Mild Parkinsonian Signs in a Hospital-based Cohort of Mild Cognitive Impairment Types: A Cross-sectional Study

Cecilia Camarda1, Paola Torelli2, Carmela Pipia3

  • 1Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy.

Abstract

Insights

Mild Parkinsonian Signs (MPS) are common in Mild Cognitive Impairment (MCI) and linked to brain changes like white matter hyperintensities and atrophy. These signs may indicate increased risk for dementia progression.

Area of Science:

  • Neurology
  • Neuroimaging
  • Geriatrics

Background:

  • Mild Parkinsonian Signs (MPS) have shown conflicting associations with Mild Cognitive Impairment (MCI) subtypes.
  • Understanding this relationship is crucial for early diagnosis and intervention in cognitive decline.

Purpose of the Study:

  • To investigate the association between individual MPS and different MCI types.
  • To evaluate the link between MPS and specific neuroimaging markers including caudate atrophy, global cerebral atrophy, White Matter Hyperintensities (WMH), and lacunes in MCI patients.

Main Methods:

  • A cross-sectional study of 1,168 MCI patients (aged 45-97) utilizing brain MRI.
  • Assessment of MPS using the Unified Parkinson's Disease Rating Scale motor section (tremor, rigidity, bradykinesia, gait/balance/axial dysfunction).
  • Evaluation of WMH, lacunes, caudate atrophy (bicaudate ratio), and global cerebral atrophy (ventricles to brain ratio). Apolipoprotein E (APOE) genotyping was also performed.

Main Results:

  • Bradykinesia and gait/balance/axial dysfunction were the most frequent MPS observed.
  • MPS were present in both amnestic and non-amnestic MCI subtypes.
  • MPS were significantly associated with WMH, lacunes, caudate atrophy, and global cerebral atrophy.

Conclusions:

  • MPS are prevalent in both amnestic and non-amnestic MCI, especially in multiple-domain MCI and in individuals with the APOE ε4 allele.
  • Vascular and atrophic brain processes (cortical and subcortical) contribute to the development of MPS in MCI.
  • Further longitudinal studies are necessary to clarify the role of MPS in the progression from MCI to dementia.

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