1
|
Carvalho de Abreu DC, Pieruccini-Faria F, Son S, Montero-Odasso M, Camicioli R. Is white matter hyperintensity burden associated with cognitive and motor impairment in patients with parkinson's disease? A systematic review and meta-analysis. Neurosci Biobehav Rev 2024; 161:105677. [PMID: 38636832 DOI: 10.1016/j.neubiorev.2024.105677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/08/2024] [Accepted: 04/12/2024] [Indexed: 04/20/2024]
Abstract
White matter damage quantified as white matter hyperintensities (WMH) may aggravate cognitive and motor impairments, but whether and how WMH burden impacts these problems in Parkinson's disease (PD) is not fully understood. This study aimed to examine the association between WMH and cognitive and motor performance in PD through a systematic review and meta-analysis. We compared the WMH burden across the cognitive spectrum (cognitively normal, mild cognitive impairment, dementia) in PD including controls. Motor signs were compared in PD with low/negative and high/positive WMH burden. We compared baseline WMH burden of PD who did and did not convert to MCI or dementia. MEDLINE and EMBASE databases were used to conduct the literature search resulting in 50 studies included for data extraction. Increased WMH burden was found in individuals with PD compared with individuals without PD (i.e. control) and across the cognitive spectrum in PD (i.e. PD, PD-MCI, PDD). Individuals with PD with high/positive WMH burden had worse global cognition, executive function, and attention. Similarly, PD with high/positive WMH presented worse motor signs compared with individuals presenting low/negative WMH burden. Only three longitudinal studies were retrieved from our search and they showed that PD who converted to MCI or dementia, did not have significantly higher WMH burden at baseline, although no data was provided on WMH burden changes during the follow up. We conclude, based on cross-sectional studies, that WMH burden appears to increase with PD worse cognitive and motor status in PD.
Collapse
Affiliation(s)
- Daniela Cristina Carvalho de Abreu
- Post-doctoral fellow at Gait and Brain Lab, University of Western Ontario, Canada, and Associated Professor of Physiotherapy Course, Department of Health Sciences, Rehabilitation and Functional Performance Program, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
| | - Frederico Pieruccini-Faria
- Deparment of Medicine, Schulich School of Medicine and Dentistry, The University of Western Ontario, Lawson Health Research Institute, St. Josephs Health Care, Parkwood Institute, Deputy Director of the Gait & Brain Lab, Canada
| | - Surim Son
- Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, Statistician, Departments of Medicine, University of Western Ontario, Canada, Parkwood Institute, Lawson Health Research Institute, Canada
| | - Manuel Montero-Odasso
- Departments of Medicine, and Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, Canada Director of Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, Canada
| | - Richard Camicioli
- Department of Medicine, Division of Neurology, University of Alberta, Canada
| |
Collapse
|
2
|
Jellinger KA. Pathobiology of Cognitive Impairment in Parkinson Disease: Challenges and Outlooks. Int J Mol Sci 2023; 25:498. [PMID: 38203667 PMCID: PMC10778722 DOI: 10.3390/ijms25010498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/11/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
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.
Collapse
Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, A-1150 Vienna, Austria
| |
Collapse
|
3
|
Zhao W, Cheng B, Zhu T, Cui Y, Shen Y, Fu X, Li M, Feng Y, Zhang S. Effects of white matter hyperintensity on cognitive function in PD patients: a meta-analysis. Front Neurol 2023; 14:1203311. [PMID: 37621858 PMCID: PMC10445042 DOI: 10.3389/fneur.2023.1203311] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 07/27/2023] [Indexed: 08/26/2023] Open
Abstract
Background Parkinson's disease (PD) is often accompanied by cognitive dysfunction, which imposes a heavy burden on patients, their families, and society. Early identification and intervention are particularly important, but reliable biomarkers for identifying PD-related cognitive impairment at an early stage are currently lacking. Although numerous clinical studies have investigated the association between brain white matter hyperintensity (WMH) and cognitive decline, the findings regarding the relationships between WMH and cognitive dysfunction in PD patients have been inconsistent. Therefore, this study aims to conduct a meta-analysis of the effect of WMH on PD cognitive function. Methods This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines. We systematically searched relevant literature from databases such as PubMed, Web of Science, EMBASE, CNKI, and CBM. The retrieval time was limited to database records created up until December 31, 2022. Additionally, we manually retrieved references for full-text reading. Statistical data analysis was performed using RevMan 5.3 and Stata 15.0 software. Results This study encompassed 23 individual studies and involved 2,429 patients with PD. The group of PD with mild cognitive impairment (PD-MCI) exhibited a significantly higher overall level of WMH than the group of PD with normal cognitive function (PD-NC) (SMD = 0.37, 95% CI: 0.21-0.52, p < 0.01). This finding was consistent across subgroup analyses based on different ethnicities (Asian or Caucasian), WMH assessment methods (visual rating scale or volumetry), and age matching. In addition to the overall differences in WMH load between the PD-MCI and PD-NC groups, the study found that specific brain regions, including periventricular white matter hyperintensity (PVH) and deep white matter hyperintensity (DWMH), had significantly higher WMH load in the PD-MCI group compared to the PD-NC group. The study also conducted a meta-analysis of WMH load data for PD with dementia (PDD) and PD without dementia (PDND), revealing that the overall WMH load in the PDD group was significantly higher than that in the PDND group (SMD = 0.98, 95% CI: 0.56-1.41, p < 0.01). This finding was consistent across subgroup analyses based on different ethnicities and age matching. Moreover, regarding specific brain regions (PVH or DWMH), the study found that the PDD group had significantly higher WMH load than the PDND group (p < 0.01). Conclusion WMH was associated with PD cognitive dysfunction. The early appearance of WMH may indicate PD with MCI.
Collapse
Affiliation(s)
- Wenhao Zhao
- Department of Neurology, Affiliated Hospital of Medical College, North Sichuan Medical College, Nanchong, China
| | - Bo Cheng
- Department of Neurology, Affiliated Hospital of Medical College, North Sichuan Medical College, Nanchong, China
| | - Tao Zhu
- Department of Preventive Medicine, North Sichuan Medical College, Nanchong, China
| | - Yingjuan Cui
- Department of Nursing, Affiliated Hospital of Medical College, North Sichuan Medical College, Nanchong, China
| | - Yao Shen
- Department of Neurology, Affiliated Hospital of Medical College, North Sichuan Medical College, Nanchong, China
| | - Xudong Fu
- Department of Neurology, Affiliated Hospital of Medical College, North Sichuan Medical College, Nanchong, China
| | - Maogeng Li
- Department of Neurology, Affiliated Hospital of Medical College, North Sichuan Medical College, Nanchong, China
| | - Yuliang Feng
- Department of Neurology, Affiliated Hospital of Medical College, North Sichuan Medical College, Nanchong, China
| | - Shushan Zhang
- Department of Neurology, Affiliated Hospital of Medical College, North Sichuan Medical College, Nanchong, China
| |
Collapse
|
4
|
Schröter N, Bormann T, Rijntjes M, Blazhenets G, Berti R, Sajonz BE, Urbach H, Weiller C, Meyer PT, Rau A, Frings L. Cognitive Deficits in Parkinson's Disease Are Associated with Neuronal Dysfunction and Not White Matter Lesions. Mov Disord Clin Pract 2023; 10:1066-1073. [PMID: 37476309 PMCID: PMC10354622 DOI: 10.1002/mdc3.13792] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 04/25/2023] [Accepted: 05/04/2023] [Indexed: 07/22/2023] Open
Abstract
Background Cognitive deficits considerably contribute to the patient's burden in Parkinson's disease (PD). While cognitive decline is linked to neuronal dysfunction, the additional role of white matter lesions (WML) is discussed controversially. Objective To investigate the influence of WML, in comparison to neuronal dysfunction, on cognitive deficits in PD. Methods We prospectively recruited patients with PD who underwent neuropsychological assessment using the Mattis Dementia Rating Scale 2 (DRS-2) or Parkinson Neuropsychometric Dementia Assessment (PANDA) and both MRI and PET with [18F]fluorodeoxyglucose (FDG). WML-load and PD cognition-related covariance pattern (PDCP) as a measure of neuronal dysfunction were read out. Relationship between cognitive performance and rank-transformed WML was analyzed with linear regression, controlling for the patients' age. PDCP subject scores were investigated likewise and in a second step adjusting for age and WML load. Results Inclusion criteria were met by 76 patients with a mean (± SD) age of 63.5 ± 9.0 years and disease duration of 10.7 ± 5.4 years. Neuropsychological testing revealed front executive and parietal deficits and a median DRS-2 score of 137 (range 119-144)/144 and PANDA score of 22 (range 3-30)/30. No association between WML and cognition was observed, whereas PDCP subject scores showed a trend-level negative correlation with the DRS-2 (P = 0.060) as well as a negative correlation with PANDA (P = 0.049) which persisted also after additional correction for WML (P = 0.039). Conclusion The present study indicates that microangiopathic WML do not have a relevant impact on neurocognitive performance in PD whereas neuronal dysfunction does.
Collapse
Affiliation(s)
- Nils Schröter
- Department of Neurology and Clinical Neuroscience, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Tobias Bormann
- Department of Neurology and Clinical Neuroscience, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Michel Rijntjes
- Department of Neurology and Clinical Neuroscience, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Ganna Blazhenets
- Department of Nuclear Medicine, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Raissa Berti
- Department of Nuclear Medicine, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Bastian E.A. Sajonz
- Department of Stereotactic and Functional Neurosurgery, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Horst Urbach
- Department of Neuroradiology, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Cornelius Weiller
- Department of Neurology and Clinical Neuroscience, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Philipp T. Meyer
- Department of Nuclear Medicine, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Alexander Rau
- Department of Neuroradiology, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburgGermany
- Department of Diagnostic and Interventional Radiology, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Lars Frings
- Department of Nuclear Medicine, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburgGermany
- Center for Geriatrics and Gerontology Freiburg, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| |
Collapse
|
5
|
Carvalho de Abreu DC, Pieruccini-Faria F, Sarquis-Adamson Y, Black A, Fraser J, Van Ooteghem K, Cornish B, Grimes D, Jog M, Masellis M, Steeves T, Nanayakkara N, Ramirez J, Scott C, Holmes M, Ozzoude M, Berezuk C, Symons S, Mohammad Hassan Haddad S, Arnott SR, Binns M, Strother S, Beaton D, Sunderland K, Theyers A, Tan B, Zamyadi M, Levine B, Orange JB, Roberts AC, Lou W, Sujanthan S, Breen DP, Marras C, Kwan D, Adamo S, Peltsch A, Troyer AK, Black SE, McLaughlin PM, Lang AE, McIlroy W, Bartha R, Montero-Odasso M. White matter hyperintensity burden predicts cognitive but not motor decline in Parkinson's disease: results from the Ontario Neurodegenerative Diseases Research Initiative. Eur J Neurol 2023; 30:920-933. [PMID: 36692250 DOI: 10.1111/ene.15692] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 12/29/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND PURPOSE The pathophysiology of Parkinson's disease (PD) negatively affects brain network connectivity, and in the presence of brain white matter hyperintensities (WMHs) cognitive and motor impairments seem to be aggravated. However, the role of WMHs in predicting accelerating symptom worsening remains controversial. The objective was to investigate whether location and segmental brain WMH burden at baseline predict cognitive and motor declines in PD after 2 years. METHODS Ninety-eight older adults followed longitudinally from Ontario Neurodegenerative Diseases Research Initiative with PD of 3-8 years in duration were included. Percentages of WMH volumes at baseline were calculated by location (deep and periventricular) and by brain region (frontal, temporal, parietal, occipital lobes and basal ganglia + thalamus). Cognitive and motor changes were assessed from baseline to 2-year follow-up. Specifically, global cognition, attention, executive function, memory, visuospatial abilities and language were assessed as were motor symptoms evaluated using the Movement Disorder Society Unified Parkinson's Disease Rating Scale Part III, spatial-temporal gait variables, Freezing of Gait Questionnaire and Activities Specific Balance Confidence Scale. RESULTS Regression analysis adjusted for potential confounders showed that total and periventricular WMHs at baseline predicted decline in global cognition (p < 0.05). Also, total WMH burden predicted the decline of executive function (p < 0.05). Occipital WMH volumes also predicted decline in global cognition, visuomotor attention and visuospatial memory declines (p < 0.05). WMH volumes at baseline did not predict motor decline. CONCLUSION White matter hyperintensity burden at baseline predicted cognitive but not motor decline in early to mid-stage PD. The motor decline observed after 2 years in these older adults with PD is probably related to the primary neurodegenerative process than comorbid white matter pathology.
Collapse
Affiliation(s)
- Daniela Cristina Carvalho de Abreu
- Gait and Brain Lab, Division of Geriatric Medicine, and Lawson Health Research Institute, Parkwood Institute, University of Western Ontario, Ontario, London, Canada
- Department of Physical Therapy, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Frederico Pieruccini-Faria
- Gait and Brain Lab, Division of Geriatric Medicine, and Lawson Health Research Institute, Parkwood Institute, University of Western Ontario, Ontario, London, Canada
- Gait and Brain Laboratory, Lawson Health Research Institute, London, Ontario, Canada
| | | | - Alanna Black
- Gait and Brain Laboratory, Lawson Health Research Institute, London, Ontario, Canada
| | - Julia Fraser
- Neuroscience, Mobility and Balance Laboratory, Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Karen Van Ooteghem
- Neuroscience, Mobility and Balance Laboratory, Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Benjamin Cornish
- Neuroscience, Mobility and Balance Laboratory, Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - David Grimes
- Department of Medicine (Neurology), Ottawa Hospital Research Institute, University of Ottawa Brain and Mind Research Institute, Ottawa, Ontario, Canada
| | - Mandar Jog
- Division of Neurology, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Mario Masellis
- Cognitive and Movement Disorders Clinic, Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | - Thomas Steeves
- Division of Neurology, Department of Medicine, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Nuwan Nanayakkara
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Joel Ramirez
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | - Christopher Scott
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | - Melissa Holmes
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | - Miracle Ozzoude
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | - Courtney Berezuk
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | - Sean Symons
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | | | - Stephen R Arnott
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Malcolm Binns
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Stephen Strother
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Derek Beaton
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Kelly Sunderland
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Athena Theyers
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Brian Tan
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Mojdeh Zamyadi
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Brian Levine
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Joseph B Orange
- School of Communication Sciences and Disorders, Faculty of Health Sciences, Canadian Centre for Activity and Aging, Western University, London, Ontario, Canada
| | - Angela C Roberts
- School of Communication Sciences and Disorders, Faculty of Health Sciences, Canadian Centre for Activity and Aging, Western University, London, Ontario, Canada
- Department of Computer Science, Western University, London, Ontario, Canada
| | - Wendy Lou
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sujeevini Sujanthan
- Department of Ophthalmology and Visual Sciences, Research Institute of the McGill University Health Center, Montreal, Quebec, Canada
| | - David P Breen
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, UK
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Connie Marras
- Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Donna Kwan
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Sabrina Adamo
- Graduate Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Alicia Peltsch
- Faculty of Engineering and Applied Science, Queen's University, Kingston, Ontario, Canada
| | - Angela K Troyer
- Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Sandra E Black
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | | | - Anthony E Lang
- Division of Neurology, Department of Medicine, Edmond J Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - William McIlroy
- Neuroscience, Mobility and Balance Laboratory, Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Robert Bartha
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Robarts Research Institute, Western University, London, Canada
| | | | - Manuel Montero-Odasso
- Gait and Brain Lab, Division of Geriatric Medicine, and Lawson Health Research Institute, Parkwood Institute, University of Western Ontario, Ontario, London, Canada
- Gait and Brain Laboratory, Lawson Health Research Institute, London, Ontario, Canada
- Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| |
Collapse
|
6
|
de Oliveira P, Martins BJ, Cardoso FEC. White matter hyperintensity presence, quantity, and location exhibits no association with motor and non-motor manifestations of PD. Parkinsonism Relat Disord 2023; 106:105245. [PMID: 36542985 DOI: 10.1016/j.parkreldis.2022.105245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 12/05/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Nonspecific areas of brain white matter hyperintensity (WMH) are commonly found in the elderly. Some studies have shown that the presence, quantity, and location of WMHs may be associated with the development of cognitive and motor decline in patients with Parkinson's disease (PD), but the results remain controversial. This study aimed to evaluate the relationship of WMH to motor and non-motor symptoms, including dysautonomia and rapid eye movement sleep behavior disorder (RBD), in patients with PD. METHODS Brain magnetic resonance images were acquired from 120 patients diagnosed with PD and analyzed for WMH classification and quantification. Motor symptoms were quantified using sub-scores of the Movement Disorder Society-Unified Parkinson Disease Rating Scale (MDS-UPDRS)-III. Dysautonomia was evaluated by autonomic reactivity tests, and polysomnography was used for the diagnosis of RBD. RESULTS Age, total value of the MDS-UPDRS-III tremor sub-score, and the presence of dysautonomia were found to be linearly positively associated. Specifically, the duration of PD was positively associated with rigidity, bradykinesia, axial symptoms, prevalence of dysautonomia, and RBD sub-scores. However, in the multivariate analysis adjusted for variables of interest, no statistical significance was found for any of the models. CONCLUSION The presence, quantity, and location of WMH were not associated with the analyzed motor and non-motor manifestations of PD.
Collapse
Affiliation(s)
- Pérola de Oliveira
- SARAH Network of Rehabilitation Hospitals, Department of Neurology, Brasília, DF, Brazil
| | - Bernardo José Martins
- SARAH Network of Rehabilitation Hospitals, Department of Neurology, Brasília, DF, Brazil
| | - Francisco Eduardo Costa Cardoso
- Federal University of Minas Gerais, Movement Disorders Unit, Neurology Service, Department of Internal Medicine, Belo Horizonte, MG, Brazil.
| |
Collapse
|
7
|
Sinani O, Dadouli K, Ntellas P, Kapsalaki EZ, Vlychou M, Raptis DG, Marogianni C, Markou K, Dardiotis E, Xiromerisiou G. Association between white matter lesions and Parkinson's disease: an impact on Postural/Gait difficulty phenotype and cognitive performance. Neurol Res 2022; 44:1122-1131. [PMID: 35994524 DOI: 10.1080/01616412.2022.2112378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND White matter hyperintensities (WMHs) may be observed on Magnetic Resonance Imaging (MRI) in patients with Parkinson disease with or without vascular risk factors. Whether WMHs may influence motor and non-motor aspects of Parkinson disease is a subject of debate. The aim of this study is to evaluate the impact of WMH severity on various aspects of Parkinson disease in combination to the estimation of the impact of cerebrovascular risk factors. MATERIALS AND METHODS We included a cohort of patients with Parkinson's disease who underwent MRI examination. The Fazekas visual rating scale was used to assess the severity and location of WMHs, and patient clinical characteristics were correlated with MRI data. RESULTS All vascular risk factors were associated with higher Fazekas score in both periventricular and deep white matter. Periventricular white matter hyperintensities (PWMHs) and deep white matter hyperintensities (DWMHs) were associated with lower scores in the ACE-R cognitive assessment scale (p < 0.001). Furthermore, PWMHs and DWMHs severity was associated with higher UPDRS motor score (p < 0.001), while the Postural Instability Gait Difficulty (PIGD) phenotype was correlated with higher burden of WMHs. CONCLUSIONS Comorbid WMHs may contribute to multi-dimension dysfunction in patients with Parkinson disease and consequently the management of vascular risk factors may be crucial to maintain motor and non-motor functions in PD.
Collapse
Affiliation(s)
- Olga Sinani
- Faculty of Medicine, University of Thessaly, Larisa, Greece
| | - Katerina Dadouli
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larisa, Greece
| | - Panagiotis Ntellas
- Department of Medical Oncology, University Hospital of Ioannina, Ioannina, Greece
| | - Eftychia Z Kapsalaki
- Department of Diagnostic Radiology, Faculty of Medicine, University of Thessaly, Larisa, Greece
| | - Marianna Vlychou
- Department of Diagnostic Radiology, Faculty of Medicine, University of Thessaly, Larisa, Greece
| | - Dimitrios G Raptis
- Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Larisa, Greece
| | | | - Katerina Markou
- Department of Neurology, University Hospital of Larisa, Larisa, Greece
| | | | - Georgia Xiromerisiou
- Department of Neurology, University Hospital of Larisa, Larisa, Greece.,Faculty of Medicine, School of Health Sciences, University of Thessaly, Volos, Greece
| |
Collapse
|
8
|
Morphological basis of Parkinson disease-associated cognitive impairment: an update. J Neural Transm (Vienna) 2022; 129:977-999. [PMID: 35726096 DOI: 10.1007/s00702-022-02522-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/25/2022] [Indexed: 12/15/2022]
Abstract
Cognitive impairment is one of the most salient non-motor symptoms of Parkinson disease (PD) that poses a significant burden on the patients and carers as well as being a risk factor for early mortality. People with PD show a wide spectrum of cognitive dysfunctions ranging from subjective cognitive decline and mild cognitive impairment (MCI) to frank dementia. The mean frequency of PD with MCI (PD-MCI) is 25.8% and the pooled dementia frequency is 26.3% increasing up to 83% 20 years after diagnosis. A better understanding of the underlying pathological processes will aid in directing disease-specific treatment. Modern neuroimaging studies revealed considerable changes in gray and white matter in PD patients with cognitive impairment, cortical atrophy, hypometabolism, dopamine/cholinergic or other neurotransmitter dysfunction and increased amyloid burden, but multiple mechanism are likely involved. Combined analysis of imaging and fluid markers is the most promising method for identifying PD-MCI and Parkinson disease dementia (PDD). Morphological substrates are a combination of Lewy- and Alzheimer-associated and other concomitant pathologies with aggregation of α-synuclein, amyloid, tau and other pathological proteins in cortical and subcortical regions causing destruction of essential neuronal networks. Significant pathological heterogeneity within PD-MCI reflects deficits in various cognitive domains. This review highlights the essential neuroimaging data and neuropathological changes in PD with cognitive impairment, the amount and topographical distribution of pathological protein aggregates and their pathophysiological relevance. Large-scale clinicopathological correlative studies are warranted to further elucidate the exact neuropathological correlates of cognitive impairment in PD and related synucleinopathies as a basis for early diagnosis and future disease-modifying therapies.
Collapse
|
9
|
Alves M, Pita Lobo P, Azevedo Kauppila L, Rebordão L, Cruz MM, Guerreiro C, Ferro JM, Ferreira JJ, Reimão S. Neuroimaging cerebrovascular biomarkers in Parkinson's disease. Neuroradiol J 2021; 35:490-496. [PMID: 34872414 PMCID: PMC9437505 DOI: 10.1177/19714009211059118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND PURPOSE The cardiovascular risk in Parkinson's disease (PD) remains uncertain and controversial. Some studies suggest PD patients present an increased risk of cerebrovascular disease. We aimed to study the prevalence of neuroimaging cerebrovascular biomarkers in PD patients compared to controls, using an accurate and complete magnetic resonance (MR) imaging evaluation. MATERIAL AND METHODS Neuroimaging sub-study within a larger cross-sectional case-control study. An enriched subgroup of PD patients (≤10 years since diagnosis) with at least a moderate cardiovascular mortality risk based on a Systematic COronary Risk Evaluation (SCORE) was compared to community-based controls regarding neuroimaging biomarkers. Patients underwent a high-resolution T1-weighted MR imaging sequence at 3.0 T to visualize neuromelanin. A 3D SWI FFE, sagittal 3D T1-weighted, axial FLAIR and diffusion-weighted image sequences were obtained. RESULTS The study included 47 patients, 24 with PD and 23 controls. PD patients presented a reduced area and signal intensity of the substantia nigra and locus coeruleus on neuromelanin-sensitive MR. The median SCORE was 5% in both groups. No significant differences regarding white matter hyperintensities (OR 4.84, 95% CI 0.50, 47.06), lacunes (OR 0.43, 95% CI 0.07, 2.63), microbleeds (OR 0.64, 95% CI 0.13, 3.26), or infarcts (0.95, 95% CI 0.12, 7.41) was found. The frequency of these neuroimaging biomarkers was very low in both groups. CONCLUSION The present study does not support an increased prevalence of neuroimaging cerebrovascular biomarkers in PD patients.
Collapse
Affiliation(s)
- Mariana Alves
- Serviço de Medicina III, 70896Hospital Pulido Valente (CHULN), Lisboa, Portugal.,Avenida Professor Egas Moniz, Faculty of Medicine, 89237University of Lisbon, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, 89237Universidade de Lisboa, Lisbon, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisbon, Lisbon, Portugal
| | - Patrícia Pita Lobo
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisbon, Lisbon, Portugal.,Departamento de Neurociências e Saúde Mental, CHULN, Lisbon, Portugal
| | | | | | - M Manuela Cruz
- Unidade de Saúde Familiar Benfica Jardim, 89237ACES Lisboa Norte, Lisbon, Portugal
| | - Carla Guerreiro
- Neurological Imaging Department, 89237Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal.,Imaging University Clinic, Faculdade de Medicina, 89237Universidade de Lisboa, Lisbon, Portugal
| | - José M Ferro
- Avenida Professor Egas Moniz, Faculty of Medicine, 89237University of Lisbon, Lisbon, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisbon, Lisbon, Portugal.,Departamento de Neurociências e Saúde Mental, CHULN, Lisbon, Portugal
| | - Joaquim J Ferreira
- Avenida Professor Egas Moniz, Faculty of Medicine, 89237University of Lisbon, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, 89237Universidade de Lisboa, Lisbon, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisbon, Lisbon, Portugal.,CNS - Campus Neurológico Sénior, Lisbon, Portugal
| | - Sofia Reimão
- Avenida Professor Egas Moniz, Faculty of Medicine, 89237University of Lisbon, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, 89237Universidade de Lisboa, Lisbon, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisbon, Lisbon, Portugal.,Neurological Imaging Department, 89237Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal.,Imaging University Clinic, Faculdade de Medicina, 89237Universidade de Lisboa, Lisbon, Portugal
| |
Collapse
|
10
|
Brain age and Alzheimer's-like atrophy are domain-specific predictors of cognitive impairment in Parkinson's disease. Neurobiol Aging 2021; 109:31-42. [PMID: 34649002 DOI: 10.1016/j.neurobiolaging.2021.08.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 11/20/2022]
Abstract
Recently, it was shown that patients with Parkinson's disease (PD) who exhibit an "Alzheimer's disease (AD)-like" pattern of brain atrophy are at greater risk for future cognitive decline. This study aimed to investigate whether this association is domain-specific and whether atrophy associated with brain aging also relates to cognitive impairment in PD. SPARE-AD, an MRI index capturing AD-like atrophy, and atrophy-based estimates of brain age were computed from longitudinal structural imaging data of 178 PD patients and 84 healthy subjects from the LANDSCAPE cohort. All patients underwent an extensive neuropsychological test battery. Patients diagnosed with mild cognitive impairment or dementia were found to have higher SPARE-AD scores as compared to patients with normal cognition and healthy controls. All patient groups showed increased brain age. SPARE-AD predicted impairment in memory, language and executive functions, whereas advanced brain age was associated with deficits in attention and working memory. Data suggest that SPARE-AD and brain age are differentially related to domain-specific cognitive decline in PD. The underlying pathomechanisms remain to be determined.
Collapse
|
11
|
Liu H, Deng B, Xie F, Yang X, Xie Z, Chen Y, Yang Z, Huang X, Zhu S, Wang Q. The influence of white matter hyperintensity on cognitive impairment in Parkinson's disease. Ann Clin Transl Neurol 2021; 8:1917-1934. [PMID: 34310081 PMCID: PMC8419402 DOI: 10.1002/acn3.51429] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/05/2021] [Accepted: 07/02/2021] [Indexed: 01/11/2023] Open
Abstract
The aim of this meta‐analysis was to review systematically and to identify the relationship between the severity and location of white matter hyperintensities (WMHs) and the degree of cognitive decline in patients with Parkinson’s disease (PD). We searched the PubMed, EMBASE, Web of Science, Ovid, and Cochrane Library databases for clinical trials of the severity and location of WMHs on the degree of cognitive impairment in PD through October 2020. We conducted the survey to compare the association of WMH burden in patients with PD with mild cognitive impairment (PD‐MCI) versus those with normal cognition (PD‐NC) and in patients with PD with dementia (PDD) versus those with PD without dementia (PD‐ND). Nine studies with PD‐MCI versus PD‐NC and 10 studies with PDD versus PD‐ND comparisons were included. The WMH burden in PD‐MCI patients was significantly different compared to that in PD‐NC patients (standard mean difference, SMD = 0.39, 95% CI: 0.12 to 0.66, p = 0.005), while there was no correlation shown in the age‐matched subgroup of the comparison. In addition, PDD patients had a significantly higher burden of WMHs (SMD = 0.8, 95% CI: 0.44 to 1.71, p < 0.0001), especially deep white matter hyperintensities (SMD = 0.54, 95% CI: 0.36 to 0.73, p < 0.00001) and periventricular hyperintensities (SMD = 0.70, 95% CI: 0.36 to 1.04, p < 0.0001), than PD‐NC patients, regardless of the adjustment of age. WMHs might be imaging markers for cognitive impairment in PDD but not in PD‐MCI, regardless of age, vascular risk factors, or race. Further prospective studies are needed to validate the conclusions.
Collapse
Affiliation(s)
- Hailing Liu
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, 510282, P.R. China.,Department of Neurology, Maoming People's Hospital, Maoming, Guangdong, China
| | - Bin Deng
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, 510282, P.R. China
| | - Fen Xie
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, 510282, P.R. China
| | - Xiaohua Yang
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, 510282, P.R. China
| | - Zhenchao Xie
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, 510282, P.R. China
| | - Yonghua Chen
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, 510282, P.R. China
| | - Zhi Yang
- Department of Neurology, Maoming People's Hospital, Maoming, Guangdong, China
| | - Xiyan Huang
- Department of Rehabilitation, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, 510282, P.R. China
| | - Shuzhen Zhu
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, 510282, P.R. China
| | - Qing Wang
- Department of Neurology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, 510282, P.R. China
| |
Collapse
|
12
|
Pierzchlińska A, Kwaśniak-Butowska M, Sławek J, Droździk M, Białecka M. Arterial Blood Pressure Variability and Other Vascular Factors Contribution to the Cognitive Decline in Parkinson's Disease. Molecules 2021; 26:molecules26061523. [PMID: 33802165 PMCID: PMC8001922 DOI: 10.3390/molecules26061523] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 11/24/2022] Open
Abstract
Dementia is one of the most disabling non-motor symptoms in Parkinson’s disease (PD). Unlike in Alzheimer’s disease, the vascular pathology in PD is less documented. Due to the uncertain role of commonly investigated metabolic or vascular factors, e.g., hypertension or diabetes, other factors corresponding to PD dementia have been proposed. Associated dysautonomia and dopaminergic treatment seem to have an impact on diurnal blood pressure (BP) variability, which may presumably contribute to white matter hyperintensities (WMH) development and cognitive decline. We aim to review possible vascular and metabolic factors: Renin-angiotensin-aldosterone system, vascular endothelial growth factor (VEGF), hyperhomocysteinemia (HHcy), as well as the dopaminergic treatment, in the etiopathogenesis of PD dementia. Additionally, we focus on the role of polymorphisms within the genes for catechol-O-methyltransferase (COMT), apolipoprotein E (APOE), vascular endothelial growth factor (VEGF), and for renin-angiotensin-aldosterone system components, and their contribution to cognitive decline in PD. Determining vascular risk factors and their contribution to the cognitive impairment in PD may result in screening, as well as preventive measures.
Collapse
Affiliation(s)
- Anna Pierzchlińska
- Department of Pharmacokinetics and Therapeutic Drug Monitoring, Pomeranian Medical University, Aleja Powstańców Wlkp 72, 70-111 Szczecin, Poland;
- Correspondence: (A.P.); (M.D.)
| | - Magdalena Kwaśniak-Butowska
- Division of Neurological and Psychiatric Nursing, Medical University of Gdansk, Aleja Jana Pawła II 50, 80-462 Gdansk, Poland; (M.K.-B.); (J.S.)
- Department of Neurology, St Adalbert Hospital, Aleja Jana Pawła II 50, 80-462 Gdansk, Poland
| | - Jarosław Sławek
- Division of Neurological and Psychiatric Nursing, Medical University of Gdansk, Aleja Jana Pawła II 50, 80-462 Gdansk, Poland; (M.K.-B.); (J.S.)
- Department of Neurology, St Adalbert Hospital, Aleja Jana Pawła II 50, 80-462 Gdansk, Poland
| | - Marek Droździk
- Department of Experimental and Clinical Pharmacology, Pomeranian Medical University, Aleja Powstańców Wlkp 72, 70-111 Szczecin, Poland
- Correspondence: (A.P.); (M.D.)
| | - Monika Białecka
- Department of Pharmacokinetics and Therapeutic Drug Monitoring, Pomeranian Medical University, Aleja Powstańców Wlkp 72, 70-111 Szczecin, Poland;
| |
Collapse
|
13
|
Linortner P, McDaniel C, Shahid M, Levine TF, Tian L, Cholerton B, Poston KL. White Matter Hyperintensities Related to Parkinson's Disease Executive Function. Mov Disord Clin Pract 2020; 7:629-638. [PMID: 32775508 PMCID: PMC7396844 DOI: 10.1002/mdc3.12956] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/05/2020] [Accepted: 04/04/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND People with Parkinson's disease (PD) can develop multidomain cognitive impairments; however, it is unclear whether different pathologies underlie domain-specific cognitive dysfunction. OBJECTIVES We investigated the contribution of vascular copathology severity and location, as measured by MRI white matter hyperintensities (WMHs), to domain-specific cognitive impairment in PD. METHODS We studied 85 PD (66.6 ± 9.2 years) and 18 control (65.9 ± 6.6) participants. Using the Fazekas scale for rating the severity of WMH, we subdivided PD into 14 PD-WMH+ and 71 PD-WMH-. Participants underwent global, executive, visuospatial, episodic memory, and language testing. We performed nonparametric permutation testing to create WMH probability maps based on PD-WMH group and cognitive test performance. RESULTS The PD-WMH+ group showed worse global and executive cognitive performance than the PD-WMH- group. On individual tests, the PD-WMH+ group showed worse Montreal Cognitive Assessment (MoCA), Stroop, Symbol Digit Modalities Test (SDMT), and Digit Span scores. WMH probability maps showed that in the PD-WMH+ group, worse Stroop was associated with lesions centered around the corticospinal tract (CST), forceps major, inferior-fronto-occipital fasciculus, and superior longitudinal fasciculus; worse SDMT with lesions around the CST, forceps major, and posterior corona radiata; worse Digit Span with lesions around the posterior corona radiata; and worse MoCA with lesions around the CST. CONCLUSIONS We found that WMH severity was associated with PD executive dysfunction, including worse attention, working memory, and processing speed. Disruption of key white matter tracts in proximity to vascular lesions could contribute to these specific cognitive impairments. Early treatment of vascular disease might mitigate some executive dysfunction in a subset of patients with PD.
Collapse
Affiliation(s)
- Patricia Linortner
- Department of Neurology and Neurological SciencesStanford UniversityPalo AltoCaliforniaUSA
| | - Colin McDaniel
- Department of Neurology and Neurological SciencesStanford UniversityPalo AltoCaliforniaUSA
| | - Marian Shahid
- Department of Neurology and Neurological SciencesStanford UniversityPalo AltoCaliforniaUSA
| | - Taylor F. Levine
- Department of Neurology and Neurological SciencesStanford UniversityPalo AltoCaliforniaUSA
- Psychological & Brain SciencesWashington UniversitySt. LouisMissouriUSA
| | - Lu Tian
- Department of Biomedical Data ScienceStanford UniversityPalo AltoCaliforniaUSA
| | - Brenna Cholerton
- Department of PathologyStanford UniversityPalo AltoCaliforniaUSA
| | - Kathleen L. Poston
- Department of Neurology and Neurological SciencesStanford UniversityPalo AltoCaliforniaUSA
- Department of NeurosurgeryStanford UniversityPalo AltoCaliforniaUSA
| |
Collapse
|
14
|
Ramirez J, Dilliott AA, Binns MA, Breen DP, Evans EC, Beaton D, McLaughlin PM, Kwan D, Holmes MF, Ozzoude M, Scott CJM, Strother SC, Symons S, Swartz RH, Grimes D, Jog M, Masellis M, Black SE, Joutel A, Marras C, Rogaeva E, Hegele RA, Lang AE. Parkinson's Disease, NOTCH3 Genetic Variants, and White Matter Hyperintensities. Mov Disord 2020; 35:2090-2095. [PMID: 32573853 DOI: 10.1002/mds.28171] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/01/2020] [Accepted: 05/26/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND White matter hyperintensities (WMH) on magnetic resonance imaging may influence clinical presentation in patients with Parkinson's disease (PD), although their significance and pathophysiological origins remain unresolved. Studies examining WMH have identified pathogenic variants in NOTCH3 as an underlying cause of inherited forms of cerebral small vessel disease. METHODS We examined NOTCH3 variants, WMH volumes, and clinical correlates in 139 PD patients in the Ontario Neurodegenerative Disease Research Initiative cohort. RESULTS We identified 13 PD patients (~9%) with rare (<1% of general population), nonsynonymous NOTCH3 variants. Bayesian linear modeling demonstrated a doubling of WMH between variant negative and positive patients (3.1 vs. 6.9 mL), with large effect sizes for periventricular WMH (d = 0.8) and lacunes (d = 1.2). Negative correlations were observed between WMH and global cognition (r = -0.2). CONCLUSION The NOTCH3 rare variants in PD may significantly contribute to increased WMH burden, which in turn may negatively influence cognition. © 2020 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Joel Ramirez
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Allison A Dilliott
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Biochemistry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Malcolm A Binns
- Rotman Research Institute, Baycrest, Toronto, Ontario, Canada
| | - David P Breen
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.,Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, United Kingdom.,Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Emily C Evans
- Mississauga Academy of Medicine, University of Toronto Mississauga, Mississauga, Ontario, Canada
| | - Derek Beaton
- Rotman Research Institute, Baycrest, Toronto, Ontario, Canada
| | - Paula M McLaughlin
- Queen's University, Centre for Neuroscience Studies, Kingston, Ontario.,Nova Scotia Health Authority, Dalhousie University, Department of Medicine-Geriatrics, Halifax, Nova Scotia, Canada
| | - Donna Kwan
- Queen's University, Centre for Neuroscience Studies, Kingston, Ontario
| | - Melissa F Holmes
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Miracle Ozzoude
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Christopher J M Scott
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | | | - Sean Symons
- Department of Medical Imaging, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Richard H Swartz
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine (Neurology), Sunnybrook Health Sciences Centre and University of Toronto, Ontario, Canada
| | - David Grimes
- University of Ottawa Brain and Mind Research Institute, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Mandar Jog
- Department of Clinical Neurological Sciences, Western University, London, Canada
| | - Mario Masellis
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine (Neurology), Sunnybrook Health Sciences Centre and University of Toronto, Ontario, Canada
| | - Sandra E Black
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine (Neurology), Sunnybrook Health Sciences Centre and University of Toronto, Ontario, Canada
| | - Anne Joutel
- Institute of Psychiatry and Neuroscience of Paris- Institut national de la santé et de la recherche médicale (INSERM), Paris Descartes University, Paris, France
| | - Connie Marras
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Ontario, Canada
| | - Robert A Hegele
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Biochemistry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Anthony E Lang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada
| | | |
Collapse
|