Visual rating of white matter hyperintensities in Parkinson's disease

Beyer, Mona K.; Aarsland, Dag; Greve, Ole Jacob; Larsen, Jan Petter

doi:10.1002/mds.20704

Cited by 99 publications

(107 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These findings should be interpreted with caution, as in addition to the small sample size analyzed, there was no difference in the WMHs burden in PD patients with dementia when compared to control subjects, whilst nondemented patients with PD exhibited fewer WMHs than controls [18].…”

Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

“…Moreover, WMHs have been related to a high risk of MCI and a greater decline in global cognitive performance, executive function, and processing speed [15]. In PD, the relationship between WMHs, MCI, and dementia remains unclear [16][17][18][19]23,34].Cross-sectional studies have reported that WMHs burden and cognitive impairment are not associated in PD [16,19,23,34]. Actually, WMHs was not found to contribute to either MCI or attention-executive dysfunction in a cohort of newly diagnosed and untreated patients with PD [19], and WMHs severity was similar in advanced PD patients with dementia, MCI or with no cognitive disability [16].…”

mentioning

confidence: 99%

See 2 more Smart Citations

The impact of silent vascular brain burden in cognitive impairment in Parkinson’s disease

González-Redondo

Toledo

Clavero

et al. 2012

Euro J of Neurology

View full text Add to dashboard Cite

BACKGROUND AND PURPOSEWhite matter hyperintensities (WMHs) detected by magnetic resonance imaging (MRI) of the brain are associated with dementia and cognitive impairment in the general population and in Alzheimer's disease. Their effect in cognitive decline and dementia associated with Parkinson's disease (PD) is still unclear. METHODSWe studied the relationship between WMHs and cognitive state in 111 patients with PD classified as cognitively normal (n = 39), with a mild cognitive impairment (MCI) (n = 46) or dementia (n = 26), in a cross-sectional and follow-up study. Cognitive state was evaluated with a comprehensive neuropsychological battery, and WMHs were identified in FLAIR and T2-weighted MRI. The burden of WMHs was rated using the Scheltens scale. RESULTSNo differences in WMHs were found between the three groups in the cross-sectional study. A negative correlation was observed between semantic fluency and the subscore for WMHs in the frontal lobe. Of the 36 non-demented patients re-evaluated after a mean follow-up of 30 months, three patients converted into MCI and 5 into dementia. Progression of periventricular WMHs was associated with an increased conversion to dementia. A marginal association between the increase in total WMHs burden and worsening in the Mini Mental State Examination was encountered. CONCLUSIONSWhite matter hyperintensities do not influence the cognitive status of patients with PD. Frontal WMHs have a negative impact on semantic fluency. Brain vascular burden may have an effect on cognitive impairment in patients with PD as WMHs increase overtime might increase the risk of conversion to dementia. This finding needs further confirmation in larger prospective studies. [5][6][7][8]. Silent vascular lesions, identified as white matter hyperintensities (WMHs) [9], are associated with dementia in the general population [10][11][12], and they are thought to aggravate cognitive impairment in Alzheimer's disease (AD) [13] and LB disease [14]. Moreover, WMHs are linked to an in-creased risk of cognitive decline in the elderly and to mild cognitive impairment (MCI) in the general population [15]. The relationship between dementia [16][17][18] and MCI [16,17,19] in PD and WMHs is controversial. Therefore, we analyzed WMHs in cerebral magnetic resonance images (MRI) from a large cohort of patients with PD using a cross-sectional and longitudinal design, to assess the possible relationship between silent vascular lesions and dementia or MCI in this population. KEYWORDS PATIENTS AND METHODSThe Ethics Committee for Medical Research of the Clinic Universidad de Navarra approved the study, and all participants, or legal representatives, provided their written informed consent.Patients with PD [21] over 60 years of age and with disease duration of at least 10 years were recruited. Patients with other neurological or psychiatric disorders, severe systemic or vascular disease (stroke, ischaemic heart disease, atherosclerosis, arterial by-pass surgery), or previous cerebral surgery were excluded. Other ...

show abstract

Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

The impact of silent vascular brain burden in cognitive impairment in Parkinson’s disease

González-Redondo

Toledo

Clavero

et al. 2012

Euro J of Neurology

View full text Add to dashboard Cite

show abstract

“…Additionally, frontal type cognitive dysfunctions in patients with MSA may be associated with subcortical cognitive dysfunctions secondary to striatal or subcortical white matter pathology [4,15,17]. Furthermore, Beyer et al [2] reported that WMH was more severe in patients with Parkinson's disease (PD) dementia compared with those with non-demented PD. WMH was the only variable that was significantly associated with minimental state examination score, suggesting that WMH in the deep white matter may contribute to dementia in PD.…”

Section: Discussionmentioning

confidence: 99%

White matter hyperintensities in patients with multiple system atrophy

et al. 2009

View full text Add to dashboard Cite

Recent studies have reported that the majority of patients with multiple system atrophy (MSA) had hypertensive heart disease. However, the effect of autonomic failure on the brain in MSA has not been studied. We consecutively enrolled 63 patients with MSA and selected 63 age-and sex-matched healthy subjects. We performed a comparative analysis of cerebrovascular lesions between the patients with MSA and the control subjects and analyzed predisposing factors for cerebrovascular lesions in the patients with MSA. There was no significant difference in lacune and territorial infarcts between the patients with MSA and the control subjects. The median grading score of white matter hyperintensity (WMH) was significantly higher in the patients with MSA (1.0, interquartile range 0.5-2.0) than the control subjects (0.0, interquartile range 0.0-1.0; P \ 0.01). In the patients with MSA, there was strong correlation between the grading score of WMH and supine systolic blood pressure (r = 0.529, P \ 0.001) after adjusting for age. Multiple linear regression analysis showed that age and supine systolic blood pressure was significantly and independently correlated with the grading score of WMH. The present study demonstrates that patients with MSA had more severe WMH and that supine systolic pressure is a major contributing factor for the severity of WMH, suggesting that patients with MSA have target-organ damage of the brain.

show abstract

“…The literature on the role of vascular risk factors, and especially on commonly found white matter hyperintensities (WMH) in MRI in elderly PD patients, is rather scarce and inconclusive, finding the contribution to be rather modest [6,7,8] or even absent [9,10,11]. Only a few studies suggest that WMH constitute an independent risk factor associated with cognitive impairment in PD [12,13]. PD as well as Alzheimer's disease (AD) belong to age-related disorders.…”

Section: Introductionmentioning

confidence: 99%

The Impact of MRI White Matter Hyperintensities on Dementia in Parkinson's Disease in Relation to the Homocysteine Level and Other Vascular Risk Factors

et al. 2012

View full text Add to dashboard Cite

Background: The role of white matter hyperintensities (WMH) and homocysteine (Hcy) and other vascular risk factors in the pathogenesis of Parkinson's disease (PD) dementia (PDD) remains unclear. Objective: The aim of the study was to assess the impact of WMH, Hcy and other biochemical and vascular risk factors on PDD. Methods: A total of 192 patients with PD and 184 age- and sex-matched healthy controls were included. A semistructured interview was used to assess demographic and clinical variables with respect to vascular risk factors (arterial hypertension, diabetes mellitus, atrial fibrillation, ischemic heart disease, obliterative atherosclerosis, hypercholesterolemia, smoking, alcohol intake). Unified Parkinson's Disease Rating Scale score, Hoehn-Yahr staging and the Schwab-England activities of daily living scale were used to assess motor abilities and activities of daily living. A complex neuropsychological examination with a battery of tests was used to classify patients into a group with dementia (PDD) and a group without dementia (PD). Neuroradiological examination of MRI scans included visual rating scales for WMH (according to the Wahlund and Erkinjunntti rating scales) and the Scheltens scale for hippocampal atrophy. Blood samples for Hcy, folate, vitamin B12, fibrinogen, lipids, glucose, creatinine, transaminases and thyroid stimulating hormone (TSH) were examined. Results: Among all patients, 57 (29.7%) fulfilled the diagnostic criteria for dementia. Significantly higher Hcy plasma levels were noted in PD and PDD groups compared to controls (p < 0.05) and in PDD when compared to PD (p < 0.05). According to multivariate regression analysis, WMH (Erkinjuntti scale), high Hcy, low vitamin B12 and folate plasma levels were independent risk factors for PDD. Vascular risk factors did not play any role in the pathogenesis of PDD and WMH. Conclusions: WMH along with Hcy, folate and vitamin B12 may impact cognition in PD. Therapy with vitamin B12, folate and catechol-O-methyltransferase inhibitors may play a potential protective role against PDD.

show abstract

Visual rating of white matter hyperintensities in Parkinson's disease

Cited by 99 publications

References 46 publications

The impact of silent vascular brain burden in cognitive impairment in Parkinson’s disease

The impact of silent vascular brain burden in cognitive impairment in Parkinson’s disease

White matter hyperintensities in patients with multiple system atrophy

The Impact of MRI White Matter Hyperintensities on Dementia in Parkinson's Disease in Relation to the Homocysteine Level and Other Vascular Risk Factors

Contact Info

Product

Resources

About