Adverse effects of hypertension, supine hypertension, and perivascular space on cognition and motor function in PD
Abstract Dilated perivascular space (dPVS) has recently been reported as a biomarker for cognitive impairment in Parkinson’s disease (PD). However, comprehensive interrelationships between various clinical risk factors, dPVS, white-matter hyperintensities (WMH), cognition, and motor function in PD h...
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doaj-8d453d4304024b5ca63b154d40a1c23e2021-08-15T11:31:22ZengNature Publishing Groupnpj Parkinson's Disease2373-80572021-08-01711710.1038/s41531-021-00214-6Adverse effects of hypertension, supine hypertension, and perivascular space on cognition and motor function in PDNa-Young Shin0Yae Won Park1Sang-Won Yoo2Ji-Yeon Yoo3Yangsean Choi4Jinhee Jang5Kook-Jin Ahn6Bum-soo Kim7Joong-Seok Kim8Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of MedicineDepartment of Neurology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Neurology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Neurology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaAbstract Dilated perivascular space (dPVS) has recently been reported as a biomarker for cognitive impairment in Parkinson’s disease (PD). However, comprehensive interrelationships between various clinical risk factors, dPVS, white-matter hyperintensities (WMH), cognition, and motor function in PD have not been studied yet. The purpose of this study was to test whether dPVS might mediate the effect of clinical risk factors on WMH, cognition, and motor symptoms in PD patients. A total of 154 PD patients were assessed for vascular risk factors (hypertension, diabetes mellitus, and dyslipidemia), autonomic dysfunction (orthostatic hypotension and supine hypertension [SH]), APOE ε4 genotype, rapid eye movement sleep-behavior disorder, motor symptoms, and cognition status. The degree of dPVS was evaluated in the basal ganglia (BG) and white matter using a 5-point visual scale. Periventricular, deep, and total WMH severity was also assessed. Path analysis was performed to evaluate the associations of these clinical factors and imaging markers with cognitive status and motor symptoms. Hypertension and SH were significantly associated with more severe BGdPVS, which was further associated with higher total WMH, consequently leading to lower cognitive status. More severe BGdPVS was also associated with worse motor symptoms, but without mediation of total WMH. Similar associations were seen when using periventricular WMH as a variable, but not when using deep WMH as a variable. In conclusion, BGdPVS mediates the effect of hypertension and SH on cognitive impairment via total and periventricular WMH, while being directly associated with more severe motor symptoms.https://doi.org/10.1038/s41531-021-00214-6 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Na-Young Shin Yae Won Park Sang-Won Yoo Ji-Yeon Yoo Yangsean Choi Jinhee Jang Kook-Jin Ahn Bum-soo Kim Joong-Seok Kim |
spellingShingle |
Na-Young Shin Yae Won Park Sang-Won Yoo Ji-Yeon Yoo Yangsean Choi Jinhee Jang Kook-Jin Ahn Bum-soo Kim Joong-Seok Kim Adverse effects of hypertension, supine hypertension, and perivascular space on cognition and motor function in PD npj Parkinson's Disease |
author_facet |
Na-Young Shin Yae Won Park Sang-Won Yoo Ji-Yeon Yoo Yangsean Choi Jinhee Jang Kook-Jin Ahn Bum-soo Kim Joong-Seok Kim |
author_sort |
Na-Young Shin |
title |
Adverse effects of hypertension, supine hypertension, and perivascular space on cognition and motor function in PD |
title_short |
Adverse effects of hypertension, supine hypertension, and perivascular space on cognition and motor function in PD |
title_full |
Adverse effects of hypertension, supine hypertension, and perivascular space on cognition and motor function in PD |
title_fullStr |
Adverse effects of hypertension, supine hypertension, and perivascular space on cognition and motor function in PD |
title_full_unstemmed |
Adverse effects of hypertension, supine hypertension, and perivascular space on cognition and motor function in PD |
title_sort |
adverse effects of hypertension, supine hypertension, and perivascular space on cognition and motor function in pd |
publisher |
Nature Publishing Group |
series |
npj Parkinson's Disease |
issn |
2373-8057 |
publishDate |
2021-08-01 |
description |
Abstract Dilated perivascular space (dPVS) has recently been reported as a biomarker for cognitive impairment in Parkinson’s disease (PD). However, comprehensive interrelationships between various clinical risk factors, dPVS, white-matter hyperintensities (WMH), cognition, and motor function in PD have not been studied yet. The purpose of this study was to test whether dPVS might mediate the effect of clinical risk factors on WMH, cognition, and motor symptoms in PD patients. A total of 154 PD patients were assessed for vascular risk factors (hypertension, diabetes mellitus, and dyslipidemia), autonomic dysfunction (orthostatic hypotension and supine hypertension [SH]), APOE ε4 genotype, rapid eye movement sleep-behavior disorder, motor symptoms, and cognition status. The degree of dPVS was evaluated in the basal ganglia (BG) and white matter using a 5-point visual scale. Periventricular, deep, and total WMH severity was also assessed. Path analysis was performed to evaluate the associations of these clinical factors and imaging markers with cognitive status and motor symptoms. Hypertension and SH were significantly associated with more severe BGdPVS, which was further associated with higher total WMH, consequently leading to lower cognitive status. More severe BGdPVS was also associated with worse motor symptoms, but without mediation of total WMH. Similar associations were seen when using periventricular WMH as a variable, but not when using deep WMH as a variable. In conclusion, BGdPVS mediates the effect of hypertension and SH on cognitive impairment via total and periventricular WMH, while being directly associated with more severe motor symptoms. |
url |
https://doi.org/10.1038/s41531-021-00214-6 |
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