Objective: The aims of this study were to investigate the effects of incidental white matter hyperintensities(WMH) on self-initiated postural control in drug-naïve, newly diagnosed Parkinson disease (PD) patients.

Background: Correlation of WMH with measurements of balance and giat in elderly has been reported. However, little is known about the interaction between WMH and self-initiated postural control in PD.

Methods: We consecutively recruited 31 newly diagnosed, drug-naïve PD patients who met the UK brain bank criteria for idiopathic Parkinson’s disease from out-patient clinic of neurology department, Soonchunhyang University Bucheon Hospital. Exclusion criteria were as follows: under 60 years old, HY stage 3 or more, MMSE <24, previous history of falls, or severe cardiopulmonary or musculoskeletal problem. Total of 25 patients (age=66±5.3 years, symptom duration=9.4±4.9 months, UPDRS III=19±9.0, MMSE=25.8±2.9; mean±SD) participated in this study with their informed consent to study protocol approved by local committee. Standard brain MRI was performed and WMH was assessed using Fazekas score. Patients were classified into two groups those with Fazekas score 0 or 1 (F01 group, n=17) and those with Fazekas score 2 or 3 (F23 group, n=8). Limit of stability (LOS) test was conducted using dynamic posturography (Neurocom). Statistical analysis was performed using SPSS ver. 18K and the nonparametric statistics were used due to the relatively small number of patients in each group.

Results: There were no significant differences between both groups for demographical profiles (age, gender, height, and weight) and clinical profiles (symptom duration, UPDRS motor subscore, and MMSE score). For parameters from LOS test, we found that reaction time(RT) to right backward and movement velocity (MVL) and maximum excursion (MXE) to backward were worse in F23 group than F01 group (1.54±0.53 vs. 1.06±0.42 sec, 1.9±0.65 vs. 2.9±1.18 deg/sec, 47.5±14.4 vs. 63.7±14.7 %, p=0.04, 0.01, 0.02, respectively) Among them, RT to right backward and MXE to backward showed significant correlations with Fazekas score across this study sample, even after considering age and cognitive function.

Conclusions: We conclude that in this cross-sectional study, WMH is independently associated with direction-specific impairment of self-initiated postural control, particularly to backward direction in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impacts-of-white-matter-hyperintensities-on-limit-of-stability-in-drug-naive-de-novo-patients-with-idiopathic-parkinsons-disease/