1. Clinical correlates of cerebral white matter abnormalities in patients with Parkinson's disease
- Author
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Bastiaan R. Bloem, Marjolein B. Aerts, Anouke van Rumund, Mayra I. Bergkamp, Daniel J. van Wamelen, Rianne A. J. Esselink, Edo Richard, Bibet L. ten Harmsen, and Frederick J. A. Meijer
- Subjects
Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Parkinson's disease ,Dopamine Agents ,Disease ,Autonomic Nervous System ,Severity of Illness Index ,Hypotension, Orthostatic ,03 medical and health sciences ,Orthostatic vital signs ,All institutes and research themes of the Radboud University Medical Center ,0302 clinical medicine ,Internal medicine ,Basal ganglia ,medicine ,Humans ,Cognitive Dysfunction ,Stage (cooking) ,Cognitive decline ,Aged ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Parkinson Disease ,Magnetic resonance imaging ,Middle Aged ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,medicine.disease ,Magnetic Resonance Imaging ,White Matter ,Hyperintensity ,Cross-Sectional Studies ,030104 developmental biology ,Neurology ,Female ,Neurology (clinical) ,Geriatrics and Gerontology ,business ,030217 neurology & neurosurgery ,Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] - Abstract
Objective To determine if autonomic dysfunction, cognitive disorders or axial disability are associated with white matter lesions (WML) in Parkinson disease (PD). Methods We performed a retrospective cross-sectional review study on 204 consecutive PD patients who underwent cerebral MRI in our center between January 2012 and July 2016. For each patient, we scored the severity of WML and PV (periventricular) WML using the Fazekas score and using the ARWMC scale for WML and BG (basal ganglia) and clinical characteristics such as neurogenic orthostatic hypotension and cognitive function. Results 204 PD patients were included of whom n = 53 (26.0%) had neurogenic orthostatic hypotension (nOH). The presence of nOH was significantly associated with the severity of WML as defined by the Fazekas score and the ARWMC scale. An ordinal regression model confirmed this association with an OR of 0.41 (95% CI 0.18–0.92: p = .03) and an OR of 0.39 (95% CI 0.17–0.88: p = .02). There were no significant associations between WML and other co-variables, including hypertension, dopaminergic medication use, Hoehn and Yahr stage, gender and cognitive decline. Conclusion The presence of nOH is associated with WML severity in PD patients. more...
- Published
- 2018
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