Abstract Details

Title The Role of White Matter Hyperintensities in Parkinson’s Disease Progression and Outcome

Topic Movement Disorders

Presentation(s) Movement Disorders Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 156

Objective To investigate the influence of white matter hyperintensities (WMH) on the longitudinal evolution of symptoms and outcome in Parkinson’s disease (PD).

Background

WMH have an important role in cognitive impairment onset in normal brain ageing in the general population, while the relationship with clinical picture and disease progression in PD is still controversial.

Design/Methods

154 PD patients underwent clinical assessment, comprehensive cognitive evaluation and Magnetic Resonance Imaging (MRI) scan once a year up to 48 months. WMH were identified on T2-weighted scans and WMH total volume was computed for each scan at baseline. According to WMH burden at baseline, PD patients were divided in subgroups: low (lowH, ≤ 25^th quartile, n=45), intermediate (mediumH, between 25^th and 75^th quartile, n=77) and high (highH, ≥ 75^th quartile, n=32) burden. Analysis of variance was used to compare groups at baseline and age-corrected linear regression models for longitudinal data were applied to longitudinal variables. The influence of WMH on the progression to Hoehn & Yahr (H&Y) ≥ 3 and dementia was investigated with Kaplan-Meier estimator analysis (KM).

Results Subjects in PD highH were the oldest (p<0.001) and showed significantly lower scores in Mini Mental State Examination and Addenbrooke’s Cognitive Examination compared with lowH, Longitudinally, the highH group showed a significant worsening in motor and non-motor variables (p<0.001) compared to lowH and mediumH, independent of the effect of age. The KM analysis showed lower rates of progression to dementia (p=0.03) and to H&Y score ≥ 3 (p=0.02) in the lowH group.

Conclusions Our study showed that higher WMH volumes are associated with a worse progression of both motor and non-motor symptoms, independently from age. Moreover, PD patients with high WMH volumes are more likely to progress to dementia and to advanced disease stages in the following 4 years.

Authors/Disclosures
Edoardo G. Spinelli, MD PRESENTER	Dr. Spinelli has nothing to disclose.
	No disclosure on file
Federica Agosta (San Raffaele Scientific Institute)	Federica Agosta has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Philips. Federica Agosta has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier INC.
	No disclosure on file
Iva Stankovic (Neurology Clinic, Clinical Center of Serbia, University of Belgrade)	Iva Stankovic has nothing to disclose.
Vladana Markovic	No disclosure on file
	No disclosure on file
Elka Stefanova	No disclosure on file
Vladimir S. Kostic, MD, PhD (Institute of Neurology CCS)	Dr. Kostic has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Roche. An immediate family member of Dr. Kostic has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Alkaloid. The institution of Dr. Kostic has received research support from Ministry of �鶹��ýӳ��, Science and Technological Development of Serbia.
Massimo Filippi, MD, F�鶹��ýӳ�� (Ospedale San Raffaele, Neuroimaging Research Unit)	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.

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