Movement Disorder: Parkinson's patients, white matter lesions and disease progression are closely related

Among the most common macrostructural changes in white matter (WM), white matter hyperintensities (WMHs) are readily identified on T2-weighted magnetic resonance imaging (MRI) scans
.

WMHs are associated with increasing age and cognitive decline in normal aging

Alterations in WM microarchitecture are also associated with neurodegeneration in PD
.

A cross-sectional study using diffusion tensor (DT) MRI revealed that diffuse WM microstructural impairment is associated with the degree of motor and cognitive impairment in PD patients

However, these studies assessed whole-brain WM and did not consider the location and severity of WMHs affecting DT MRI indicators
.

Only a few reports have specifically assessed the involvement of normal-appearing white matter (NAWM) in PD, and they have not found significant changes in PD patients compared with healthy controls, nor have they found any associations with clinical features

Here, Pietro Giuseppe Scamarcia et al from IRCCS San Raffaele Scientific Institute, Italy, systematically explored the evolution of MRI changes in WMHs and NAWM DT, and their relationship to the progression of motor and cognitive impairment in a large cohort of PD patients for up to 4 years vertical tracking
.

A total of 154 Parkinson's disease patients underwent annual clinical, cognitive, and magnetic resonance imaging (MRI) assessments for 4 years
.

Sixty healthy controls received the same regimen at baseline

They found that at baseline, PD patients showed changes in all DT MRI measures compared with controls
.

Longitudinal, there were no significant changes in DT MRI indices and no associations with clinical variables were found
.

WMH volume varies over time and is associated with impairments in overall cognition, executive function, and language

The significance of this study is the discovery that, in PD, there is an association between WMHs and cognitive deterioration, with a negligible contribution of WM microstructural damage to clinical deterioration
.

WMHs assessed by MRI may provide an important tool for monitoring the development of cognitive impairment in PD patients

In PD, there is an association between WMHs and cognitive deterioration

Original source:
Scamarcia PG, Agosta F, Spinelli EG, et al.

Longitudinal White Matter Damage Evolution in Parkinson's Disease.
Mov Disord.
Published online November 22, 2021:mds.
28864.
doi:10.

Longitudinal White Matter Damage Evolution in Parkinson's Disease.

 

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