Perivascular Spaces in the Basal Ganglia and Long-term Motor Prognosis in Newly Diagnosed Parkinson Disease. (20th April 2021)

• Record Type: Journal Article
• Authors: Chung, Seok Jong; Yoo, Han Soo; Shin, Na-Young; Park, Yae Won; Lee, Hye Sun; Hong, Ji-Man; Kim, Yun Joong; Lee, Seung-Koo; Lee, Phil Hyu; Sohn, Young H.
• Is Part Of: Neurology. Volume 96:Number 16(2021)
• Publication Date: 2021-04-20
• Subjects: Neurology -- Periodicals; Neurology -- Periodicals; Neurologie -- Périodiques; 616.8
• DOI: 10.1212/WNL.0000000000011797
• Languages: English
• ISSNs: 0028-3878

Abstract

Abstract : Objective: To investigate the association between enlarged perivascular spaces (PVS) in the basal ganglia (BG-PVS) and long-term motor outcomes in Parkinson disease (PD). Methods: We reviewed the medical records of 248 patients with drug-naive early-stage PD (follow-up >3 years, mean age 67.44 ± 8.46 years, 130 female) who underwent brain MRI and dopamine transporter (DAT) scans at initial assessment. The number of baseline enlarged BG-PVS was counted on axial T2-weighted images. Then, patients were divided into 2 groups: a PD group with a low number (0–10) of enlarged PVS (PD-EPVS−; n = 156) and a PD group with a high number (>10) of enlarged PVS (PD-EPVS+; n = 92). We used Cox regression models to compare the levodopa-induced dyskinesia (LID)–, wearing-off–, and freezing of gait (FOG)–free times between groups. We also compared longitudinal increases in levodopa-equivalent dose per body weight between groups using a linear mixed model. Results: Patients in the PD-EPVS+ group were older (72.28 ± 6.07 years) and had greater small vessel disease burden than those in the PD-EPVS− group (64.58 ± 8.38 years). The PD-EPVS+ group exhibited more severely decreased DAT availability in all striatal subregions except the ventral striatum. The risk of FOG was higher in the PD-EPVS+ group, but the risk of LID or wearing-off was comparable between groups. The PD-EPVS+ group required higher doses of dopaminergic medications for effective symptom control compared to the PD-EPVS− group. Conclusion: This study suggests that baseline enlarged BG-PVS can be an indicator of the progression of motor disability in PD.