There are two main reasons for the difficulty in early diagnosis of Parkinson’s disease: 1. Parkinson’s disease is mainly characterized by slowness of action, tremor, tonicity or abnormal gait posture, with slowness of action as the main feature among the above four groups of symptoms, and some patients do not have obvious tremor or tonicity, and early patients do not have obvious postural or gait abnormalities, which makes clinical diagnosis difficult. 2. The average age of onset of Parkinson’s disease is 60 years old, and most patients develop the disease before the age of 65. Since there are relatively few brain diseases before the age of 65, it is easier to diagnose patients with Parkinson’s disease-like symptoms before the age of 65. After the age of 65, with increasing age and long-term effects of middle-aged hypertension, smoking and diabetes, cerebral arteriosclerosis or asymptomatic cerebral infarction is very common, and multiple cerebral infarctions can also cause Parkinson’s disease-like symptoms, therefore, the clinical diagnosis of Parkinson’s patients with symptoms after the age of 65 is It is very difficult to diagnose Parkinson’s patients with symptoms after 65 years of age. Recent studies have found that noninvasive brain parenchymal ultrasonography is helpful in the diagnosis of atypical or elderly Parkinson’s disease. Foreign researchers compared 199 patients with Parkinson’s disease and 201 healthy controls, and the diagnostic sensitivity and specificity were 95% and 96%, respectively, using a nigrostriatal echogenic area of 0.20 cm2 as the cut-off value (Mehnert, 2010). Our preliminary study of ultrasonography in Parkinson’s patients found that the nigrostriatal echogenic high-signal site (left/right) and area size predicted Parkinson’s disease symptoms and could suggest nigrostriatal pathological changes in Parkinson’s symptoms, contributing to the diagnosis of Parkinson’s disease.