Objective: The aim of this study is to investigate the clinical and biochemical profile of patients with PD with and without WMH.

Background: Parkinson’s disease (PD) is the fastest growing neurological disorder, surpassing Alzheimer’s disease. Cardiovascular disease and associated risk factors are also common among the elderly, and their association with PD has been debated. Cerebral white matter hyperintensities (WMH) are recognized as a cerebrovascular disease marker, and their presence in PD is associated with non-dopaminergic, axial motor symptoms and cognitive symptoms.

Methods: In total 91 patients with available brain MRI were included in this pilot project. All participants had given written consent to recruitment in an academic, hospital-based cohort, at the movement disorders clinic in the Department of Neurology, Karolinska University Hospital Huddinge. The presence and severity of WMH were assessed by a neuroradiologist according to Fazekas. Patients were divided in those with no or light WMH (Fazekas 0 or 1; n=66), and with moderate or severe WMH (Fazekas 2 or 3; n=25). Categorical variables were compared with the chi-square test and continuous variables were compared with the Wilcoxon rank-sum test. Logistic regression analysis was used to investigate predictors of WMH.

Results: Patients with light WMH were younger than those with severe WMH (median age 64.5 vs. 74 respectively; p<0.0001), and had less often hypertension (29% vs. 56%, p=0.02). Glucose and HbA1c levels did not differ between the two groups. Amyloid-beta (range 252 to 1600 ng/L, n=32) in cerebrospinal fluid was lower in patients with severe WMH compared to those with light WMH (median 558 ng/L vs 994 ng/L; p=0.009). Time from PD diagnosis to MRI was similar in the two groups (median time 1 year). In a multivariate model adjusting for age and hypertension, amyloid level in csf was an independent predictor of WMH (OR 0.64; 95% CI 0.43-0.95; p=0.02 for every 100-units increase of amyloid-beta).

Conclusions: In our study, we observed lower amyloid-beta levels in cerebrospinal fluid of patients with PD and severe WMH compared to patients with PD and light WMH. Further investigation of the impact of this association on development of dementia and all-cause mortality is ongoing. Part of the results included in this abstract are accepted for presentation as a poster in the European Academy of Neurology congress in Lisbon, 2018.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/decreased-amyloid-beta-in-patients-with-idiopathic-parkinsons-disease-and-white-matter-hyperintensities/