Date: Monday, October 8, 2018
Session Title: Parkinson's Disease: Neuroimaging And Neurophysiology
Session Time: 1:15pm-2:45pm
Location: Hall 3FG
Objective: To examine white matter hyperintensity grade (WMHG) by parkinsonism type, and the association between WMHG and mortality among incident parkinsonism patients in a population-based study.
Background: The presence of white matter hyperintensities has been associated with a higher risk of stroke, dementia and mortality.
Methods: Using the medical records-linkage system of the Rochester Epidemiology Project, we identified 669 patients with a diagnosis of parkinsonism from 1991 through 2010. A movement disorders specialist reviewed the records of all patients and ascertained the diagnosis, symptom onset date and death date or last visiting date; 328 (49%) had MRIs after parkinsonism onset. WMHG was evaluated according to Manolio WMHG. General linear models and cox proportional hazard models were used to examine the associations of WMHG, parkinsonism type and mortality, adjusting for age, sex, parkinsonism duration and history of cerebral vascular disease (CVD).
Results: The median disease duration was 3.6 years (interquartile range (IQR), 1.2-7.0). In multivariate models, 91 clinically diagnosed non-synucleinopathy patients had higher WMHG (b=0.34, 95% CI: 0.13-0.54) compared to 237 synucleinopathy patients; 168 non-PD parkinsonism patients had higher WMHG (b=0.26, 95% CI: 0.08-0.45) than 160 PD patients. PD dementia patients (n=66) also had higher WMHG (b=0.36, 95% CI: 0.09-0.62) than 171 PD without dementia, but the difference was attenuated and no longer significant after adjustment. Higher WMHG was associated with an increased risk of mortality among all groups except PD with dementia, but these associations were attenuated in multivariate models.
Conclusions: Among incident parkinsonism patients, WMHG was greater in those without versus with clinically diagnosed synucleinopathies, and with non-PD parkinsonisms compared to PD. Further, WMHG was not associated with mortliaty among any parkinsonism patients.
To cite this abstract in AMA style:J. Yu, R. Brown, J. Huston, M. Mielke, C. stang, P. Turcano, R. Savica. White Matter Hyperintensities and Mortality among Patients with Parkinsonism in Olmsted County, MN (1995-2010) [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/white-matter-hyperintensities-and-mortality-among-patients-with-parkinsonism-in-olmsted-county-mn-1995-2010/. Accessed December 2, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/white-matter-hyperintensities-and-mortality-among-patients-with-parkinsonism-in-olmsted-county-mn-1995-2010/