Axial signs and magnetic resonance imaging correlates in Parkinson's disease.
BACKGROUND
Age-related brain changes may contribute to axial features in Parkinson's disease (PD).


OBJECTIVE
To determine if ventricular volume and white matter high signal changes (WMC) are related to motor signs in PD and controls independent of age.


METHODS
Patients were rated with the Unified Parkinson's Disease Rating Scale (subscore A: tremor, rigidity, bradykinesia, and facial expression; subscore B: speech and axial impairment). Steps and time taken to walk 9.144 meters were measured. Total ventricular volume (TVV) and intracranial volume (ICV) were measured on T1-weighted MRI using manual tracing software. WMC were rated on axial T2-weighted, dual-echo or FLAIR MR images using a visual scale.


RESULTS
TVV (cm3) (PD: 36.48 +/- 15.93; controls: 32.16 +/- 14.20, p = 0.21) and WMC did not differ between groups (PD: 3.7 +/- 4.2; controls: 3.2 +/- 3.1, p = 0.55). Age correlated positively with ICV-corrected TVV and WMC in PD (cTVV: r = 0.48, p = 0.003; WMC: r = 0.42, p = 0.01) and controls (cTVV: r = 0.31, p = 0.04; WMC: r = 0.44, p = 0.003). Subscore B (r = 0.42, p = 0.01) but not subscore A (r = 0.25, p = 0.14) correlated with cTVV in PD. Steps and walking time correlated with cTVV and WMC in PD; cadence correlated with cTVV and steps with WMC in controls. Age-adjustment eliminated correlations.


CONCLUSIONS
Subscore B, but not subscore A correlated positively with ventricular volume in PD, though this association was accounted for by age. Age-related brain change super-imposed on PD may contribute to axial features.
Acharya
Hernish J
HJ
Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Canada.
Bouchard
Thomas P
TP
Emery
Derek J
DJ
Camicioli
Richard M
RM
D000367:Age Factors; D000368:Aged; D000375:Aging / Q000473:pathology*; D001284:Atrophy / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D018476:Hypokinesia / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D020547:Lateral Ventricles / Q000473:pathology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000592:standards*; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D009434:Neural Pathways / Q000473:pathology / Q000503:physiopathology; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D014202:Tremor / Q000209:etiology / Q000473:pathology / Q000503:physiopathology