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- Title
Exploring the association between Cerebral small‐vessel diseases and motor symptoms in Parkinson's disease.
- Authors
Wan, Ying; Hu, Wenjian; Gan, Jing; Song, Lu; Wu, Na; Chen, Yuzhen; Liu, Zhenguo
- Abstract
Objectives: to explore the association between cerebral small‐vessel diseases (CSVDs) and motor symptoms in Parkinson's disease (PD). Methods: 137 PD patients were recruited into the study. Detailed motor symptoms, including tremor, rigidity, bradykinesia, and axial impairment, were evaluated using Unified Parkinson's disease Rating Scale (UPDRS). Non‐motor symptoms, including cognition, anxiety, and depression, were evaluated using Montreal Cognitive Assessment (MoCA), Hamilton anxiety scale (HAMA), and Hamilton depression scale (HAMD). Brain MRI was used to assess the subtypes of CSVDs, including lacunes, enlarged perivascular spaces (EPVS), and white matter hyperintensities (WMH). WMH were furtherly divided into deep WMH (DWMH) and periventricular hyperintensities (PVH). The association between CSVDs and motor symptoms was analyzed. Patients were divided into the postural instability and gait disability (PIGD) group and non‐PIGD group. Demographic, clinical and CSVDs variables were compared between the two groups. Results: CSVDs subtypes were all detected in the participants with different prevalence rates and severity degrees. We found a close association between EPVS in basal ganglia and the tremor score (p = 0.032), and between DWMH in the frontal and occipital lobes and the axial motor score (p < 0.05) through the spearman and multivariate liner regression analysis. Compared with the non‐PIGD group, the PIGD group demonstrated more serious cognitive impairment and DWMH in the frontal and occipital lobes (p < 0.05). The demographic characteristics and vascular risk factors of the PIGD group were not different from those of the non‐PIGD group. Cognitive impairment and DWMH in the frontal lobe were identified to be independent risk factors of PIGD motor phenotype. Conclusions: We identified a close association between the CSVDs and motor symptoms in PD and DWMH in the frontal lobe was a risk factor of PIGD motor phenotype, which supports the contribution of vascular pathology in PD. Our study provided a fresh data of the comorbid cerebral small‐vessel diseases (CSVDs) in the Chinese Parkinson's disease (PD) patients and supported a close link between the CSVDs burden and motor symptoms in PD. Our study provided the first data of enlarged perivascular spaces in the PD patients. The data confirmed that deep white matter hyperintensities of the frontal lobe as an independent risk factor of postural instability and gait disability motor phenotype.
- Subjects
CEREBRAL small vessel diseases; PARKINSON'S disease; SYMPTOMS; MONTREAL Cognitive Assessment; OCCIPITAL lobe; FRONTAL lobe; UNILATERAL neglect; HAMILTON Depression Inventory
- Publication
Brain & Behavior, 2019, Vol 9, Issue 4, pN.PAG
- ISSN
2162-3279
- Publication type
Article
- DOI
10.1002/brb3.1219