Clinical Characteristics Of Parkinson's Disease With White Matter Lesions

ObjectiveTo investigate the association between white matter lesions(WMLs)and the severity of Parkinson's disease(PD)and cogtivement impairment in PD.MethodsA total of 352 patients who were hospitalized in our hospital and older than 60 years were enrolled in the study between January 2016 and October 2017.All patients were diagnosed as PD and were examined by magnetic resonance imaging(MRI).The diagnosis of WMLs was based on the results of MRI.We divided WMLs into Fazekas 0-3 levels according to the severity of WMLs,using the visual scale of Fazekas.According to WMLs diagnosis,the patients were divided into two groups: PD with WMLs and PD without PD.According to the severity of PD,patients with PD were divided into mild PD,moderate PD and severe PD.According to the severity of cognitive impairement,patients with PD were divided into PD with normal cognitive function(PD-NC),mild cognitive impairment in PD(PD-MCI)and PD dementia(PDD).Multivariate logistic regression analysis was used to analyze the associations between WMLs and the severity of PD and cogtivement impairment in PD.Results 1.Multivariate logistics regression analysis showed that the association between age(OR: 2.11,95% CI: 1.58–2.59),longer duration of PD(OR: 1.80,95% CI: 1.43–2.17),hypertension(OR: 2.07,95% CI: 1.55–2.53),diabetes(OR: 1.88,95% CI: 1.49–2.24),hyperlipemia(OR: 1.64,95% CI: 1.22–2.03),metabolic syndrome(OR: 1.95,95% CI: 1.43–2.42)and PD with WMLs were statistically significant.2.Multivariate logistics regression analysis showed that he association between Fazekas 2 WMLs and moderate and severe PD was statistically significant(OR: 1.26,95%CI: 1.07–1.48;OR: 1.64;95%CI: 1.39–1.81).Meanwhile,Fazekas 3 WMLs and moderate and severe PD was statistically significant(OR: 2.19,95%CI: 1.76–2.57;OR: 2.46;95%CI: 1.84–3.02).Fazekas 1 WMLs was significantly associated with gait /posture impairment in PD,Fazekas 2 and Fazekas 3 WMLs were significantly associated with resting tremor,rigidity and gait /posture impairment in PD(all P<0.05).3.Multivariate logistics regression analysis showed that the association between Fazekas 2 WMLs and PD-MCI and PDD was statistically significant(OR: 1.14,95%CI: 1.05–1.27;OR: 1.67,95%CI: 1.29–2.08).Meanwhile,Fazekas 3 WMLs and PD-MCI and PDD was statistically significant(OR: 2.82,95%CI: 2.07–3.61;OR: 3.19,95%CI: 2.32–3.94).Fazekas 2 and Fazekas 3 WMLs were significantly associated with memory,attention,executive function,language and visuospatial function impairment in PD(all P<0.05).Conclusion 1.The association between age,the longer duration of PD,hypertension,diabetes,hyperlipidemia,and metabolic syndrome and the risk of PD with WMLs were statistically significant.2.Multivariate logistics regression analysis showed that WMLs was significantly associated with the severity of PD.3.Fazekas 1 was significantly associated with gait /posture impairment in PD,and Fazekas 2 and Fazekas 3 WMLs were significantly associated with resting tremor,rigidity and gait /posture impairment in PD.4.Multivariate logistics regression analysis showed that WMLs was significantly associated with cognitive impairment in PD.