Objective: Search for the clinical correlation of the most used leukoaraiosis scales in Parkinson’s disease and ischemic stroke.

Background: In recent decades, there has been a growing interest in the areas of leukoaraiosis (LA) or white matter lesions (WML) evidenced in neuroimaging studies in the elderly population.Whether leukoaraiosis is  related to aging or is caused by diseases such as hypertension, diabetes, cerebrovascular disease or neurodegenerative diseases such as PD.

Method: Database of the population with cerebral vascular disease and PD patients from the Outpatient Department of the University Hospital “Dr. Jose E. Gonzalez”. Demographic, clinical, and paraclinical data were collected for this study from January 2014 to October 2020. We included patients with PD, of indistinct sex and age > 18 years, patients with ischemic stroke,  both populations had to have MRI and at least a FLAIR sequence. 4 scales were evaluated by magnetic resonance: Fazekas et al, modified Scheltens et al, Ylikoski et al, and ARWMC (Wahlund et al).

Results: 49 patients with Parkinson’s disease and 48 with cerebrovascular ischemic events were recruited. Spearman’s ratio coefficient was used to show the convergent validity in the different visual scales of leukoaraiosis and the volumetric measurements. Visual scales for leukoaraiosis, the best correlated with the volume of leukoaraiosis measured was the Ylikoski scale for Parkinson’s disease and the Fazekas scale for ischemic stroke. The correlation coefficients between volume and scales were moderate ( 0.30-0.59). Spearman’s coefficient showed high correlation coefficients between all the scales (> 0.60). The total periventricular score of the Scheltens and Ylikoski scales moderately correlated (R= 0.320, p=0.039, R= 0.334, p=0.031, respectively) with the MDS-UPDRS part III motor score. Similarly, in the ischemic cerebrovascular event population, no significant correlations were found when comparing the volume of leukoaraiosis with the MoCA, NIHSS.

Conclusion: No superiority of visual scales to volumetric analysis of leukoaraiosis was found in terms of clinical correlation in patients with Parkinson’s disease or ischemic stroke.
Prospective studies are required that evaluate at the beginning, and later, one or three years after having diagnosed Parkinson’s disease through the use of clinical scales and visual scales of LSB.

References: 1. Marek,M.,Horyniecki,M.,Frączek,M.,&Kluczewska,E.(2018).Leukoaraiosis- new concepts and modern imaging. Polish Journal of Radiology, 83, e76–e81. https://doi.org/10.5114/pjr.2018.74344
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6. Wahlund, L. O., Barkhof, ; F, Fazekas, ; F, Bronge, ; L, Augustin, ; M, Sjögren, ; M, Wallin, ; A, Ader, ; H, Leys, ; D, Pantoni, ; L, Pasquier, ; F, Erkinjuntti, ; T, & Scheltens, ; P. (2001). A New Rating Scale for Age-Related White Matter Changes Applicable to MRI and CT. http://ahajournals.org

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-correlation-of-visual-leukoaraiosis-scales-and-volumetric-analysis-in-patients-with-ischemic-cerebral-vascular-event-and-parkinsons-disease/