Highlights
- •Motor dysfunction in Parkinson's Disease (PD) is apparently multifactorial.
- •Attributing the appropriate motor phenotype requires a prolonged clinical observation.
- •Comorbid white matter disease is important in the development of the motor phenotype of PD.
- •Comorbidities only give a partial contribution in defining the motor subtype, compared to white matter disease.
- •Gender is important in defining the motor course of PD.
Abstract
Background
Parkinson's Disease (PD) patients are usually divided into Tremor Dominant (TD) and
Postural Instability/Gait Difficulty (PIGD) subtypes. The latter is characterized
by axial motor symptoms and worse outcomes, possibly also because of comorbid white
matter disease. Therefore, the current study investigated the importance of Age-Related
White Matter Changes (ARWMCs) in the development of different PD motor phenotypes.
Methods
The present 4-year longitudinal study recruited 63 de novo PD patients, who underwent
MRI at the time of the diagnosis to rate ARWMCs. Motor subtypes (PIGD or TD) were
evaluated at baseline visit, and after 2 and 4 years. Age, gender, UPDRS part III total score, comorbidities and ARWMC total score
were included in a mixed effect logistic regression model for repeated measures.
Results
The likelihood of being PIGD subtype during the study period was associated with higher
ARWMC total score (OR = 2.743; 95%CI = 1.137–7.802), but not with age (OR = 0.967; 95%CI = 0.818–1.143), female gender (OR = 0.169; 95%CI = 0.014–1.970), UPDRS part III total score (OR = 1.942; 95%CI = 0.888–13.470), and comorbidities (OR = 2.979; 95%CI = 0.560–15.849).
Conclusion
Motor dysfunction in PD is apparently multifactorial and, in particular, comorbid
white matter disease might concur in the development of axial impairment.
Keywords
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Article info
Publication history
Published online: June 08, 2016
Accepted:
June 7,
2016
Received in revised form:
May 7,
2016
Received:
March 16,
2016
Identification
Copyright
© 2016 Elsevier B.V. All rights reserved.
