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The influence of white matter hyperintensities on the clinical features of Parkinson's disease
Abstract:
This study was designed to investigate the influence of white matter hyperintensities (WMH) on clinical features of Parkinson's disease (PD) patients. The study subjects were 44 patients with PD who took a brain MRI. The severity of Parkinsonian symptoms was assessed in both 'on' and 'off' states, using the UPDRS-motor score. Thirteen patients (30%) showed WMH. The patients with WMH were significantly older than those without WMH (67 +/- 5.7 vs 60 +/- 6.4 years). In both 'off' and 'on' states, the gait scores were significantly higher in patients with WMH than in those without WMH (1.6 +/- 0.18 vs 1.1 +/- 0.12, P < 0.05), but other motor symptom (tremor, bradykinesia, rigidity) scores between the two patient groups were not statistically different. After taking a single dose of oral levodopa/benserazide (200mg/50mg), the patients with WMH showed significantly less improvement in bradykinesia score than those without WMH (25 +/- 4.1% vs 40 +/- 4.0%, P < 0.05), but the improvements in other symptoms were comparable between the two groups. These results suggest that WMH on MRI may influence Parkinsonian motor symptoms, particularly gait symptom and levodopa-responsiveness to bradykinesia symptom.
Insights
White matter hyperintensities (WMH) in Parkinson's disease (PD) patients are linked to worse gait symptoms and reduced levodopa response for bradykinesia. These findings highlight WMH as a potential factor influencing PD progression and treatment efficacy.
Area of Science:
- Neurology
- Neuroimaging
- Movement Disorders
Background:
- Parkinson's disease (PD) is a neurodegenerative disorder affecting motor function.
- White matter hyperintensities (WMH) are common findings on brain MRI in older adults and may be associated with cerebrovascular disease.
- The impact of WMH on the clinical presentation and treatment response in PD patients is not fully understood.
Purpose of the Study:
- To investigate the influence of white matter hyperintensities (WMH) on the clinical features of Parkinson's disease (PD) patients.
- To assess the relationship between WMH and specific motor symptoms and levodopa responsiveness in PD.
Main Methods:
- A cohort of 44 Parkinson's disease patients underwent brain MRI to identify white matter hyperintensities (WMH).
- Parkinsonian symptom severity was evaluated using the UPDRS-motor score in both 'on' and 'off' medication states.
- Levodopa responsiveness for bradykinesia was assessed after a single oral dose of levodopa/benserazide.
Main Results:
- Thirteen patients (30%) exhibited WMH and were significantly older than those without WMH.
- Patients with WMH showed significantly higher gait impairment scores in both 'on' and 'off' states compared to those without WMH.
- WMH patients demonstrated significantly less improvement in bradykinesia following levodopa administration compared to non-WMH patients.
Conclusions:
- White matter hyperintensities (WMH) on MRI may influence specific motor symptoms in Parkinson's disease, particularly gait.
- WMH are associated with reduced levodopa responsiveness for bradykinesia in PD patients.
- These findings suggest WMH could be a relevant imaging biomarker for predicting clinical course and treatment outcomes in Parkinson's disease.