tool for sarcopenia staging in PD, potentially enabling early intervention during the critical 3.15–3.45 m/s therapeutic window before irreversible muscle remodeling occurs.