Association between white matter lesion and clinical symptoms in patients with Parkinson's disease

Abstract:

Objective To investigate the influence of cerebral white matter lesion（WML） on motor symptoms，cognitive function，and mood in patients with Parkinson's disease（PD）.Methods A total of 123 patients with PD who visited the Department of Neurology of the Second Affiliated Hospital of Anhui Medical University from January 2018 to December 2023 were included. Age‐related White Matter Changes（ARWMC） scale was used to evaluate the degree of cerebral WML on cranial MRI imaging，according to the score of the scale，the patients were divided into mild WML group with 46 patients and moderate‐to‐severe WML group with 77 patients. The Unified Parkinson's Disease Rating Scale Part Ⅲ（UPDRS‐Ⅲ） and Hoehn‐Yahr（H‐Y） Rating Scale were used to assess motor symptoms and disease severity； Mini‐Mental State Examination（MMSE） was used to assess cognitive function in PD； Hamilton Depression Scale and Hamilton Anxiety Scale were used to assess the emotion of PD patients； Barthel Index was used to assess the activities of daily living. The scores of motor symptoms，cognitive function，and mood in patients were compared between the two groups， and the relationship between WML and PD patients symptoms was analyzed by Logistic regression.Results The moderate‐to‐severe WML group had a significantly higher incidence rate of hypertension than the mild WML group（41.6% vs. 23.9%，P<0.05）. Compared with the mild WML group，the moderate‐to‐severe WML group had significantly higher H‐Y stage［2.5（1.5，3.0） vs. 2.0（1.5，2.5），P<0.05］ and UPDRS‐Ⅲ score（34.0±16.5 vs. 24.09±11.04，P<0.01）. Compared with the mild WML group，the moderate‐to‐severe WML group had significantly lower MMSE score［24.0（18.5，27.0） vs. 26.0（23.8，27.0），P<0.01］ and Barthel Index［（77.4±17.4） vs.（83.5±11.7），P<0.05］. The correlation analysis showed that total ARWMC score was positively correlated with H‐Y stage，UPDRS‐Ⅲ score，and age，while it was negatively correlated with MMSE score and Barthel Index. The logistic regression analysis showed a significant association between severe WML impairment and cognitive impairment（β=1.072，95% confidence interval：1.078~7.918，P=0.035）.Conclusion WML is associated with dyskinesia，cognitive impairment，and reduction in quality of life in PD.