Lacunes may worsen cognition but not motor function in Parkinson's disease

Chen, Keke; Jin, Zhaohui; Fang, Jinping; Lin, Qi; Liu, Cui; Wang, Ruidan; Su, Yuan; Yan, None Hongjiao; Liu, Aixian; Xi, Jianing; Fang, Boyan

doi:10.1002/brb3.2880

Cited by 3 publications

(1 citation statement)

References 61 publications

(92 reference statements)

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“…A meta-analysis of its influence on cognitive function in PD showed different effects—most on EF, memory and overall cognitive function [ 441 ], whereas others found no correlation between CSVD pathology and dementia [ 442 , 443 ]. Lacunes were independently associated with worse attention and processing speed and may accelerate the course of PD [ 444 ]. Increased perivascular space in the basal ganglia and WMH was associated with cognitive decline in PD [ 203 , 445 ], as were cerebral microbleeds (CMB), which were both related to hypertension [ 397 ].…”

Section: Impact Of Other Co-pathologies In Cognition In Pdmentioning

confidence: 99%

Pathobiology of Cognitive Impairment in Parkinson Disease: Challenges and Outlooks

Jellinger

2023

IJMS

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Cognitive impairment (CI) is a characteristic non-motor feature of Parkinson disease (PD) that poses a severe burden on the patients and caregivers, yet relatively little is known about its pathobiology. Cognitive deficits are evident throughout the course of PD, with around 25% of subtle cognitive decline and mild CI (MCI) at the time of diagnosis and up to 83% of patients developing dementia after 20 years. The heterogeneity of cognitive phenotypes suggests that a common neuropathological process, characterized by progressive degeneration of the dopaminergic striatonigral system and of many other neuronal systems, results not only in structural deficits but also extensive changes of functional neuronal network activities and neurotransmitter dysfunctions. Modern neuroimaging studies revealed multilocular cortical and subcortical atrophies and alterations in intrinsic neuronal connectivities. The decreased functional connectivity (FC) of the default mode network (DMN) in the bilateral prefrontal cortex is affected already before the development of clinical CI and in the absence of structural changes. Longitudinal cognitive decline is associated with frontostriatal and limbic affections, white matter microlesions and changes between multiple functional neuronal networks, including thalamo-insular, frontoparietal and attention networks, the cholinergic forebrain and the noradrenergic system. Superimposed Alzheimer-related (and other concomitant) pathologies due to interactions between α-synuclein, tau-protein and β-amyloid contribute to dementia pathogenesis in both PD and dementia with Lewy bodies (DLB). To further elucidate the interaction of the pathomechanisms responsible for CI in PD, well-designed longitudinal clinico-pathological studies are warranted that are supported by fluid and sophisticated imaging biomarkers as a basis for better early diagnosis and future disease-modifying therapies.

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Section: Impact Of Other Co-pathologies In Cognition In Pdmentioning

confidence: 99%

Pathobiology of Cognitive Impairment in Parkinson Disease: Challenges and Outlooks

Jellinger

2023

IJMS

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Lacunes may worsen cognition but not motor function in Parkinson's disease

et al. 2022

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Background As one of the imaging markers of cerebral small vessel disease, lacunes has received little attention. The objective of this study was to investigate the associations of lacunes, cognition and motor function in patients with Parkinson's disease (PD) and whether these associations are independent of other imaging markers. Methods Patients were consecutively included from April 2019 to July 2022 in Beijing Rehabilitation Hospital. All patients underwent brain magnetic resonance imaging scans, clinical scale evaluations, and neuropsychological tests, as well as quantitative evaluation of postural control. To eliminate the possible factors contributing to cognition and motor dysfunction in patients with PD, in particular white matter hyperintensities and enlarged perivascular space in the basal ganglia, multivariate linear regression models were constructed to sort out the effect of lacunes. Results Ninety‐four patients were included in this study, 56 without lacunes and 38 with lacunes. Patients with lacunes showed shorter disease duration, slower gait speed and spent more time on Trail‐Making Test part A (TMT‐A) than those without lacunes. The number of lacunes were positively correlated with the time to complete the TMT‐A and negatively related to gait speed. Multivariate linear regression models showed that the presence of lacunes was associated with longer TMT‐A time after adjusting for potential confounders. Conclusions Lacunes were independently associated with worse visual scanning, attention, and processing speed in patients with PD. In addition, lacunes may accelerate the course of PD. Early treatment of vascular disease provides an alternate way to mitigate some motor and cognitive dysfunction in patients with PD.

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Neuroimaging and fluid biomarkers in Parkinson’s disease in an era of targeted interventions

Zarkali,

Thomas,

Zetterberg

et al. 2024

Nat Commun

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A major challenge in Parkinson’s disease is the variability in symptoms and rates of progression, underpinned by heterogeneity of pathological processes. Biomarkers are urgently needed for accurate diagnosis, patient stratification, monitoring disease progression and precise treatment. These were previously lacking, but recently, novel imaging and fluid biomarkers have been developed. Here, we consider new imaging approaches showing sensitivity to brain tissue composition, and examine novel fluid biomarkers showing specificity for pathological processes, including seed amplification assays and extracellular vesicles. We reflect on these biomarkers in the context of new biological staging systems, and on emerging techniques currently in development.

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Lacunes may worsen cognition but not motor function in Parkinson's disease

Cited by 3 publications

References 61 publications

Pathobiology of Cognitive Impairment in Parkinson Disease: Challenges and Outlooks

Pathobiology of Cognitive Impairment in Parkinson Disease: Challenges and Outlooks

Lacunes may worsen cognition but not motor function in Parkinson's disease

Neuroimaging and fluid biomarkers in Parkinson’s disease in an era of targeted interventions

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