16 research outputs found
The impact of silent vascular brain burden in cognitive impairment in Parkinson's disease
White matter hyperintensities (WMHs) detected by magnetic
resonance imaging (MRI) of the brain are associated with dementia and cognitive
impairment in the general population and in Alzheimer's disease. Their effect in
cognitive decline and dementia associated with Parkinson's disease (PD) is still
unclear. METHODS: We studied the relationship between WMHs and cognitive state in
111 patients with PD classified as cognitively normal (n = 39), with a mild
cognitive impairment (MCI) (n = 46) or dementia (n = 26), in a cross-sectional
and follow-up study. Cognitive state was evaluated with a comprehensive
neuropsychological battery, and WMHs were identified in FLAIR and T2-weighted
MRI. The burden of WMHs was rated using the Scheltens scale. RESULTS: No
differences in WMHs were found between the three groups in the cross-sectional
study. A negative correlation was observed between semantic fluency and the
subscore for WMHs in the frontal lobe. Of the 36 non-demented patients
re-evaluated after a mean follow-up of 30 months, three patients converted into
MCI and 5 into dementia. Progression of periventricular WMHs was associated with
an increased conversion to dementia. A marginal association between the increase
in total WMHs burden and worsening in the Mini Mental State Examination was
encountered. CONCLUSIONS: White matter hyperintensities do not influence the
cognitive status of patients with PD. Frontal WMHs have a negative impact on
semantic fluency. Brain vascular burden may have an effect on cognitive
impairment in patients with PD as WMHs increase overtime might increase the risk
of conversion to dementia. This finding needs further confirmation in larger
prospective studies
Homocysteine and cognitive impairment in Parkinson's disease: a biochemical, neuroimaging, and genetic study.
8 páginas, 1 figura, 4 tablas.The role of the plasma level of homocysteine (Hcy), as a primary outcome, and the effect of silent cerebrovascular lesions and genetic variants related to Hcy metabolism, as secondary outcomes, in the cognitive decline and dementia in Parkinson's disease (PD) were studied. This case-control study focused on 89 PD patients of minimum 10 years of evolution and older than 60 years, who were neuropsychologically classified either as cognitively normal (n = 37), having mild cognitive impairment (Petersen criteria) (n = 22), or suffering from dementia (DSM-IV) (n = 30), compared with cognitively normal age-matched control subjects (n = 30). Plasma levels of Hcy, vitamins B12 and B6, folic acid, polymorphisms in genes related to Hcy metabolism (MTHFR, MTR, MTRR, and CBS) and silent cerebrovascular events were analyzed. Plasma levels of Hcy were increased in PD patients (P = 0.0001). There were no differences between the groups of patients. The brain vascular burden was similar among PD groups. There was no association between polymorphisms in the studied genes and the Hcy plasma levels or cognitive status in PD patients. We found no evidence for a direct relationship between Hcy plasma levels and cognitive impairment and dementia in PD. No indirect effect through cerebrovascular disease or genetic background was found either.This study was partially funded by a grant from the Government of Navarra (49/2004) Spain, a research grant from Novartis Pharma (Basel, Switzerland) and by the agreement between FIMA and the ‘UTE project FIMA’. Work performed at JP-T laboratory has been funded by the Ministerio de Educación y Ciencia, Spain (SAF2006-00724).Peer reviewe