Cognitive function in Parkinson's disease: associations with perivascular space in basal ganglia
Zhenglong Luo1,2, Yangfan Zhu1,2, Yongyun Zhu1,2
1Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan Province, P.R. China.
Background:
Cognitive impairment is one of the most common symptoms of Parkinson's disease (PD), and may be detectable through changes in neural features visualized by magnetic resonance imaging (MRI). Mild cognitive impairment is a transitional state between normal aging and dementia, and early recognition of Parkinson's disease with mild cognitive impairment (PD-MCI) can help improve the quality of life and treatment for patients. This study investigated the association of enlarged perivascular space (EPVS) and white matter hyperintensity (WMH) with PD-MCI.
Aims:
This study aimed to evaluate whether EPVS and WMH can be used as potential MRI markers for PD-MCI.
Methods:
This retrospective study involved 200 patients with PD who underwent cranial MRI in our hospital from April 2021 to April 2022. Patients were divided into those with no cognitive impairment (PD-NCI) or mild cognitive impairment. Uni- and multivariate logistic regression analyzed associations of EPVS, WMH, and clinicodemographic characteristics with cognitive decline.
Results:
Univariate regression identified severe EPVS in basal ganglia, severe WMH, older age, late-onset, male sex, low educational level, longer duration of disease, low triglycerides, low uric acid, and low scores on the Mini-mental State Exam as risk factors for PD-MCI. After adjusting for clinicodemographic risk factors in multivariate regression, low education level and EPVS in basal ganglia remained risk factors for cognitive impairment.
Conclusions:
Severe EPVS in basal ganglia and poor education, but not WMH, are independent risk factors of PD-MCI. Our findings suggest that non-invasive detection of EPVS in basal ganglia by MRI may be a valuable early indicator of cognitive decline in PD patients.
Insights
Enlarged perivascular spaces (EPVS) in the basal ganglia, not white matter hyperintensities (WMH), are linked to mild cognitive impairment in Parkinson's disease (PD-MCI). MRI detection of EPVS may aid early diagnosis of cognitive decline in PD patients.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Cognitive impairment is a common Parkinson's disease (PD) symptom.
- Mild cognitive impairment (MCI) in PD (PD-MCI) signifies a transition towards dementia.
- Early identification of PD-MCI is crucial for patient care and treatment.
Purpose of the Study:
- To assess if enlarged perivascular spaces (EPVS) and white matter hyperintensities (WMH) on MRI can serve as biomarkers for PD-MCI.
- To investigate the association between EPVS, WMH, and cognitive decline in Parkinson's disease patients.
Main Methods:
- Retrospective analysis of cranial MRI scans from 200 PD patients (April 2021-April 2022).
- Patients categorized into PD with no cognitive impairment (PD-NCI) or PD with mild cognitive impairment (PD-MCI).
- Logistic regression models (univariate and multivariate) used to analyze associations between MRI findings, clinicodemographic factors, and cognitive status.
Main Results:
- Univariate analysis revealed severe EPVS in basal ganglia, severe WMH, older age, late-onset, male sex, low education, longer disease duration, low triglycerides, low uric acid, and low Mini-mental State Exam scores as risk factors for PD-MCI.
- Multivariate regression, after adjusting for clinicodemographic factors, identified low education level and EPVS in basal ganglia as independent risk factors for cognitive impairment.
Conclusions:
- Severe EPVS in basal ganglia and lower educational attainment are independent predictors of PD-MCI.
- WMH were not found to be an independent risk factor for PD-MCI in this study.
- Non-invasive MRI detection of basal ganglia EPVS shows potential as an early indicator for cognitive decline in Parkinson's disease.
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