Diffusion tensor imaging and mild parkinsonian signs in cerebral small vessel disease

Karlijn F de Laat, Anouk G W van Norden, Lucas J B van Oudheusden, Inge W M van Uden, David G Norris, Marcel P Zwiers, Frank-Erik de Leeuw

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Although the role of cerebral small vessel disease (SVD), including white matter lesions (WMLs) and lacunar infarcts, in mild parkinsonian signs (MPS) is increasingly being recognized, not all individuals with SVD have MPS. Using diffusion tensor imaging (DTI), we investigated whether the presence of MPS was dependent on the microstructural integrity underlying WMLs, the early loss of integrity of the normal-appearing white matter (NAWM) and location of this damage. We examined 483 elderly subjects with SVD and without parkinsonism. Subjects with severe loss of integrity within their WMLs had a higher risk of MPS, regardless of WML volume (fractional anisotropy odds ratios = 1.9; 95% confidence interval, 1.1-3.4). The same was found in the normal-appearing white matter, but this association disappeared after adjustment for WMLs and lacunar infarcts. The integrity of the periventricular frontal regions-of-interest was significantly lower in subjects with MPS than without, independent of WMLs and lacunar infarcts. This study indicates that integrity of WMLs, especially in the frontal lobe, is associated with MPS. Diffusion tensor imaging may be of added value in investigating the underlying mechanisms of parkinsonian signs in subjects with SVD.

Original languageEnglish
Pages (from-to)2106-12
Number of pages7
JournalNeurobiology of Aging
Volume33
Issue number9
DOIs
Publication statusPublished - Sep 2012

Cite this

de Laat, K. F., van Norden, A. G. W., van Oudheusden, L. J. B., van Uden, I. W. M., Norris, D. G., Zwiers, M. P., & de Leeuw, F-E. (2012). Diffusion tensor imaging and mild parkinsonian signs in cerebral small vessel disease. Neurobiology of Aging, 33(9), 2106-12. https://doi.org/10.1016/j.neurobiolaging.2011.09.001
de Laat, Karlijn F ; van Norden, Anouk G W ; van Oudheusden, Lucas J B ; van Uden, Inge W M ; Norris, David G ; Zwiers, Marcel P ; de Leeuw, Frank-Erik. / Diffusion tensor imaging and mild parkinsonian signs in cerebral small vessel disease. In: Neurobiology of Aging. 2012 ; Vol. 33, No. 9. pp. 2106-12.
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abstract = "Although the role of cerebral small vessel disease (SVD), including white matter lesions (WMLs) and lacunar infarcts, in mild parkinsonian signs (MPS) is increasingly being recognized, not all individuals with SVD have MPS. Using diffusion tensor imaging (DTI), we investigated whether the presence of MPS was dependent on the microstructural integrity underlying WMLs, the early loss of integrity of the normal-appearing white matter (NAWM) and location of this damage. We examined 483 elderly subjects with SVD and without parkinsonism. Subjects with severe loss of integrity within their WMLs had a higher risk of MPS, regardless of WML volume (fractional anisotropy odds ratios = 1.9; 95{\%} confidence interval, 1.1-3.4). The same was found in the normal-appearing white matter, but this association disappeared after adjustment for WMLs and lacunar infarcts. The integrity of the periventricular frontal regions-of-interest was significantly lower in subjects with MPS than without, independent of WMLs and lacunar infarcts. This study indicates that integrity of WMLs, especially in the frontal lobe, is associated with MPS. Diffusion tensor imaging may be of added value in investigating the underlying mechanisms of parkinsonian signs in subjects with SVD.",
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de Laat, KF, van Norden, AGW, van Oudheusden, LJB, van Uden, IWM, Norris, DG, Zwiers, MP & de Leeuw, F-E 2012, 'Diffusion tensor imaging and mild parkinsonian signs in cerebral small vessel disease' Neurobiology of Aging, vol. 33, no. 9, pp. 2106-12. https://doi.org/10.1016/j.neurobiolaging.2011.09.001

Diffusion tensor imaging and mild parkinsonian signs in cerebral small vessel disease. / de Laat, Karlijn F; van Norden, Anouk G W; van Oudheusden, Lucas J B; van Uden, Inge W M; Norris, David G; Zwiers, Marcel P; de Leeuw, Frank-Erik.

In: Neurobiology of Aging, Vol. 33, No. 9, 09.2012, p. 2106-12.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Diffusion tensor imaging and mild parkinsonian signs in cerebral small vessel disease

AU - de Laat, Karlijn F

AU - van Norden, Anouk G W

AU - van Oudheusden, Lucas J B

AU - van Uden, Inge W M

AU - Norris, David G

AU - Zwiers, Marcel P

AU - de Leeuw, Frank-Erik

N1 - Copyright © 2012 Elsevier Inc. All rights reserved.

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Y1 - 2012/9

N2 - Although the role of cerebral small vessel disease (SVD), including white matter lesions (WMLs) and lacunar infarcts, in mild parkinsonian signs (MPS) is increasingly being recognized, not all individuals with SVD have MPS. Using diffusion tensor imaging (DTI), we investigated whether the presence of MPS was dependent on the microstructural integrity underlying WMLs, the early loss of integrity of the normal-appearing white matter (NAWM) and location of this damage. We examined 483 elderly subjects with SVD and without parkinsonism. Subjects with severe loss of integrity within their WMLs had a higher risk of MPS, regardless of WML volume (fractional anisotropy odds ratios = 1.9; 95% confidence interval, 1.1-3.4). The same was found in the normal-appearing white matter, but this association disappeared after adjustment for WMLs and lacunar infarcts. The integrity of the periventricular frontal regions-of-interest was significantly lower in subjects with MPS than without, independent of WMLs and lacunar infarcts. This study indicates that integrity of WMLs, especially in the frontal lobe, is associated with MPS. Diffusion tensor imaging may be of added value in investigating the underlying mechanisms of parkinsonian signs in subjects with SVD.

AB - Although the role of cerebral small vessel disease (SVD), including white matter lesions (WMLs) and lacunar infarcts, in mild parkinsonian signs (MPS) is increasingly being recognized, not all individuals with SVD have MPS. Using diffusion tensor imaging (DTI), we investigated whether the presence of MPS was dependent on the microstructural integrity underlying WMLs, the early loss of integrity of the normal-appearing white matter (NAWM) and location of this damage. We examined 483 elderly subjects with SVD and without parkinsonism. Subjects with severe loss of integrity within their WMLs had a higher risk of MPS, regardless of WML volume (fractional anisotropy odds ratios = 1.9; 95% confidence interval, 1.1-3.4). The same was found in the normal-appearing white matter, but this association disappeared after adjustment for WMLs and lacunar infarcts. The integrity of the periventricular frontal regions-of-interest was significantly lower in subjects with MPS than without, independent of WMLs and lacunar infarcts. This study indicates that integrity of WMLs, especially in the frontal lobe, is associated with MPS. Diffusion tensor imaging may be of added value in investigating the underlying mechanisms of parkinsonian signs in subjects with SVD.

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KW - Anisotropy

KW - Brain Infarction/etiology

KW - Brain Mapping

KW - Cerebral Small Vessel Diseases/complications

KW - Diffusion Tensor Imaging

KW - Female

KW - Humans

KW - Image Processing, Computer-Assisted

KW - Magnetic Resonance Imaging

KW - Male

KW - Mental Status Schedule

KW - Middle Aged

KW - Nerve Fibers, Myelinated/pathology

KW - Parkinsonian Disorders/etiology

KW - Retrospective Studies

KW - Surveys and Questionnaires

U2 - 10.1016/j.neurobiolaging.2011.09.001

DO - 10.1016/j.neurobiolaging.2011.09.001

M3 - Article

VL - 33

SP - 2106

EP - 2112

JO - Neurobiology of Aging

JF - Neurobiology of Aging

SN - 0197-4580

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