Objective: To investigate the potential impact of white matter hyperintensity (WMH) on motor compensation in Parkinson’s disease (PD).

Background: WMHs, the loss of vascular integrity, are commonly observed magnetic resonance imaging (MRI) findings in normal elderly people as well as patients with wide range of neurological disorders including PD. Growing evidences suggest that comorbid WMHs in PD affect the multiple axis of nervous system function including cognition, mood and behavior as well as motor control. However, little is known about the contribution of WMH to capacity of motor compensation in PD.

Methods: This study included 228 de novo patients with PD (109 men and 119 women) whom underwent both brain MRI and dopamine transporter (DAT) PET scans at their initial diagnostic workup. A severity of WMH was determined by a widely used visual rating scale of Fazekas (FRS) that consists of semi-quantitative rating for region of periventricular and deep white matter. Patients were classified into two groups, according to the severity of WMH, i.e., sum of FRS score of the periventricular and deep white matter.

Results: A severity of total WMH was well correlated to Unified PD rating scale (UPDRS) motor score (r = 0.243; p = 0.001). A fewer WMH group showed significantly lower UPDRS motor score compared to greater WMH group (20.1 ± 9.6 vs 26.9 ± 10.6; p < 0.001), although DAT binding to the posterior putamen were comparable between the two groups (1.26 ± 0.45 vs 1.24 ± 0.64; p = 0.808). Level of WMH (fewer WMH/greater WMH) revealed a significant contribution to UPDRS motor score (ß = 5.34 (1.89); p = 0.005) after controlling for potentially confounding covariates (age, sex, disease duration, hypertension, diabetes mellitus, smoking, and DAT binding to the posterior putamen).

Conclusions: This study demonstrated a potential detrimental impact of WMH on motor compensation in PD. A future therapy preventing WMH may enhance the capacity of motor compensation in patients with PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impact-of-white-matter-hyperintensity-on-motor-compensation-in-parkinsons-disease/