Study On The Correlation Between Cerebral Blood Flow Changes In Decubitus And Orthostatic Position And White Matter Lesion In Parkinson’s Disease

Objective:To investigate the correlation between the change of cerebral blood flow parameter in decubitus and orthostatic positions and white matter lesion(WML)in PD patients.Methods:The clinical data of 71 PD patients hospitalized in the Department of Neurology of Xinjiang Uygur Autonomous Region People’s Hospital from January 2020 to December 2020 were collected.According to the T2WI-FLAIR sequence,they were divided into two groups: WML combined group(n=48)and WML free group(n=23).Transcranial Doppler ultrasonography(TCD)was performed on all patients.Bilateral middle cerebral artery(MCA)blood flow parameters,including systolic blood flow velocity(Vs),diastolic blood flow velocity(Vd),mean blood flow velocity(Vm),pulse index(PI)and resistance index(RI),were recorded in the decubitus and orthostatic positions for 3 minutes,respectively.Compare two groups of patients with general clinical data,merge disease,blood tests,and the change of cerebral blood flow parameter in decubitus and orthostatic positions(ΔVs、ΔVd、ΔVm、ΔPI and ΔRI).The binary logistic regression was used to analyze the risk factors of WML in PD patients,and to explore the relationship between the changes of cerebral blood flow parameters in the decubitus and orthostatic positions and WML in PD patients.Results:There were statistically significant differences in age,course of disease,hypertension prevalence,the left middle cerebral artery(LMCA)indexes(ΔVs、ΔVd、ΔVm、ΔPI and ΔRI)and the right middle cerebral artery(RMCA)indexes(ΔVs、ΔVd、ΔVm)between the two groups(P<0.05).Further binary logistic regression analysis showed that age,disease duration,ΔVs and ΔRI of LMCA were significantly correlated with WML in PD patients(P<0.05),and age(OR=5.88,95%CI:1.94-36.77,P=0.008),course of disease(OR=1.87,95%CI:1.01-3.49,P=0.049),the change value of LMCA systolic blood flow velocity in the decubitus and orthostatic positions(OR=1.13,95%CI:1.05-1.22,P=0.001),and the change value of LMCA pulse index in the decubitus and orthostatic positions(OR=1.82,95%CI:1.25-3.59,P=0.043)were all independent risk factors for WML in PD patients.Conclusion:PD patients with WML had higher age,longer course of disease,more hypertension,and obvious changes in cerebral blood flow in the decubitus and orthostatic positions.Age,course of disease,ΔVs and ΔRI of LMCA may be independent risk factors for WML in PD patients.