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Abstract
Objective To determine whether deep white matter and periventricular hyperintensities affect the motor symptoms of Parkinson disease (PD) differently, we analyzed MRI and dopamine transporter imaging.
Methods We analyzed the medical records of patients with de novo PD who underwent dopamine transporter PET scanning and MRI at their first visit. Deep white matter and periventricular hyperintensities were scored with a visual rating scale, and motor symptoms were assessed by Unified Parkinson's Disease Rating Scale motor score and tremor, rigidity, bradykinesia, and axial symptom subscores. The influence of white matter hyperintensity on motor symptoms was explored using multivariable linear regression models.
Results A total of 93 patients (mean age, 67.2 ± 9.9 years; 44 male) were included and the mean motor score was 25.0 ± 10.8. Subscores for bradykinesia and axial symptoms were correlated with both deep white matter and periventricular hyperintensities scores. Multivariable linear regression models revealed that deep white matter hyperintensities score was significantly associated with subscore for bradykinesia and periventricular hyperintensities score was associated with subscores for bradykinesia and axial symptoms after adjusting for putaminal dopamine transporter availability and clinical factors.
Conclusions These results demonstrate that deep white matter hyperintensities are associated with bradykinesia and periventricular hyperintensities are associated with bradykinesia and axial symptoms in patients with PD independently of the severity of dopaminergic depletion.
Glossary
- CI=
- confidence interval;
- DAT=
- dopamine transporter;
- DWMHs=
- deep white matter hyperintensities;
- 18F-FP-CIT PET=
- [18F] N-(3-fluoropropyl)-2β-carbon ethoxy-3β-(4-iodophenyl) nortropane PET;
- FLAIR=
- fluid-attenuated inversion recovery;
- ICC=
- intraclass correlation coefficient;
- MNI=
- Montreal Neurologic Institute;
- NPH=
- normal-pressure hydrocephalus;
- PD=
- Parkinson disease;
- PVHs=
- periventricular hyperintensities;
- UPDRS=
- Unified Parkinson's Disease Rating Scale;
- VOI=
- volume of interest;
- WMHs=
- white matter hyperintensities
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
↵* These authors contributed equally to this work.
- Received October 10, 2019.
- Accepted in final form February 10, 2020.
- © 2020 American Academy of Neurology
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