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Axial Signs and Magnetic Resonance Imaging Correlates in Parkinson's Disease

Published online by Cambridge University Press:  02 December 2014

Hernish J. Acharya ,
Thomas P. Bouchard ,
Derek J. Emery  and
Richard M. Camicioli
Hernish J. Acharya
Affiliation:
Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Alberta, Canada
Thomas P. Bouchard
Affiliation:
Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Alberta, Canada
Derek J. Emery
Affiliation:
Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
Richard M. Camicioli
Affiliation:
Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Alberta, Canada
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Abstract

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Background:

Age-related brain changes may contribute to axial features in Parkinson's disease (PD).

Objectives:

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.

Conclusion:

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.

Résumé:

RÉSUMÉ:Contexte:

Les changements du cerveau qui sont reliés à l'âge peuvent contribuer aux manifestations axiales dans la maladie de Parkinson (MP).

Objectifs:

Déterminer si le volume ventriculaire et les changements du signal élevé de la substance blanche (CSB) sont reliés aux signes moteurs chez des patients atteints de MP et chez des sujets témoins, sans égard à l'âge.

Méthodes:

Les patients étaient évalués au moyen de la Unified Parkinson's Disease Rating Scale (sous-score A : tremblement, rigidité, bradycinésie et expression faciale; sous-score B : dysarthrie et manifestations axiales). Les pas et le temps requis pour parcourir 9.144 mètres ont été mesurés. Le volume ventriculaire total (VVT) et le volume intracrânien (VIC) ont été mesurés par IRM pondérée en T1, au moyen d'un logiciel de calque manuel. Les CSB ont été évalués au moyen d'une échelle visuelle sur des images axiales pondérées en T2, double écho ou FLAIR.

Résultats:

Le VVT (cm3 ) (MP : 36,48 ± 15,93; témoins : 32,16 ± 14,20; p = 0,21) et les CSB n'étaient pas différents entre les groupes (MP : 3,7 ± 4,2; témoins : 3,2 ± 3,1; p = 0,55). L'âge était corrélé au VVT corrigé pour le VIC et les CSB dans la MP (VVTc : r = 0,48; p = 0,003; CSB : r = 0,42; p = 0,01) et les témoins (VVTc : r = 0,31; p = 0,04; CSB : r = 0,44; p = 0,003). Le sous-score B (r = 0,42; p = 0,01) était corrélé au VVTc chez les patients atteints de MP, mais non le sous-score A (r = 0,25; p = 0,14). Les pas et le temps de marche étaient corrélés au VVT et aux CSB dans la MP; la cadence était corrélée au VVTc et les pas aux CSB chez les témoins. L'ajustement pour l'âge annulait les corrélations.

Conclusion:

Il y avait une corrélation positive entre le sous-score B et le volume ventriculaire dans la MP, ce qui n'était pas le cas du sous-score A, mais cette association était due à l'âge. Les changements reliés à l'âge surajoutés à la MP peuvent contribuer aux manifestations axiales chez les patients atteints de MP.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 34 , Issue 1 , February 2007 , pp. 56 - 61
Copyright
Copyright © The Canadian Journal of Neurological 2007

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