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The burden of white matter hyperintensities is a predictor of progressive mild cognitive impairment in patients with Parkinson's disease.

 M. K. Sunwoo  ;  S. Jeon  ;  J. H. Ham  ;  J. Y. Hong  ;  J. E. Lee  ;  J.-M. Lee  ;  Y. H. Sohn  ;  P. H. Lee 
 EUROPEAN JOURNAL OF NEUROLOGY, Vol.21(6) : 922-928, 2014 
Journal Title
Issue Date
Aged ; Aged, 80 and over ; Cognition ; Cognitive Dysfunction/complications ; Cognitive Dysfunction/pathology* ; Disease Progression ; Female ; Humans ; Longitudinal Studies ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neuropsychological Tests ; Parkinson Disease/complications ; Parkinson Disease/pathology* ; White Matter/pathology*
Parkinson's disease ; dementia converters ; white matter hyperintensities
BACKGROUND AND PURPOSE: To evaluate whether white matter hyperintensities (WMHs) may act as an independent predictor for progression of cognitive status, the authors analyzed the longitudinal effects of WMHs on cognitive dysfunction in non-demented patients with Parkinson's disease (PD). METHODS: A total of 111 patients with PD were enrolled, including subjects with mild cognitive impairment (MCI, n = 65) and cognitively normal subjects (CN, n = 46). These individuals were classified as MCI converters (n = 22) or MCI non-converters (n = 43) and CN converters (n = 18) or CN non-converters (n = 28) based on whether they were subsequently diagnosed with PD dementia or PD-MCI during a minimum 24-month follow-up. The WMH burden and the Cholinergic Pathway Hyperintensities Scale (CHIPS) and their relationships to longitudinal changes in cognitive performance were examined. RESULTS: PD-MCI converters had larger WMH volume (14421.0 vs. 5180.4, P < 0.001) and higher CHIPS score (22.6 vs. 11.2, P = 0.001) compared with PD-MCI non-converters. Logistic regression analysis revealed in patients with PD-MCI that WMH volume (odds ratio 1.616, P = 0.009) and CHIPS score (odds ratio 1.084, P = 0.007) were independently associated with PD dementia conversion. However, WMH volume and CHIPS score did not differ between PD-CN converters and PD-CN non-converters. In patients with PD-MCI, both WMH volume and CHIPS score were closely associated with longitudinal decline in general cognition, semantic fluency and Stroop test scores. CONCLUSIONS: The present study demonstrates that WMH burden is a significant predictor of conversion from PD-MCI to PD dementia and is related to ongoing decline in frontal-lobe-based cognitive performance.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Sunwoo, Mun Kyung(선우문경)
Sohn, Young Ho(손영호) ORCID logo https://orcid.org/0000-0001-6533-2610
Lee, Ji Eun(이지은)
Lee, Phil Hyu(이필휴) ORCID logo https://orcid.org/0000-0001-9931-8462
Ham, Jee Hyun(함지현)
Hong, Jin Yong(홍진용)
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