Abstract Details

Title White Matter Hyperintensities Successfully Differentiate Parkinson's Disease Patients with and without Cognitive Impairment

Topic Aging and Dementia

Presentation(s) P06 - (-)

Poster/Presentation
Number 050

Objective

Background BACKGROUND: Cerebral WMH detected on magnetic resonance imaging (MRI) brain scans are associated with cognitive impairment in the elderly and in Alzheimer's disease. Less is known, however, about the contributions of WMH to PD mild cognitive impairment (PD-MCI) and PD dementia (PDD).

Design/Methods DESIGN/METHODS: 98 PD subjects underwent clinical and neuropsychological evaluations and MRI brain scans (1.5T GE Signa). A blinded rater measured WMH on FLAIR sequences using the Scheltens scale. Subjects were classified as cognitively normal (PD-NC), PD-MCI, or PDD using published Movement Disorder Society criteria for PD-MCI and PDD.

Results RESULTS: PD-NC (n=29), PD-MCI (n=44), and PDD (n=25) subjects did not differ in age, education, or vascular risk factors. Demented subjects had significantly longer PD duration and worse motor function. Total WMH scores differed among the cognitive groups (p=0.01) with significantly greater WMH burden in PDD compared to PD-NC subjects. Cerebral localization of WMH differed among the cognitive groups, with respect to periventricular and deep WMH (p=0.005 and p=0.03, respectively) but not basal ganglia or infratentorial regions. Periventricular WMH load was greatest in PDD, followed by PD-MCI, and least in PD-NC subjects, thereby differentiating PDD from PD-NC subjects (p=0.01) and PD-MCI from PD-NC subjects (p=0.02). Additionally, deep WMH were significantly greater in PDD compared to PD-NC subjects (p=0.02). Specifically, deep WMH located in the parietal lobe, differed among the cognitive groups (p=0.01), whereas other lobar regions did not. Moreover, the parietal lobe WMH distinguished PDD from PD-NC subjects (p=0.01) and PD-MCI from PD-NC subjects (p=0.02).

Conclusions CONCLUSIONS: Increased WMH burden in PD is associated with worse cognitive status, regardless of age or vascular risk factors. Periventricular and deep WMH, especially in the parietal lobe, differentiate the cognitive groups, and thus, may serve as markers of cognitive decline in PD.

Authors/Disclosures
Jennifer G. Goldman, MD, MS, FAAN PRESENTER	Dr. Goldman has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for Parkinson's Foundation Scientific Advisory Board. The institution of Dr. Goldman has received research support from Michael J. Fox Foundation. The institution of Dr. Goldman has received research support from Parkinson's Foundation.
John S. Ebersole, MD (University of Chicago)	No disclosure on file
Bryan A. Bernard, PhD (Rush University Medical Center)	Dr. Bernard has nothing to disclose.
	No disclosure on file
Edward Fox, MD, PhD, FAAN	Dr. Fox has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion Pharmaceuticals. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Fox has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Fox has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for GW Pharmaceuticals. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Alexion. Dr. Fox has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. Dr. Fox has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Fox has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Bristol Myers Squibb. The institution of Dr. Fox has received research support from Biogen. The institution of Dr. Fox has received research support from Genentech. The institution of Dr. Fox has received research support from Celgene - BMS. The institution of Dr. Fox has received research support from Chugai. The institution of Dr. Fox has received research support from Novartis. The institution of Dr. Fox has received research support from EMD-Serono. The institution of Dr. Fox has received research support from TG Therapeutics. The institution of Dr. Fox has received research support from AbbVie. The institution of Dr. Fox has received research support from Sanofi Genzyme. The institution of Dr. Fox has received research support from AbbVie.
Christopher Goetz, MD, FAAN (Rush University Medical Center)	The institution of Dr. Goetz has received research support from Michael J. Fox Foundation. The institution of Dr. Goetz has received research support from NIH. The institution of Dr. Goetz has received research support from Department of Defense. Dr. Goetz has received publishing royalties from a publication relating to health care. Dr. Goetz has received publishing royalties from a publication relating to health care. Dr. Goetz has received publishing royalties from a publication relating to health care.
	No disclosure on file
	No disclosure on file

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