期刊
PARKINSONISM & RELATED DISORDERS
卷 19, 期 7, 页码 680-683出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.parkreldis.2013.03.008
关键词
Mild cognitive impairment (MCI); Parkinson's disease; Volumetric MRI; White matter disease; Cerebral small vessel disease
资金
- Lundbeck
- Novartis
- Pfizer
- Eisai
- Singhealth Foundation
- Media Development Authority of Singapore
- National Medical Research Council of Singapore
- Singapore Millenium Foundation
- GlaxoSmithKline Pte Ltd.
- Singapore National Research Foundation
Background: Mild cognitive impairment (MCI) and dementia contribute to a poor quality of life among patients with PD. The influence of cerebral ischemia as a risk factor for MCI in PD has not been adequately investigated. To address this issue, we examined the influence of the volume and distribution of white matter hyperintensity (WMH) as a risk factor for MCI in early PD. Methods: Prospective study of patients with early idiopathic PD. All patients had baseline MRI-FLAIR, clinical assessment and detailed neuropsychological evaluation. Data on demographics, vascular risk factors, cognitive performance and WMH volumes were analyzed. Results: 91 patients; mean age 64.9 years, mean education of 10.5 years. 24 patients fulfilled the Movement Disorder Society criteria for MCI and were classified as PD-MCI while the rest were classified as PD with no cognitive impairment (PD-NCI). Patients with PD-MCI and PD-NCI did not differ in Hoehn & Yahr staging. PD-MCI patients had a higher prevalence of diabetes mellitus, hypertension and hyperlipidemia. PD-MCI patients had significantly greater volume of periventricular (6.04 ml vs. 2.66 ml, p = 0.001) and deep subcortical WMH (2.16 vs.1.44, p = 0.002). Regional WMH was significantly greater among PD-MCI in the frontal, parietal and occipital regions. Logistic regression analyses demonstrated WMH to be associated with PD-MCI independent of age, education, and vascular risk factors. Increasing WMH volume was associated with lower performance on executive function, memory and language. Conclusions: WMH is an important risk factor for PD-MCI independent of vascular risk factors. PD patients with WMH should be regularly screened for MCI. (c) 2013 Elsevier Ltd. All rights reserved.
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