Abstract
The relation of white matter hyperintense lesions to episodic memory impairment in patients with Parkinson’s disease (PD) is still controversial. We aimed at evaluating the relation between white matter hyperintense lesions and episodic memory decline in patients with PD. In this multicentric prospective study, twenty-one normal controls, 15 PD patients without mild cognitive impairment (MCI) and 13 PD patients with MCI were selected to conduct a clinico-radiological correlation analysis. Performance during episodic memory testing, age-related white matter changes score, total manual and automated white matter hyperintense lesions volume and lobar white matter hyperintense lesions volumes were compared between groups using the Kruskal-Wallis and Wilcoxon signed-rank tests, and correlations were assessed using the Spearman test. MCI PD patients had impaired free recall. They also had higher total, left prefrontal and left temporal white matter hyperintense lesions volumes than normal controls. Free recall performance was negatively correlated with the total white matter hyperintense lesions volume, either manually or automatically delineated, but not with the age-related white matter changes score. Using automated segmentation, both the left prefrontal and temporal white matter hyperintense lesions volumes were negatively correlated with the free recall performance. Early episodic memory impairment in MCI PD patients may be related to white matter hyperintense lesions, mainly in the prefrontal and temporal lobes. This relation is influenced by the method used for white matter hyperintense lesions quantification. Automated volumetry allows for detecting those changes.
Highlights
Cognitive dysfunction in elderly subjects may be linked to white matter hyperintense lesions (WMHL) related to cerebral small vessel disease (CSVD) (Zhou et al 2015; Maillard et al 2012; Smith et al 2011)
Out of 67 patients who underwent MRI, thirty-four patients met the criteria of idiopathic Parkinson’s disease (PD), eight patients those of vascular parkinsonism (VP), seven patients those of Progressive Supranuclear Palsy (PSP), four patients those of multiple system atrophy (MSA), three patients those of corticobasal dementia (CBD), one met criteria for Lewy body dementia, and ten could not yet be classified
mild cognitive impairment (MCI) PD patients had impaired free and cued recall, global memory, initiation and conceptualization compared with normal controls (NC) (Table 2)
Summary
Cognitive dysfunction in elderly subjects may be linked to white matter hyperintense lesions (WMHL) related to cerebral small vessel disease (CSVD) (Zhou et al 2015; Maillard et al 2012; Smith et al 2011). In elderly hypertensive patients with subjective memory complaints, higher WMHL volume has been correlated with lower grey matter metabolism, independently of age, gender or grey matter atrophy (Verger et al 2016). Higher WMHL load has been reported in mild cognitive impaired. 5 I2FH, Montpellier University Hospital Center, Montpellier, France. 10 Department of Radiology, Caremeau University Hospital Center, Nimes, France. Episodic memory (EM) is early impaired in PD and may be a risk factor for future cognitive decline (Broeders et al 2013). A recent critical review of the pertinent literature (Vesely and Rektor 2016) suggested that the controversial results on the contribution of WMHL to cognitive decline in PD might be due to differences in methods of cognitive testing and WMHL load assessment from MRI
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