RT Journal Article
SR Electronic
T1 White Matter Hyperintensities and Cognitive Decline in de Novo Parkinson’s Disease Patients
JF bioRxiv
FD Cold Spring Harbor Laboratory
SP 230896
DO 10.1101/230896
A1 Mahsa Dadar
A1 Yashar Zeighami
A1 Yvonne Yau
A1 Seyed-Mohammad Fereshtehnejad
A1 Josefina Maranzano
A1 Ronald B. Postuma
A1 Alain Dagher
A1 D. Louis Collins
YR 2017
UL http://biorxiv.org/content/early/2017/12/08/230896.abstract
AB Objective White Matter Hyperintensities (WMHs) are associated with cognitive decline in normative aging and Alzheimer’s disease. However, the pathogenesis of cognitive decline in Parkinson’s disease (PD) is not directly related to vascular causes, and therefore the role of WMHs in PD remains unclear. If WMH has a higher impact on cognitive decline in PD, vascular pathology should be assessed and treated with a higher priority in this population. Here we investigate whether WMH leads to increased cognitive decline in PD, and if these effects relate to cortical thinningMethods To investigate the role of WMHs in PD, it is essential to study recently-diagnosed/non-treated patients. De novo PD patients and age-matched controls (NPD=365,NControl=174) with FLAIR/T2-weighted scans at baseline were selected from Parkinson’s Progression Markers Initiative (PPMI). WMHs and cortical thickness were measured to analyse the relationship between baseline WMHs and future cognitive decline (follow-up:4.09±1.14 years) and cortical thinning (follow-up:1.05±0.10 years).Results High WMH load (WMHL) at baseline in PD was associated with increased cognitive decline, significantly more than i) PDs with low WMHL and ii) controls with high WMHL. Furthermore, PD patients with higher baseline WMHL showed more cortical thinning in right frontal lobe than subjects with low WMHL. Cortical thinning of this region also predicted decline in performance on a cognitive test.Interpretation Presence of WMHs in de novo PD patients predicts greater future cognitive decline and cortical thinning than in normal aging. Recognizing WMHs as a potential predictor of cognitive deficit in PD provides an opportunity for timely interventions.