Cerebral small vessel disease and incident parkinsonism: The RUN DMC study
- PMID: 26446068
- PMCID: PMC4642143
- DOI: 10.1212/WNL.0000000000002082
Cerebral small vessel disease and incident parkinsonism: The RUN DMC study
Abstract
Objective: To investigate the relation between baseline cerebral small vessel disease (SVD) and the risk of incident parkinsonism using different MRI and diffusion tensor imaging (DTI) measures.
Methods: In the Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort (RUN DMC) study, a prospective cohort study, 503 elderly participants with SVD and without parkinsonism were included in 2006. During follow-up (2011-2012), parkinsonism was diagnosed according to UK Brain Bank criteria. Cox regression analysis was used to investigate the association between baseline imaging measures and incident all-cause parkinsonism and vascular parkinsonism (VP). Tract-based spatial statistics analysis was used to identify differences in baseline DTI measures of white matter (WM) tracts between participants with VP and without parkinsonism.
Results: Follow-up was available from 501 participants (mean age 65.6 years; mean follow-up duration 5.2 years). Parkinsonism developed in 20 participants; 15 were diagnosed with VP. The 5-year risk of (any) parkinsonism was increased for those with a high white matter hyperintensity (WMH) volume (hazard ratio [HR] 1.8 per SD increase, 95% confidence interval [CI] 1.3-2.4) and a high number of lacunes (HR 1.4 per number increase, 95% CI 1.1-1.8) at baseline. For VP, this risk was also increased by the presence of microbleeds (HR 5.7, 95% CI 1.9-16.8) and a low gray matter volume (HR 0.4 per SD increase, 95% CI 0.2-0.8). Lower fractional anisotropy values in bifrontal WM tracts involved in movement control were observed in participants with VP compared to participants without parkinsonism.
Conclusions: SVD at baseline, especially a high WMH volume and a high number of lacunes, is associated with incident parkinsonism. Our findings favor a role of SVD in the etiology of parkinsonism.
© 2015 American Academy of Neurology.
Figures
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Comment in
- Neurology. 2016 Mar 29;86(13):1268-9
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Parkinsonism, small vessel disease, and white matter disease: Is there a link?Neurology. 2015 Nov 3;85(18):1532-3. doi: 10.1212/WNL.0000000000002091. Epub 2015 Oct 7. Neurology. 2015. PMID: 26446067 No abstract available.
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Author Response.Neurology. 2016 Mar 29;86(13):1268-9. doi: 10.1212/WNL.0000000000002554. Neurology. 2016. PMID: 27022177 No abstract available.
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