Higher white-matter hyperintensity tied to greater parkinsonism risk in elderly: JAMA

Chicago, Illinois: Higher levels of both white matter hyperintensity (WMH) and indices of cerebrovascular disease pathologies are associated with more progressive parkinsonism in older adults, shows a recently released research. The study was published in the journal JAMA Neurology on November 1, 2021.

Progressive parkinsonism is a common occurrence in older adults without a diagnosis of Parkinson's disease. It is associated with adverse health outcomes but its pathologic basis is controversial. Shahram Oveisgharan, Rush University Medical Center, Chicago, Illinois, and colleagues, therefore, aimed to examine if the burden of cerebral white matter hyperintensity, a common manifestation of cerebrovascular disease pathologies, is associated with the rate of progressive parkinsonism in a community-based cohort study. 

The study included participants recruited in 3 ongoing cohorts that began enrollment in 1994, 1997, and 2004. Participants were observed for a mean of 7.5 years, prior to death. From 4427 participants enrolled in the 3 cohorts, 2134 died. Postmortem autopsy was performed in 1725 decedents, and 598 also had ex vivo brain magnetic resonance imaging (MRI).

Participants were excluded if they were missing any of the 9 postmortem pathology indices (n = 22) or repeated parkinsonism assessment (n = 41) or had received a clinical diagnosis of Parkinson disease at any point before or during the study (n = 19) and were analyzed from April 2020 to August 2021.