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Perivascular Spaces in the Basal Ganglia and Long-term Motor Prognosis in Newly Diagnosed Parkinson Disease

Authors
 Seok Jong Chung  ;  Han Soo Yoo  ;  Na-Young Shin  ;  Yae Won Park  ;  Hye Sun Lee  ;  Ji-Man Hong  ;  Yun Joong Kim  ;  Seung-Koo Lee  ;  Phil Hyu Lee  ;  Young H Sohn 
Citation
 NEUROLOGY, Vol.96(16) : e2121-e2131, 2021-04 
Journal Title
NEUROLOGY
ISSN
 0028-3878 
Issue Date
2021-04
MeSH
Aged ; Basal Ganglia / pathology* ; Disease Progression ; Female ; Glymphatic System / pathology* ; Humans ; Male ; Middle Aged ; Motor Disorders / etiology ; Motor Disorders / pathology ; Parkinson Disease / complications ; Parkinson Disease / pathology* ; Prognosis
Abstract
Objective: To investigate the association between enlarged perivascular spaces (PVS) in the basal ganglia (BG-PVS) and long-term motor outcomes in Parkinson disease (PD).

Methods: We reviewed the medical records of 248 patients with drug-naive early-stage PD (follow-up >3 years, mean age 67.44 ± 8.46 years, 130 female) who underwent brain MRI and dopamine transporter (DAT) scans at initial assessment. The number of baseline enlarged BG-PVS was counted on axial T2-weighted images. Then, patients were divided into 2 groups: a PD group with a low number (0-10) of enlarged PVS (PD-EPVS-; n = 156) and a PD group with a high number (>10) of enlarged PVS (PD-EPVS+; n = 92). We used Cox regression models to compare the levodopa-induced dyskinesia (LID)-, wearing-off-, and freezing of gait (FOG)-free times between groups. We also compared longitudinal increases in levodopa-equivalent dose per body weight between groups using a linear mixed model.

Results: Patients in the PD-EPVS+ group were older (72.28 ± 6.07 years) and had greater small vessel disease burden than those in the PD-EPVS- group (64.58 ± 8.38 years). The PD-EPVS+ group exhibited more severely decreased DAT availability in all striatal subregions except the ventral striatum. The risk of FOG was higher in the PD-EPVS+ group, but the risk of LID or wearing-off was comparable between groups. The PD-EPVS+ group required higher doses of dopaminergic medications for effective symptom control compared to the PD-EPVS- group.

Conclusion: This study suggests that baseline enlarged BG-PVS can be an indicator of the progression of motor disability in PD.
Full Text
https://n.neurology.org/content/96/16/e2121.long
DOI
10.1212/WNL.0000000000011797
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yun Joong(김윤중) ORCID logo https://orcid.org/0000-0002-2956-1552
Park, Yae Won(박예원) ORCID logo https://orcid.org/0000-0001-8907-5401
Sohn, Young Ho(손영호) ORCID logo https://orcid.org/0000-0001-6533-2610
Yoo, Han Soo(유한수) ORCID logo https://orcid.org/0000-0001-7846-6271
Lee, Seung Koo(이승구) ORCID logo https://orcid.org/0000-0001-5646-4072
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
Hong, Ji Man(홍지만) ORCID logo https://orcid.org/0000-0002-0696-8448
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/183974
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