Clinical correlates of cerebral white matter abnormalities in patients with Parkinson's disease

Parkinsonism Relat Disord. 2018 Apr;49:28-33. doi: 10.1016/j.parkreldis.2017.12.029. Epub 2017 Dec 27.

Abstract

Objective: To determine if autonomic dysfunction, cognitive disorders or axial disability are associated with white matter lesions (WML) in Parkinson disease (PD).

Methods: We performed a retrospective cross-sectional review study on 204 consecutive PD patients who underwent cerebral MRI in our center between January 2012 and July 2016. For each patient, we scored the severity of WML and PV (periventricular) WML using the Fazekas score and using the ARWMC scale for WML and BG (basal ganglia) and clinical characteristics such as neurogenic orthostatic hypotension and cognitive function.

Results: 204 PD patients were included of whom n = 53 (26.0%) had neurogenic orthostatic hypotension (nOH). The presence of nOH was significantly associated with the severity of WML as defined by the Fazekas score and the ARWMC scale. An ordinal regression model confirmed this association with an OR of 0.41 (95% CI 0.18-0.92: p = .03) and an OR of 0.39 (95% CI 0.17-0.88: p = .02). There were no significant associations between WML and other co-variables, including hypertension, dopaminergic medication use, Hoehn and Yahr stage, gender and cognitive decline.

Conclusion: The presence of nOH is associated with WML severity in PD patients.

Keywords: Magnetic resonance imaging; Orthostatic hypotension; Parkinson's disease; White matter lesions.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Autonomic Nervous System / physiopathology*
  • Cognitive Dysfunction / physiopathology
  • Cross-Sectional Studies
  • Dopamine Agents / therapeutic use
  • Female
  • Humans
  • Hypotension, Orthostatic / physiopathology*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Parkinson Disease / diagnostic imaging
  • Parkinson Disease / pathology*
  • Parkinson Disease / physiopathology*
  • Retrospective Studies
  • Severity of Illness Index*
  • White Matter / diagnostic imaging
  • White Matter / pathology*

Substances

  • Dopamine Agents