Yoonju Lee1, Jeongmin Ko1, Ye Eun Choi1, Jungsu S Oh1, Jae Seung Kim1, Mun Kyung Sunwoo1, Jung Han Yoon1, Suk Yun Kang1, Jin Yong Hong2. 1. From the Department of Health Promotion (Y.L.), Severance Check-up, Yonsei University Health System, Seoul; Department of Neurology (Y.L.), Yonsei University College of Medicine, Seoul; Department of Neurology (J.K., J.Y.H.), Yonsei University Wonju College of Medicine, Wonju; Department of Nuclear Medicine (Y.E.C., J.S.O., J.S.K.), Asan Medical Center, University of Ulsan College of Medicine, Seoul; INFINITT Healthcare (Y.E.C.), Seoul; Department of Neurology (M.K.S.), Bundang Jesaeng General Hospital, Seongnam; Department of Neurology (J.H.Y.), Ajou University School of Medicine, Suwon; and Department of Neurology (S.Y.K.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea. 2. From the Department of Health Promotion (Y.L.), Severance Check-up, Yonsei University Health System, Seoul; Department of Neurology (Y.L.), Yonsei University College of Medicine, Seoul; Department of Neurology (J.K., J.Y.H.), Yonsei University Wonju College of Medicine, Wonju; Department of Nuclear Medicine (Y.E.C., J.S.O., J.S.K.), Asan Medical Center, University of Ulsan College of Medicine, Seoul; INFINITT Healthcare (Y.E.C.), Seoul; Department of Neurology (M.K.S.), Bundang Jesaeng General Hospital, Seongnam; Department of Neurology (J.H.Y.), Ajou University School of Medicine, Suwon; and Department of Neurology (S.Y.K.), Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea. mlunoilu@hanmail.net.
Abstract
OBJECTIVE: To determine whether deep white matter and periventricular hyperintensities affect the motor symptoms of Parkinson disease (PD) differently, we analyzed MRI and dopamine transporter imaging. METHODS: We analyzed the medical records of patients with de novo PD who underwent dopamine transporter PET scanning and MRI at their first visit. Deep white matter and periventricular hyperintensities were scored with a visual rating scale, and motor symptoms were assessed by Unified Parkinson's Disease Rating Scale motor score and tremor, rigidity, bradykinesia, and axial symptom subscores. The influence of white matter hyperintensity on motor symptoms was explored using multivariable linear regression models. RESULTS: A total of 93 patients (mean age, 67.2 ± 9.9 years; 44 male) were included and the mean motor score was 25.0 ± 10.8. Subscores for bradykinesia and axial symptoms were correlated with both deep white matter and periventricular hyperintensities scores. Multivariable linear regression models revealed that deep white matter hyperintensities score was significantly associated with subscore for bradykinesia and periventricular hyperintensities score was associated with subscores for bradykinesia and axial symptoms after adjusting for putaminal dopamine transporter availability and clinical factors. CONCLUSIONS: These results demonstrate that deep white matter hyperintensities are associated with bradykinesia and periventricular hyperintensities are associated with bradykinesia and axial symptoms in patients with PD independently of the severity of dopaminergic depletion.
OBJECTIVE: To determine whether deep white matter and periventricular hyperintensities affect the motor symptoms of Parkinson disease (PD) differently, we analyzed MRI and dopamine transporter imaging. METHODS: We analyzed the medical records of patients with de novo PD who underwent dopamine transporter PET scanning and MRI at their first visit. Deep white matter and periventricular hyperintensities were scored with a visual rating scale, and motor symptoms were assessed by Unified Parkinson's Disease Rating Scale motor score and tremor, rigidity, bradykinesia, and axial symptom subscores. The influence of white matter hyperintensity on motor symptoms was explored using multivariable linear regression models. RESULTS: A total of 93 patients (mean age, 67.2 ± 9.9 years; 44 male) were included and the mean motor score was 25.0 ± 10.8. Subscores for bradykinesia and axial symptoms were correlated with both deep white matter and periventricular hyperintensities scores. Multivariable linear regression models revealed that deep white matter hyperintensities score was significantly associated with subscore for bradykinesia and periventricular hyperintensities score was associated with subscores for bradykinesia and axial symptoms after adjusting for putaminal dopamine transporter availability and clinical factors. CONCLUSIONS: These results demonstrate that deep white matter hyperintensities are associated with bradykinesia and periventricular hyperintensities are associated with bradykinesia and axial symptoms in patients with PD independently of the severity of dopaminergic depletion.