Introduction

Previous studies have found associations between grey matter atrophy and white matter hyperintensities (WMH) of vascular origin with cognitive and motor deficits in Parkinson’s disease (PD). Here we investigate these relationships in a sample of PD patients and age-matched healthy controls.

Methods

Data included 50 PD patients and 45 age-matched controls with T1-weighted and FLAIR scans at baseline, 18-months, and 36-months follow-up. Deformation-based morphometry was used to measure grey matter atrophy. SNIPE (Scoring by Nonlocal Image Patch Estimator) was used to measure Alzheimer’s disease-like textural patterns in the hippocampi. WMHs were segmented using T1-weighted and FLAIR images. The relationship between MRI features and clinical scores was assessed using mixed-effects models. The motor subscore of the Unified Parkinson's Disease Rating Scale (UPDRSIII), number of steps in a walking trial, and Dementia Rating Scale (DRS) were used respectively as measures of motor function, gait, and cognition.

Results

Substantia nigra atrophy was significantly associated with motor deficits, with a greater impact in PDs (p < 0.05). Hippocampal SNIPE scores were associated with cognitve decline in both PD and controls (p < 0.01). WMH burden was significantly associated with cognitive decline and increased motor deficits in the PD group, and gait deficits in both PD and controls (p < 0.03).

Conclusion

While substantia nigra atrophy and WMH burden were significantly associated with additional motor deficits, WMH burden and hippocampal atrophy were associated with cognitive deficits in PD patients. These results suggest an additive contribution of both grey and white matter damage to the motor and cognitive deficits in PD.

中文翻译：

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帕金森病灰质和白质病理学的认知和运动相关性。

 介绍

先前的研究发现，灰质萎缩和血管起源的白质高信号（WMH）与帕金森病（PD）的认知和运动缺陷之间存在关联。在这里，我们在 PD 患者和年龄匹配的健康对照样本中研究了这些关系。

 方法

数据包括 50 名 PD 患者和 45 名年龄匹配的对照者，在基线、18 个月和 36 个月随访时进行了 T1 加权和 FLAIR 扫描。基于变形的形态测量用于测量灰质萎缩。 SNIPE（非局部图像补丁估计器评分）用于测量海马体中类似阿尔茨海默病的纹理模式。使用 T1 加权和 FLAIR 图像对 WMH 进行分割。使用混合效应模型评估 MRI 特征和临床评分之间的关​​系。统一帕金森病评定量表（UPDRSIII）的运动子评分、步行试验中的步数和痴呆评定量表（DRS）分别用作运动功能、步态和认知的测量。

 结果

黑质萎缩与运动缺陷显着相关，对 PD 的影响更大 (p < 0.05)。海马 SNIPE 评分与 PD 和对照组的认知能力下降相关（p < 0.01）。 WMH 负担与 PD 组的认知能力下降和运动缺陷增加以及 PD 和对照组的步态缺陷显着相关 (p < 0.03)。

 结论

虽然黑质萎缩和 WMH 负担与额外的运动缺陷显着相关，但 WMH 负担和海马萎缩与 PD 患者的认知缺陷相关。这些结果表明灰质和白质损伤对帕金森病的运动和认知缺陷有累加作用。