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White matter hyperintensities, gray matter atrophy and cognitive deficits in Parkinson’s disease
Author(s) -
Dadar Mahsa,
Gee Myrlene,
Duchesne Simon,
Camicioli Richard
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.041161
Subject(s) - hyperintensity , atrophy , medicine , magnetic resonance imaging , cohort , psychology , cardiology , white matter , fluid attenuated inversion recovery , grey matter , radiology
Background MRI features of grey matter atrophy and White Matter Hyperintensities (WMHs) of cerebrovascular origin have been linked to cognitive symptoms in Parkinson’s disease (PD) (Yau 2018, Dadar 2018). Here we assess the relationship between WMH burden, gray matter atrophy in the Hippocampi and cognitive symptoms in PD. Method Data included 50 PD patients and 45 age‐matched controls with T1‐weighted and FLAIR scans at baseline, month18, and month36. WMHs were segmented using T1‐weighted and FLAIR images and a random forests classifier (Dadar et al. 2017, Figure 1.a). SNIPE (Scoring by Nonlocal Image Patch Estimator) was used to measure Alzheimer’s‐disease‐like atrophy patterns in the left and right hippocampi (Figure 1.b, Coupé et al. 2019). The relationship between MRI features and clinical scores was assessed using mixed‐effects models: where Cohort denotes a categorical variable contrasting PD versus controls, and ID denotes the categorical random effects. The variables of interest were MRI‐Feature (implying an overall association between the MRI feature and clinical score of interest) and the interaction term Cohort:MRI‐Score (implying an additional PD‐specific impact of the MRI‐Feature on the Clinical‐Score). Log‐transformed WMH volumes and SNIPE grading in the left and right Hippocampi were used as MRI features. Total Dementia Rating Scale (DRS) was the dependent variable of interest reflecting cognitive performance. Result WMH load significantly increased with age in both groups (t=9.95, p<0.0001). We did not find a significant group difference in WMH volumes. We did not find a significant association between WMH load and Total DRS score in either group. Total DRS significantly decreased with age (t=‐2.23, p<0.04) and decrease in Hippocampal grading (t LeftHC =2.83, p RighHC =0.005, t LeftHC =2.55, p RighHC =0.01), with a marginally greater impact in PDs (Figure 2, t LeftHC =1.80, p RighHC =0.07, t LeftHC =1.58, p RighHC =0.10). Conclusion In our cohort, hippocampal atrophy was significantly associated with cognitive deficits in both controls and PD patients, with a slightly greater impact in the PD group. We did not observe an impact of vascular disease burden on cognitive performance.