WHITE-MATTER HYPERINTENSITIES IN PARKINSONS-DISEASE - CLINICAL CORRELATIONS

Objectives: To verify recent preliminary data indicating that white ma tter hyperintensities on magnetic resonance imaging are more abundant in patients with Parkinson's disease (PD) than in healthy subjects and to examine possible correlation between these abnormalities and clini cal features of PD. Design: Magnetic resonance imaging data on patient s with PD and normal subjects were compared as to frequency, extent, a nd topographic location of white matter hyperintensities; moreover, in the PD group, we studied the possible correlation of white matter hyp erintensities with clinical features such as severity, disease duratio n, and therapy. Setting: The outpatient clinic of the Institute of Cli nical Neurology and the Neuroradiology Unit of the University of Pisa (Italy). Patients: We studied 102 nondemented patients with idiopathic PD and 68 sex- and age-matched healthy controls, all screened for abs ence of cerebrovascular risk factors. Outcome Measures: White matter h yperintensities were classified as periventricular hyperintensities an d deep hyperintensities. Frequency, extent, and topographic location o f both periventricular and deep hyperintensities were evaluated. The c linical parameters examined were disease duration, treatment type, and disease severity (using Hoehn and Yahr staging and the Unified Parkin son's Disease Rating Scale), as well as disease progression index (rat io between Hoehn and Yahr stage and disease duration). Results: The fr equency and the extent of periventricular hyperintensities were signif icantly higher in patients with PD than in healthy subjects. Moreover, within the PD group, the patients who had periventricular hyperintens ities had significantly shorter disease duration and greater disease s everity, ie, a higher disease progression index, than those who did no t. Conclusion: These data suggest that periventricular hyperintensitie s may represent a marker for a clinical subtype of PD characterized by a more rapid neurodegenerative process.