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Title: Cerebral white matter hyperintensity in Parkinson's disease: A major risk factor for mild cognitive impairment
Authors: Kandiah, N. 
Mak, E.
Ng, A.
Huang, S.
Au, W.L. 
Sitoh, Y.Y.
Tan, L.C.S. 
Keywords: Cerebral small vessel disease
Mild cognitive impairment (MCI)
Parkinson's disease
Volumetric MRI
White matter disease
Issue Date: Jul-2013
Citation: Kandiah, N., Mak, E., Ng, A., Huang, S., Au, W.L., Sitoh, Y.Y., Tan, L.C.S. (2013-07). Cerebral white matter hyperintensity in Parkinson's disease: A major risk factor for mild cognitive impairment. Parkinsonism and Related Disorders 19 (7) : 680-683. ScholarBank@NUS Repository.
Abstract: Background: Mild cognitive impairment (MCI) and dementia contribute to a poor quality of life among patients with PD. The influence of cerebral ischemia as a risk factor for MCI in PD has not been adequately investigated. To address this issue, we examined the influence of the volume and distribution of white matter hyperintensity (WMH) as a risk factor for MCI in early PD. Methods: Prospective study of patients with early idiopathic PD. All patients had baseline MRI-FLAIR, clinical assessment and detailed neuropsychological evaluation. Data on demographics, vascular risk factors, cognitive performance and WMH volumes were analyzed. Results: 91 patients; mean age 64.9 years, mean education of 10.5 years. 24 patients fulfilled the Movement Disorder Society criteria for MCI and were classified as PD-MCI while the rest were classified as PD with no cognitive impairment (PD-NCI). Patients with PD-MCI and PD-NCI did not differ in Hoehn&Yahr staging. PD-MCI patients had a higher prevalence of diabetes mellitus, hypertension and hyperlipidemia. PD-MCI patients had significantly greater volume of periventricular (6.04ml vs. 2.66ml, p=0.001) and deep subcortical WMH (2.16 vs.1.44, p=0.002). Regional WMH was significantly greater among PD-MCI in the frontal, parietal and occipital regions. Logistic regression analyses demonstrated WMH to be associated with PD-MCI independent of age, education, and vascular risk factors. Increasing WMH volume was associated with lower performance on executive function, memory and language. Conclusions: WMH is an important risk factor for PD-MCI independent of vascular risk factors. PD patientswith WMH should be regularly screened for MCI. © 2013 Elsevier Ltd.
Source Title: Parkinsonism and Related Disorders
ISSN: 13538020
DOI: 10.1016/j.parkreldis.2013.03.008
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