White matter hyperintensities as a predictor of freezing of gait in Parkinson's disease

Seok Jong Chung, Yang Hyun Lee, Han Soo Yoo, Jungsu S. Oh, Jae Seung Kim, Byoung Seok Ye, Young H. Sohn, philhyu Lee

Research output: Contribution to journalArticle

Abstract

Introduction: To investigate the effect of white matter hyperintensities (WMH) on long-term motor outcomes in Parkinson's disease (PD). Methods: We retrospectively reviewed medical records of 268 patients with de novo PD (follow-up > 3 years). According to the Clinical Research Center for Dementia of South Korea (CREDOS) WMH visual rating scale scores, the patients were divided into two groups: a PD group with minimal WMH (PD-WMH-; n = 198) and a PD group with moderate to severe WMH (PD-WMH+; n = 70). We compared longitudinal increases in doses of dopaminergic medications between the two groups using a mixed model. We also assessed the effects of WMH on the development of freezing of gait (FOG). Results: Patients in the PD-WMH + group were older than those in the PD-WMH- group, and had more severe motor deficits and more severely decreased striatal dopamine transporter availability. The PD-WMH + group required higher doses of dopaminergic medications for symptom control, compared to the PD-WMH- group, over the follow-up period. After adjusting for age, sex, striatal dopamine transporter availability, and levodopa-equivalent dose, the PD-WMH + group showed a higher risk of developing FOG (HR, 3.29; 95% CI, 1.79–6.05; p < 0.001) than the PD-WMH- group. Conclusion: This study demonstrates that WMH burden negatively affects the longitudinal requirement of dopaminergic medication and the development of FOG. These findings suggest that baseline WMH severity or volume may be a useful prognostic marker of motor outcomes in PD.

Original languageEnglish
JournalParkinsonism and Related Disorders
DOIs
Publication statusPublished - 2019 Jan 1

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Gait
Freezing
Parkinson Disease
Corpus Striatum
Dopamine Plasma Membrane Transport Proteins
White Matter
Republic of Korea
Levodopa
Medical Records
Dementia

All Science Journal Classification (ASJC) codes

  • Neurology
  • Geriatrics and Gerontology
  • Clinical Neurology

Cite this

Chung, Seok Jong ; Lee, Yang Hyun ; Yoo, Han Soo ; Oh, Jungsu S. ; Kim, Jae Seung ; Ye, Byoung Seok ; Sohn, Young H. ; Lee, philhyu. / White matter hyperintensities as a predictor of freezing of gait in Parkinson's disease. In: Parkinsonism and Related Disorders. 2019.
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abstract = "Introduction: To investigate the effect of white matter hyperintensities (WMH) on long-term motor outcomes in Parkinson's disease (PD). Methods: We retrospectively reviewed medical records of 268 patients with de novo PD (follow-up > 3 years). According to the Clinical Research Center for Dementia of South Korea (CREDOS) WMH visual rating scale scores, the patients were divided into two groups: a PD group with minimal WMH (PD-WMH-; n = 198) and a PD group with moderate to severe WMH (PD-WMH+; n = 70). We compared longitudinal increases in doses of dopaminergic medications between the two groups using a mixed model. We also assessed the effects of WMH on the development of freezing of gait (FOG). Results: Patients in the PD-WMH + group were older than those in the PD-WMH- group, and had more severe motor deficits and more severely decreased striatal dopamine transporter availability. The PD-WMH + group required higher doses of dopaminergic medications for symptom control, compared to the PD-WMH- group, over the follow-up period. After adjusting for age, sex, striatal dopamine transporter availability, and levodopa-equivalent dose, the PD-WMH + group showed a higher risk of developing FOG (HR, 3.29; 95{\%} CI, 1.79–6.05; p < 0.001) than the PD-WMH- group. Conclusion: This study demonstrates that WMH burden negatively affects the longitudinal requirement of dopaminergic medication and the development of FOG. These findings suggest that baseline WMH severity or volume may be a useful prognostic marker of motor outcomes in PD.",
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White matter hyperintensities as a predictor of freezing of gait in Parkinson's disease. / Chung, Seok Jong; Lee, Yang Hyun; Yoo, Han Soo; Oh, Jungsu S.; Kim, Jae Seung; Ye, Byoung Seok; Sohn, Young H.; Lee, philhyu.

In: Parkinsonism and Related Disorders, 01.01.2019.

Research output: Contribution to journalArticle

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AU - Chung, Seok Jong

AU - Lee, Yang Hyun

AU - Yoo, Han Soo

AU - Oh, Jungsu S.

AU - Kim, Jae Seung

AU - Ye, Byoung Seok

AU - Sohn, Young H.

AU - Lee, philhyu

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AB - Introduction: To investigate the effect of white matter hyperintensities (WMH) on long-term motor outcomes in Parkinson's disease (PD). Methods: We retrospectively reviewed medical records of 268 patients with de novo PD (follow-up > 3 years). According to the Clinical Research Center for Dementia of South Korea (CREDOS) WMH visual rating scale scores, the patients were divided into two groups: a PD group with minimal WMH (PD-WMH-; n = 198) and a PD group with moderate to severe WMH (PD-WMH+; n = 70). We compared longitudinal increases in doses of dopaminergic medications between the two groups using a mixed model. We also assessed the effects of WMH on the development of freezing of gait (FOG). Results: Patients in the PD-WMH + group were older than those in the PD-WMH- group, and had more severe motor deficits and more severely decreased striatal dopamine transporter availability. The PD-WMH + group required higher doses of dopaminergic medications for symptom control, compared to the PD-WMH- group, over the follow-up period. After adjusting for age, sex, striatal dopamine transporter availability, and levodopa-equivalent dose, the PD-WMH + group showed a higher risk of developing FOG (HR, 3.29; 95% CI, 1.79–6.05; p < 0.001) than the PD-WMH- group. Conclusion: This study demonstrates that WMH burden negatively affects the longitudinal requirement of dopaminergic medication and the development of FOG. These findings suggest that baseline WMH severity or volume may be a useful prognostic marker of motor outcomes in PD.

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