Brain atrophy and strategic lesion location increases risk of parkinsonism in cerebral small vessel disease

Mayra I. Bergkamp (Corresponding Author), Anil M. Tuladhar, Helena M. van der Holst, Esther M.C. van Leijsen, Mohsen Ghafoorian, Ingeborg W.M. van Uden, Ewoud J. van Dijk, David G. Norris, Bram Platel, Rianne A.J. Esselink, Frank Erik de Leeuw

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Abstract

Introduction: Incident parkinsonism in patients with comparable cerebral small vessel disease (SVD) burden is not fully explained by presence of SVD alone. We therefore investigated if severity of SVD, SVD location, incidence of SVD and/or brain atrophy plays a role in this distinct development of parkinsonism. Methods: Participants were from the RUN DMC study, a prospective cohort of 503 individuals with SVD. Parkinsonism was diagnosed according to the UKPDS brain bank criteria. Fine and Gray method was used to assess the association between SVD and incident parkinsonism. Differences in white matter hyperintensities (WMH) progression and brain atrophy were calculated with a linear mixed effect analysis. Results: After a median follow-up of 8.6 years, 32 of 501 participants developed parkinsonism (6.4%). The highest WMH load was found in the frontal lobe for both groups. Presence of more than one lacune at baseline was higher in the group who developed parkinsonism, especially in the frontal lobe (22% versus 3%, p < 0.001) and basal ganglia (12.5% versus 1%, p-value <0.001). The annual rate of total brain atrophy was significantly higher for those who developed parkinsonism compared to those who did not (8.7 ml [95%CI 7.1–10.3] and 4.9 ml [95%CI 4.5–5.3], respectively). While WMH progression was not different, incidence of lacunes and microbleeds was higher in the group with parkinsonism. Conclusion: The risk of parkinsonism in patients with SVD is especially increased when WMH and lacunes are present in the frontal lobe. A higher brain atrophy rate might further increase this risk.

Original languageEnglish
Pages (from-to)94-100
Number of pages7
JournalParkinsonism and Related Disorders
Volume61
DOIs
Publication statusPublished - 1 Apr 2019
Externally publishedYes

Fingerprint

Cerebral Small Vessel Diseases
Parkinsonian Disorders
Atrophy
Brain
Frontal Lobe
Incidence
Brain Diseases
Basal Ganglia
Prospective Studies

Keywords

  • Brain atrophy
  • Cerebral small vessel disease
  • Parkinsonism

Cite this

Bergkamp, M. I., Tuladhar, A. M., van der Holst, H. M., van Leijsen, E. M. C., Ghafoorian, M., van Uden, I. W. M., ... Leeuw, F. E. D. (2019). Brain atrophy and strategic lesion location increases risk of parkinsonism in cerebral small vessel disease. Parkinsonism and Related Disorders, 61, 94-100. https://doi.org/10.1016/j.parkreldis.2018.11.010
Bergkamp, Mayra I. ; Tuladhar, Anil M. ; van der Holst, Helena M. ; van Leijsen, Esther M.C. ; Ghafoorian, Mohsen ; van Uden, Ingeborg W.M. ; van Dijk, Ewoud J. ; Norris, David G. ; Platel, Bram ; Esselink, Rianne A.J. ; Leeuw, Frank Erik de. / Brain atrophy and strategic lesion location increases risk of parkinsonism in cerebral small vessel disease. In: Parkinsonism and Related Disorders. 2019 ; Vol. 61. pp. 94-100.
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abstract = "Introduction: Incident parkinsonism in patients with comparable cerebral small vessel disease (SVD) burden is not fully explained by presence of SVD alone. We therefore investigated if severity of SVD, SVD location, incidence of SVD and/or brain atrophy plays a role in this distinct development of parkinsonism. Methods: Participants were from the RUN DMC study, a prospective cohort of 503 individuals with SVD. Parkinsonism was diagnosed according to the UKPDS brain bank criteria. Fine and Gray method was used to assess the association between SVD and incident parkinsonism. Differences in white matter hyperintensities (WMH) progression and brain atrophy were calculated with a linear mixed effect analysis. Results: After a median follow-up of 8.6 years, 32 of 501 participants developed parkinsonism (6.4{\%}). The highest WMH load was found in the frontal lobe for both groups. Presence of more than one lacune at baseline was higher in the group who developed parkinsonism, especially in the frontal lobe (22{\%} versus 3{\%}, p < 0.001) and basal ganglia (12.5{\%} versus 1{\%}, p-value <0.001). The annual rate of total brain atrophy was significantly higher for those who developed parkinsonism compared to those who did not (8.7 ml [95{\%}CI 7.1–10.3] and 4.9 ml [95{\%}CI 4.5–5.3], respectively). While WMH progression was not different, incidence of lacunes and microbleeds was higher in the group with parkinsonism. Conclusion: The risk of parkinsonism in patients with SVD is especially increased when WMH and lacunes are present in the frontal lobe. A higher brain atrophy rate might further increase this risk.",
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Bergkamp, MI, Tuladhar, AM, van der Holst, HM, van Leijsen, EMC, Ghafoorian, M, van Uden, IWM, van Dijk, EJ, Norris, DG, Platel, B, Esselink, RAJ & Leeuw, FED 2019, 'Brain atrophy and strategic lesion location increases risk of parkinsonism in cerebral small vessel disease' Parkinsonism and Related Disorders, vol. 61, pp. 94-100. https://doi.org/10.1016/j.parkreldis.2018.11.010

Brain atrophy and strategic lesion location increases risk of parkinsonism in cerebral small vessel disease. / Bergkamp, Mayra I. (Corresponding Author); Tuladhar, Anil M.; van der Holst, Helena M.; van Leijsen, Esther M.C.; Ghafoorian, Mohsen; van Uden, Ingeborg W.M.; van Dijk, Ewoud J.; Norris, David G.; Platel, Bram; Esselink, Rianne A.J.; Leeuw, Frank Erik de.

In: Parkinsonism and Related Disorders, Vol. 61, 01.04.2019, p. 94-100.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Brain atrophy and strategic lesion location increases risk of parkinsonism in cerebral small vessel disease

AU - Bergkamp, Mayra I.

AU - Tuladhar, Anil M.

AU - van der Holst, Helena M.

AU - van Leijsen, Esther M.C.

AU - Ghafoorian, Mohsen

AU - van Uden, Ingeborg W.M.

AU - van Dijk, Ewoud J.

AU - Norris, David G.

AU - Platel, Bram

AU - Esselink, Rianne A.J.

AU - Leeuw, Frank Erik de

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Introduction: Incident parkinsonism in patients with comparable cerebral small vessel disease (SVD) burden is not fully explained by presence of SVD alone. We therefore investigated if severity of SVD, SVD location, incidence of SVD and/or brain atrophy plays a role in this distinct development of parkinsonism. Methods: Participants were from the RUN DMC study, a prospective cohort of 503 individuals with SVD. Parkinsonism was diagnosed according to the UKPDS brain bank criteria. Fine and Gray method was used to assess the association between SVD and incident parkinsonism. Differences in white matter hyperintensities (WMH) progression and brain atrophy were calculated with a linear mixed effect analysis. Results: After a median follow-up of 8.6 years, 32 of 501 participants developed parkinsonism (6.4%). The highest WMH load was found in the frontal lobe for both groups. Presence of more than one lacune at baseline was higher in the group who developed parkinsonism, especially in the frontal lobe (22% versus 3%, p < 0.001) and basal ganglia (12.5% versus 1%, p-value <0.001). The annual rate of total brain atrophy was significantly higher for those who developed parkinsonism compared to those who did not (8.7 ml [95%CI 7.1–10.3] and 4.9 ml [95%CI 4.5–5.3], respectively). While WMH progression was not different, incidence of lacunes and microbleeds was higher in the group with parkinsonism. Conclusion: The risk of parkinsonism in patients with SVD is especially increased when WMH and lacunes are present in the frontal lobe. A higher brain atrophy rate might further increase this risk.

AB - Introduction: Incident parkinsonism in patients with comparable cerebral small vessel disease (SVD) burden is not fully explained by presence of SVD alone. We therefore investigated if severity of SVD, SVD location, incidence of SVD and/or brain atrophy plays a role in this distinct development of parkinsonism. Methods: Participants were from the RUN DMC study, a prospective cohort of 503 individuals with SVD. Parkinsonism was diagnosed according to the UKPDS brain bank criteria. Fine and Gray method was used to assess the association between SVD and incident parkinsonism. Differences in white matter hyperintensities (WMH) progression and brain atrophy were calculated with a linear mixed effect analysis. Results: After a median follow-up of 8.6 years, 32 of 501 participants developed parkinsonism (6.4%). The highest WMH load was found in the frontal lobe for both groups. Presence of more than one lacune at baseline was higher in the group who developed parkinsonism, especially in the frontal lobe (22% versus 3%, p < 0.001) and basal ganglia (12.5% versus 1%, p-value <0.001). The annual rate of total brain atrophy was significantly higher for those who developed parkinsonism compared to those who did not (8.7 ml [95%CI 7.1–10.3] and 4.9 ml [95%CI 4.5–5.3], respectively). While WMH progression was not different, incidence of lacunes and microbleeds was higher in the group with parkinsonism. Conclusion: The risk of parkinsonism in patients with SVD is especially increased when WMH and lacunes are present in the frontal lobe. A higher brain atrophy rate might further increase this risk.

KW - Brain atrophy

KW - Cerebral small vessel disease

KW - Parkinsonism

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U2 - 10.1016/j.parkreldis.2018.11.010

DO - 10.1016/j.parkreldis.2018.11.010

M3 - Article

VL - 61

SP - 94

EP - 100

JO - Parkinsonism & Related Disorders

JF - Parkinsonism & Related Disorders

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