Objective: This study investigated the association of enlarged perivascular space (EPVS) and white matter hyperintensity (WMH) with cognitive impairment in Parkinson’s disease (PD).

Background: Cognitive impairment seriously affects the quality of life, disability, and mortality of PD patients. In recent years, with the development of imaging technology, EPVS, and WMH have been increasingly studied, while the study of their effects on cognitive function in PD is still in the exploratory stage.

Method: Two hundred PD patients were included, and patients were classified into two categories based on the collected MoCA results using predefined diagnostic cutoffs. PD patients without cognitive impairment (PD-NCI) were defined as having a score >23, while mild cognitive impairment (PD-MCI) was defined as having a score of 22-23 or a score >22 without functional impairment. All subjects were scanned using 3T MRI to acquire T1WI, T2WI, and FLAIR of cranial MRI sequences to produce axial, coronal, and sagittal images. EPVS and WMH were assessed according to the vascular change reporting criteria of the neuroimaging criteria. General clinical information, disease duration, levodopa dose, H-Y staging, and UPDRSIII were completed for all patients with Parkinson’s disease. Univariate and multivariate logistic regression was used to analyze the relationship between EPVS, WMH, and cognitive decline and to explore independent risk factors for cognitive impairment.

Results: Compared to the PD-NCI group, patients in the PD-MCI group were older, had a greater age of onset, longer duration of PD, were more often male, and had a lower level of education. Cognitive impairment was more common in patients with mid to late-stage PD than in those with early-stage PD. After adjusting for clinicodemographic (age, sex, age at PD onset, education, PD duration, triglycerides, uric acid, and Hoehn-Yahr stage) risk factors in multivariate logistic regression models, low education (OR 0. 262, 95% CI 0.084-0.824, P=0.022) and severe EPVS in the basal ganglia region (OR 3.373, P= 0.022). 95% CI 1.348-8.442, P=0.009) remained as risk factors for cognitive dysfunction in PD.

Conclusion: Severe EPVS and low education level in the basal ganglia region were independent risk factors for PD-MCI; however, WMH was not an independent risk predictor for PD-MCI.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cognitive-function-in-parkinsons-disease-associations-with-perivascular-space-in-basal-ganglia/