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The study aimed to investigate the plasma apolipoprotein A-1 (ApoA-1) and endothelin -1 (ET-1) changes in early Parkinson disease (PD), and analyze their relationship with cognitive function and cerebral white matter structure (WMS) change. 76 early PD patients were selected as group PD, and 30 cases of healthy persons were selected as control group. They all scanned with magnetic resonance imaging (MRI) diffusion tensor. The ApoA-1, ET-1, WMS changes, and Montreal Cognitive Assessment (MoCA) scores were recorded in the two groups of subjects. The results revealed that ApoA-1 level and Mo CA score in PD group decreased, FA value in bilateral temporal lobe, left anterior cingulate tract, corpus callosum, and other cerebral WMS area in PD group were also decreased, and ET-1 level in PD group increased (P<0.05). Compared with those of PD group patients with Mo CA≥26, plasma ApoA-1 levels and cerebral WMS FA values of the patients with Mo CA<26 were decreased, (P<0.05); the MoCA score of PD group was positively correlated with the cerebral WMS FA values (P<0.05). In short, the ApoA-1 level in patients with early PD decreased, while the ET-1 level increased, and both were related to cognitive function and WMS.