The aim of this meta-analysis was to review systematically and to identify the relationship between the severity and location of white matter hyperintensities (WMHs) and the degree of cognitive decline in patients with Parkinson’s disease (PD). We searched the PubMed, EMBASE, Web of Science, Ovid, and Cochrane Library databases for clinical trials of the severity and location of WMHs on the degree of cognitive impairment in PD through October 2020. We conducted the survey to compare the association of WMH burden in patients with PD with mild cognitive impairment (PD-MCI) versus those with normal cognition (PD-NC) and in patients with PD with dementia (PDD) versus those with PD without dementia (PD-ND). Nine studies with PD-MCI versus PD-NC and 10 studies with PDD versus PD-ND comparisons were included. The WMH burden in PD-MCI patients was significantly different compared to that in PD-NC patients (standard mean difference, SMD = 0.39, 95% CI: 0.12 to 0.66, p = 0.005), while there was no correlation shown in the age-matched subgroup of the comparison. In addition, PDD patients had a significantly higher burden of WMHs (SMD = 0.8, 95% CI: 0.44 to 1.71, p < 0.0001), especially deep white matter hyperintensities (SMD = 0.54, 95% CI: 0.36 to 0.73, p < 0.00001) and periventricular hyperintensities (SMD = 0.70, 95% CI: 0.36 to 1.04, p < 0.0001), than PD-NC patients, regardless of the adjustment of age. WMHs might be imaging markers for cognitive impairment in PDD but not in PD-MCI, regardless of age, vascular risk factors, or race. Further prospective studies are needed to validate the conclusions.

中文翻译：

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白质高信号对帕金森病认知障碍的影响

这项荟萃分析的目的是系统地回顾并确定白质高信号 (WMH) 的严重程度和位置与帕金森病 (PD) 患者认知能力下降程度之间的关系。我们在 PubMed、EMBASE、Web of Science、Ovid 和 Cochrane 图书馆数据库中搜索了截至 2020 年 10 月 WMH 的严重程度和位置对 PD 认知障碍程度的临床试验。我们进行了调查以比较 WMH 负担的相关性在患有轻度认知障碍的 PD 患者 (PD-MCI) 与认知正常的患者 (PD-NC) 和患有痴呆症的 PD 患者 (PDD) 与患有非痴呆症的 PD (PD-ND) 患者中。纳入了 PD-MCI 与 PD-NC 比较的 9 项研究和 PDD 与 PD-ND 比较的 10 项研究。p  = 0.005），而在比较的年龄匹配亚组中没有显示相关性。此外，PDD 患者的 WMH 负担明显更高（SMD = 0.8, 95% CI: 0.44 to 1.71, p  < 0.0001），尤其是深部白质高信号（SMD = 0.54, 95% CI: 0.36 to 0.73, p  < 0.00001) 和脑室周围高信号 (SMD = 0.70, 95% CI: 0.36 to 1.04, p  < 0.0001)，与 PD-NC 患者相比，无论年龄调整如何。无论年龄、血管危险因素或种族如何，WMH 可能是 PDD 中认知障碍的影像标志物，但不是 PD-MCI。需要进一步的前瞻性研究来验证结论。