Quantitative brain measurements in community-dwelling elderly persons with mild parkinsonian signs.
BACKGROUND
Mild parkinsonian signs (MPS) are a marker of incident dementia. They have been linked with cerebrovascular disease, which can be evaluated using magnetic resonance imaging (MRI). Also, if MPS are a marker for developing Alzheimer-type changes, hippocampal volume on MRI might be diminished in individuals with MPS.


OBJECTIVE
To examine white matter hyperintensity (WMH) volume and total hippocampal volume in elderly individuals with and without MPS.


METHODS
Community-dwelling elderly persons in northern Manhattan (New York), New York, underwent neurologic examination and brain MRI. The WMH volume (derived from fluid-attenuated inversion recovery-weighted MRIs using a semiautomated thresholding approach) and total hippocampal volume (derived manually) were expressed relative to total cranial volume.


RESULTS
Mild parkinsonian signs were present in 111 of 666 participants (16.7%). Mean (SD) relative WMH volume was larger in participants with MPS vs those without MPS (1.70 [1.28] vs 1.17 [1.18]; P<.001). In a multivariate logistic regression analysis adjusting for age, sex, race/ethnicity, years of educational achievement, and depression, relative WMH volume was associated with MPS (odds ratio, 1.26; 95% confidence interval, 1.08-1.47; P=.004). In both unadjusted and adjusted analyses, total relative hippocampal volume was similar in participants with MPS vs those without MPS regardless of cognitive status.


CONCLUSIONS
In this MRI study of community-dwelling elderly persons, WMH volume was associated with MPS and total relative hippocampal volume was not. These data raise the possibility that vascular disease could have a role in the development of MPS.
Louis
Elan D
ED
Unit 198, Department of Neurology, Columbia University, 710 W 168th St, New York, NY 10032, USA. EDL2@columbia.edu
Brickman
Adam M
AM
DeCarli
Charles
C
Small
Scott A
SA
Marder
Karen
K
Schupf
Nicole
N
Brown
Truman R
TR
D000368:Aged; D000369:Aged, 80 and over; D001931:Brain Mapping; D005260:Female; D015577:Geriatric Assessment; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D020734:Parkinsonian Disorders / Q000473:pathology*; D012111:Residence Characteristics