Category: Parkinson's Disease: Neuroimaging
Objective: Objective: To investigate the association between cerebral white matter lesions (WML) and motor symptoms in Parkinson’s disease (PD).
Background: Background: Previous studies have shown that WML contribute to clinical symptom expression in PD. However, data on the influence of WML located in specific brain regions on motor symptoms remain sparse.
Method: Methods: In this prospective, multicenter, international study, assessments included the Scales for Outcomes in PD (SCOPA)-motor examination, exploring specific motor aspects of PD including (1) tremor, (2) bradykinesia, (3) axial symptoms, (4) dysphagia and dysarthria, (5) dyskinesia, and (6) motor fluctuations. We used two visual semiquantitative rating scales to quantify WML: The Fazekas scale, which distinguishes between periventricular (PWML) and deep WML and the age-related white matter changes (ARWMC) scale, which differentiates between WML in frontal, parieto-occipital, temporal, infratentorial, and basal ganglia areas. For grading the WML, we used axial fluid-attenuated inversion recovery (FLAIR) imaging or axial T2-weighted imaging, when FLAIR sequences were not available. MRI images were inspected by two experienced neuroradiologists in consensus (MS and NA) for visual rating. We used Spearman correlation analyses to explore associations between specific motor symptoms and WML in different locations.
Results: Results: 293 patients with PD (Cologne, London, Toronto) were included in our study. Axial symptoms were associated with PWML (rs=0.27; p<.001), as well as lesions in frontal (rs=0.18; p=.005), parieto-occipital (rs=0.17; p=.005), and basal ganglia regions (rs=0.13; p=.030). Dysarthria and dysphagia were only associated with PWML (rs=0.13; p=.034). Dyskinesia was correlated with PWML (rs=0.19; p=.002), and WML in frontal (rs=0.19; p=.002), parieto-occipital (rs=0.12; p=.049), and basal ganglia regions (rs =0.13; p=.030). Tremor, bradykinesia, and presence of motor fluctuations were not associated with WML burden.
Conclusion: Conclusions: Our results suggest that WML are weakly associated with specific motor symptoms in PD. The results might be helpful to understand further their pathophysiology underlying PD and improve treatment strategies, including the role and management of vascular risk factors.
To cite this abstract in AMA style:
S. Jost, A. Sauerbier, A. Rizos, M. Picillo, D. van Wamelen, V. Stopic, JN. Petry-Schmelzer, M. Schönfeld, N. Abdullayev, K. Ashkan, K. Rukavina, J. Jarosz, M. Sommerauer, M. Qamar, R. Cury, E. Fonoff, M. Dos Santos-Ghilardi, A. Othman, M. Muthuraman, GR. Fink, A. Antonini, L. Timmermann, P. Martinez-Martin, A. Fasano, K. Ray Chaudhuri, H. Dafsari. White matter lesions and motor symptoms in Parkinson’s disease [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/white-matter-lesions-and-motor-symptoms-in-parkinsons-disease/. Accessed September 7, 2024.« Back to 2023 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/white-matter-lesions-and-motor-symptoms-in-parkinsons-disease/