Open AccessExploring the association between Cerebral small‐vessel diseases and motor symptoms in Parkinson's disease
Author(s) -
Wan Ying,
Hu Wenjian,
Gan Jing,
Song Lu,
Wu Na,
Chen Yuzhen,
Liu Zhenguo
Publication year - 2019
Publication title -
brain and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.915
H-Index - 41
ISSN - 2162-3279
DOI - 10.1002/brb3.1219
Subject(s) - hamd , hyperintensity , leukoaraiosis , anxiety , depression (economics) , rating scale , hamilton anxiety rating scale , parkinson's disease , cognitive impairment , medicine , disease , cardiology , physical medicine and rehabilitation , physical therapy , psychology , dementia , psychiatry , magnetic resonance imaging , radiology , developmental psychology , macroeconomics , economics
Objectives to explore the association between cerebral small‐vessel diseases ( CSVD s) and motor symptoms in Parkinson's disease ( PD ). Methods 137 PD patients were recruited into the study. Detailed motor symptoms, including tremor, rigidity, bradykinesia, and axial impairment, were evaluated using Unified Parkinson's disease Rating Scale ( UPDRS ). Non‐motor symptoms, including cognition, anxiety, and depression, were evaluated using Montreal Cognitive Assessment (Mo CA ), Hamilton anxiety scale ( HAMA ), and Hamilton depression scale ( HAMD ). Brain MRI was used to assess the subtypes of CSVD s, including lacunes, enlarged perivascular spaces ( EPVS ), and white matter hyperintensities ( WMH ). WMH were furtherly divided into deep WMH ( DWMH ) and periventricular hyperintensities ( PVH ). The association between CSVD s and motor symptoms was analyzed. Patients were divided into the postural instability and gait disability ( PIGD ) group and non‐ PIGD group. Demographic, clinical and CSVD s variables were compared between the two groups. Results CSVD s subtypes were all detected in the participants with different prevalence rates and severity degrees. We found a close association between EPVS in basal ganglia and the tremor score ( p = 0.032), and between DWMH in the frontal and occipital lobes and the axial motor score ( p < 0.05) through the spearman and multivariate liner regression analysis. Compared with the non‐ PIGD group, the PIGD group demonstrated more serious cognitive impairment and DWMH in the frontal and occipital lobes ( p < 0.05). The demographic characteristics and vascular risk factors of the PIGD group were not different from those of the non‐ PIGD group. Cognitive impairment and DWMH in the frontal lobe were identified to be independent risk factors of PIGD motor phenotype. Conclusions We identified a close association between the CSVD s and motor symptoms in PD and DWMH in the frontal lobe was a risk factor of PIGD motor phenotype, which supports the contribution of vascular pathology in PD .