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White Matter Hyperintensities as a Predictor of Freezing of Gait in Parkinson's Disease

 Seok Jong Chung  ;  Yang Hyun Lee  ;  Han Soo Yoo  ;  Jungsu S Oh  ;  Jae Seung Kim  ;  Byoung Seok Ye  ;  Young H Sohn  ;  Phil Hyu Lee 
 PARKINSONISM & RELATED DISORDERS, Vol.66 : 105-109, 2019-09 
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Issue Date
Disease progression ; Dopamine transporter ; Freezing of gait ; Parkinson's disease ; White matter
Introduction: To investigate the effect of white matter hyperintensities (WMH) on long-term motor outcomes in Parkinson's disease (PD). Methods: We retrospectively reviewed medical records of 268 patients with de novo PD (follow-up > 3 years). According to the Clinical Research Center for Dementia of South Korea (CREDOS) WMH visual rating scale scores, the patients were divided into two groups: a PD group with minimal WMH (PD-WMH-; n = 198) and a PD group with moderate to severe WMH (PD-WMH+; n = 70). We compared longitudinal increases in doses of dopaminergic medications between the two groups using a mixed model. We also assessed the effects of WMH on the development of freezing of gait (FOG). Results: Patients in the PD-WMH + group were older than those in the PD-WMH- group, and had more severe motor deficits and more severely decreased striatal dopamine transporter availability. The PD-WMH + group required higher doses of dopaminergic medications for symptom control, compared to the PD-WMH- group, over the follow-up period. After adjusting for age, sex, striatal dopamine transporter availability, and levodopa-equivalent dose, the PD-WMH + group showed a higher risk of developing FOG (HR, 3.29; 95% CI, 1.79-6.05; p < 0.001) than the PD-WMH- group. Conclusion: This study demonstrates that WMH burden negatively affects the longitudinal requirement of dopaminergic medication and the development of FOG. These findings suggest that baseline WMH severity or volume may be a useful prognostic marker of motor outcomes in PD.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Sohn, Young Ho(손영호) ORCID logo https://orcid.org/0000-0001-6533-2610
Ye, Byoung Seok(예병석) ORCID logo https://orcid.org/0000-0003-0187-8440
Yoo, Han Soo(유한수) ORCID logo https://orcid.org/0000-0001-7846-6271
Lee, Yang Hyun(이양현)
Lee, Phil Hyu(이필휴) ORCID logo https://orcid.org/0000-0001-9931-8462
Chung, Seok Jong(정석종) ORCID logo https://orcid.org/0000-0001-6086-3199
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