title: White matter changes and the development of motor phenotypes in de novo Parkinson's Disease.
abstract: BACKGROUND
  Parkinson's Disease (PD) patients are usually divided into Tremor Dominant (TD) and Postural Instability/Gait Difficulty (PIGD) subtypes. The latter is characterized by axial motor symptoms and worse outcomes, possibly also because of comorbid white matter disease. Therefore, the current study investigated the importance of Age-Related White Matter Changes (ARWMCs) in the development of different PD motor phenotypes.
  
  
  METHODS
  The present 4-year longitudinal study recruited 63 de novo PD patients, who underwent MRI at the time of the diagnosis to rate ARWMCs. Motor subtypes (PIGD or TD) were evaluated at baseline visit, and after 2 and 4years. Age, gender, UPDRS part III total score, comorbidities and ARWMC total score were included in a mixed effect logistic regression model for repeated measures.
  
  
  RESULTS
  The likelihood of being PIGD subtype during the study period was associated with higher ARWMC total score (OR=2.743; 95%CI=1.137-7.802), but not with age (OR=0.967; 95%CI=0.818-1.143), female gender (OR=0.169; 95%CI=0.014-1.970), UPDRS part III total score (OR=1.942; 95%CI=0.888-13.470), and comorbidities (OR=2.979; 95%CI=0.560-15.849).
  
  
  CONCLUSIONS
  Motor dysfunction in PD is apparently multifactorial and, in particular, comorbid white matter disease might concur in the development of axial impairment.
authors.affiliation: Department of Neurosciences, Reproductive Science and Odontostomatology, Federico II University, Naples, Italy. Electronic address: moccia.marcello@gmail.com.
authors.forename: Marcello
authors.initials: M
authors.lastname: Moccia
authors.affiliation: Neuroradiology Unit, Department of Advanced Biomedical Sciences, University "Federico II", Naples, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Tedeschi
authors.affiliation: Neuroradiology Unit, Department of Advanced Biomedical Sciences, University "Federico II", Naples, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Ugga
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, United Kingdom; Department of Neurological and Movement Sciences, University of Verona, Verona, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Erro
authors.affiliation: Center for Neurodegenerative Diseases (CEMAND), Neuroscience Section, Department of Medicine, University of Salerno, Salerno, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Picillo
authors.affiliation: Neuroradiology Unit, Department of Advanced Biomedical Sciences, University "Federico II", Naples, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Caranci
authors.affiliation: Center for Neurodegenerative Diseases (CEMAND), Neuroscience Section, Department of Medicine, University of Salerno, Salerno, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Barone
authors.affiliation: Neuroradiology Unit, Department of Advanced Biomedical Sciences, University "Federico II", Naples, Italy.
authors.forename: Arturo
authors.initials: A
authors.lastname: Brunetti
mesh_terms: D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging*; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D010641:Phenotype; D004856:Postural Balance; D011446:Prospective Studies; D012720:Severity of Illness Index; D012727:Sex Characteristics; D014202:Tremor / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D066127:White Matter / Q000000981:diagnostic imaging*
keywords: Comorbidities; MRI; PIGD; Parkinson; Progression; Vascular; White matter