Association between white matter lesions and Parkinson's disease: an impact on Postural/Gait difficulty phenotype and
Olga Sinani1, Katerina Dadouli2, Panagiotis Ntellas3
1Faculty of Medicine, University of Thessaly, Larisa, Greece.
Background:
White matter hyperintensities (WMHs) may be observed on Magnetic Resonance Imaging (MRI) in patients with Parkinson disease with or without vascular risk factors. Whether WMHs may influence motor and non-motor aspects of Parkinson disease is a subject of debate. The aim of this study is to evaluate the impact of WMH severity on various aspects of Parkinson disease in combination to the estimation of the impact of cerebrovascular risk factors.
Materials And Methods:
We included a cohort of patients with Parkinson's disease who underwent MRI examination. The Fazekas visual rating scale was used to assess the severity and location of WMHs, and patient clinical characteristics were correlated with MRI data.
Results:
All vascular risk factors were associated with higher Fazekas score in both periventricular and deep white matter. Periventricular white matter hyperintensities (PWMHs) and deep white matter hyperintensities (DWMHs) were associated with lower scores in the ACE-R cognitive assessment scale (p < 0.001). Furthermore, PWMHs and DWMHs severity was associated with higher UPDRS motor score (p < 0.001), while the Postural Instability Gait Difficulty (PIGD) phenotype was correlated with higher burden of WMHs.
Conclusions:
Comorbid WMHs may contribute to multi-dimension dysfunction in patients with Parkinson disease and consequently the management of vascular risk factors may be crucial to maintain motor and non-motor functions in PD.
Insights
White matter hyperintensities (WMHs) worsen motor and cognitive decline in Parkinson's disease (PD). Managing vascular risk factors is crucial for preserving motor and non-motor functions in PD patients with WMHs.
Area of Science:
- Neurology
- Neuroimaging
- Geriatrics
Background:
- White matter hyperintensities (WMHs) are common in Parkinson's disease (PD) patients, irrespective of vascular risk factors.
- The influence of WMHs on motor and non-motor symptoms in PD remains under investigation.
- This study examines the impact of WMH severity and vascular risk factors on PD progression.
Purpose of the Study:
- To evaluate the association between white matter hyperintensity severity and clinical manifestations in Parkinson's disease.
- To assess the combined impact of WMHs and cerebrovascular risk factors on motor and cognitive functions in PD patients.
- To determine the relationship between WMH burden and specific PD phenotypes, such as Postural Instability Gait Difficulty (PIGD).
Main Methods:
- A cohort of Parkinson's disease patients underwent Magnetic Resonance Imaging (MRI).
- The Fazekas scale was utilized to quantify the severity and location of white matter hyperintensities (WMHs).
- Clinical data, including cognitive assessments (ACE-R) and motor scores (UPDRS), were correlated with MRI findings and vascular risk factors.
Main Results:
- All identified vascular risk factors correlated with increased Fazekas scores for both periventricular and deep white matter hyperintensities (PWMHs and DWMHs).
- Higher severity of PWMHs and DWMHs was associated with significantly lower scores on the ACE-R cognitive assessment (p < 0.001).
- Increased PWMHs and DWMHs severity correlated with higher UPDRS motor scores (p < 0.001), and the PIGD phenotype was linked to a greater WMH burden.
Conclusions:
- Co-occurring white matter hyperintensities contribute to multi-dimensional dysfunction in Parkinson's disease patients.
- Effective management of vascular risk factors is essential for maintaining motor and non-motor functions in PD.
- Targeting vascular health may be a key strategy to mitigate the progression of Parkinson's disease symptoms.
Related Concept Videos
01:15Parkinson's Disease: Overview
01:24Parkinson's Disease: Treatment
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
01:37Neural Regulation