Correlation between total MRI burden in cerebral small vascular disease and cognitive impairment in Parkinson's Disease
Objective Parkinson's disease(PD)combined with cerebral small vessel disease(CSVD)may aggravate cognitive impairment in PD.This study aimed to investigate the relationship between the total burden of CSVD and cognitive function in PD.Methods This retrospective study compared the clinical and neuroimaging features of 165 PD patients,all of whom underwent MRI of the brain and assessed total CSVD burden by presumed vascular origin lacune,white matter hyperintensity(WMH),cerebral microbleed(CMB),and the enlarged perivascular space(EPVS).Cognitive function was assessed by performing the Montreal Cognitive Evaluation Scale(MoCA)in patients,who were divided into PD with mild cognitive impairment(PD-MCI)and PD with dementia(PDD)groups.Multivariate binary Logistic regression models were used to identify independent risk factors for cognitive decline.Operating characteristic curve(ROC)analysis was used to quantify the accuracy of the lacune and the CSVD total load in distinguishing PD-MCI from PDD.Results Patients with PDD had significantly greater periventricular white matter hyperintensity(PVH),lacune,deep white matter hyperintensity(DWMH),basal perivascular space enlargement(BG-EPVS),and CSVD scores than patients with PD-MCI.Multivariate binary logistic regression showed that lacune[OR(95％CI)=2.418(1.088,5.371),P=0.030]and total CSVD burden[OR(95％CI)=1.572(1.138,2.171),P=0.006]were independently associated with cognitive decline in PD patients.Furthermore,the ROC curve results confirmed that lacune and total CSVD load had good accuracy in distinguishing PD-MCI and PDD.Conclusion The overall burden of CSVD exhibits a strong association with cognitive impairment among patients with PD.The lacune and total burden of CSVD can be used as a key indicator to predict cognitive decline in PD patients.
Total cerebral small vascular disease scoreLacuneParkinson's disease with mild cognitive impairmentParkinson's disease with dementia
万方数据
维普
