Characteristics of Cognitive Impairment and Their Relationship With Total Cerebral Small Vascular Disease Score in Parkinson's Disease

Miaomiao Hou; Xiaojun Hou; Yiqing Qiu; Jiali Wang; Mingyang Zhang; Xiaowei Mao; Xi Wu

doi:10.3389/fnagi.2022.884506

Characteristics of Cognitive Impairment and Their Relationship With Total Cerebral Small Vascular Disease Score in Parkinson's Disease

Front Aging Neurosci. 2022 Jul 7:14:884506. doi: 10.3389/fnagi.2022.884506. eCollection 2022.

Authors

Miaomiao Hou¹, Xiaojun Hou², Yiqing Qiu³, Jiali Wang³, Mingyang Zhang⁴, Xiaowei Mao², Xi Wu³

Affiliations

¹ Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Department of Neurology, The First Affiliated Hospital of Naval Medical University, Shanghai, China.
³ Department of Neurosurgery, The First Affiliated Hospital of Naval Medical University, Shanghai, China.
⁴ Department of Chemistry, University of Utah, Salt Lake City, UT, United States.

Abstract

Background: This study aimed to investigate the characteristics of cognitive dysfunctions and their relationship with total cerebral small vascular disease (CSVD) in Parkinson's disease (PD).

Methods: A total of 174 idiopathic PD patients who underwent brain magnetic resonance imaging (MRI) were recruited. Demographic information, vascular disease risk factors, motor function (MDS-UPDRS III score), and cognitive level (MoCA, MMSE) were collected for these patients. The total CSVD burden was scored based on lacunes, enlarged perivascular spaces (EPVS), high-grade white matter hyperintensities (WMH), and cerebral microbleeds (CMBs) for each subject.

Results: Cognitive scores on MoCA for language, delayed recall, and orientation were significantly reduced in PD patients with CSVD burden ≥ 1 than in those with CSVD burden = 0. Educational level, PDQ 39, and CSVD burden were significantly associated with MoCA scores in individuals with PD. For the whole group, the full model accounted for 33.6% variation in total MoCA scores. In which, CSVD burden explained 2.7% of the results, and the detection of lacunes, WMH, EPVS, and strictly lobar CMBs were significantly correlated with MoCA scores. The stability of the outcomes was confirmed by sensitivity analysis.

Conclusion: CSVD can independently contribute to cognitive decline in PD and cause damage in specific cognitive domains. Promoting neurovascular health may help preserve cognitive functions in PD.

Keywords: CSVD burden; MRI; Parkinson’s disease; cerebral small vascular disease; cognitive impairment.