[The influence of vascular risk factors and white matter hyperintensities on the degree of motor impairment in Parkinson's disease].
OBJECTIVE
The aim of the study was to assess the prevalence of vascular risk factors and white matter hyperintensities (WMH) in patients with Parkinson's disease (PD) and its impact on clinical features such as motor impairment.


METHODS
60 patients with PD [25 women and 35 men; mean age 68.4 (51-81) years, mean duration of disease 8.4 (1-27) years] with good response to L-Dopa were studied. Besides neurological examination, the degree of motor impairment was evaluated in all patients using UPDRS, Hoehn-Yahr, and Schwab-England scales. All patients underwent MRI to assess the degree of WMH using Age Related White Matter Changes (ARWMC) Wahlund scale. Moreover, the prevalence of classic vascular risk factors included arterial hypertension, diabetes mellitus t. 1 and 2; plasma cholesterol, cardiovascular diseases, alcohol abuse and smoking was assessed.


RESULTS
Presence of at least one vascular risk factor was noted in 19 patients (31.7%). No significant differences were found between the groups of patients with and without vascular risk factors with regard to all clinical parameters and total ARWMC score. These factors did not differ between the groups of patients with more than 3 vascular risk factors and other patients. WMH (ARWMC > or =1) occurred in 33 patients (55%). No significant differences in all analysed clinical factors and the total number of vascular risk factors between the groups with (ARWMC > or =1) and without (ARWMC=0) WMH were found. The group of patients with at least one focus with score of 2 in the Wahlund scale did not differ significantly in all analysed clinical parameters from the rest of the patients.


CONCLUSIONS
Our data suggest that the severity of WMH and incidence of vascular risk factors are not significantly related with the degree of motor disability in PD.
Derejko
Mirosława
M
Zakład Neurofizjologii Klinicznej, Instytut Psychiatrii i Neurologii, ul. Sobieskiego 9, 02-957 Warszawa. mderejko@yahoo.com
Sławek
Jarosław
J
Wieczorek
Dariusz
D
Dubaniewicz
Mirosława
M
Lass
Piotr
P
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019957:Motor Skills Disorders / Q000175:diagnosis* / Q000209:etiology; D009460:Neurologic Examination / Q000379:methods; D010300:Parkinson Disease / Q000150:complications / Q000503:physiopathology*; D011237:Predictive Value of Tests; D017397:Prefrontal Cortex / Q000473:pathology*; D011597:Psychomotor Performance; D012307:Risk Factors; D012720:Severity of Illness Index