Longitudinal White Matter Damage Evolution in Parkinson's Disease

Area of Science:

• Neuroimaging
• Neurology
• Gerontology

Background:

• White matter hyperintensities (WMHs) are implicated in cognitive decline during normal aging.
• The specific role of WMHs and white matter (WM) microstructural integrity in Parkinson's disease (PD) progression remains debated.

Purpose of the Study:

• To examine the long-term changes in cerebral white matter (WM) structure.
• To investigate the relationship between WM alterations and clinical progression in PD patients.

Main Methods:

• 154 PD patients and 60 controls underwent annual MRI scans and clinical/cognitive assessments for up to 4 years.
• Tract-based spatial statistics analyzed diffusion tensor (DT) MRI metrics in WM and normal-appearing white matter (NAWM).
• Linear mixed-effects models and regression analyses assessed longitudinal changes and risk factors for disease progression.

Main Results:

• PD patients exhibited baseline alterations in DT MRI measures compared to controls.
• WMH volume increased over time and correlated with cognitive impairments (global, executive, language).
• Baseline WMH volume moderately predicted progression to mild cognitive impairment.

Conclusions:

• WMHs are associated with cognitive decline in PD patients.
• Cerebral white matter microstructural damage has minimal impact on clinical PD progression.
• MRI-assessed WMHs serve as a valuable tool for monitoring cognitive impairment development in PD.