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Open Access 01-02-2021 | Parkinson's Disease | Original Communication

Vascular risk factors, white matter lesions and cognitive impairment in Parkinson’s disease: the PACOS longitudinal study

Authors: Alessandra Nicoletti, Antonina Luca, Roberta Baschi, Calogero Edoardo Cicero, Giovanni Mostile, Marco Davì, Giuseppe La Bianca, Vincenzo Restivo, Mario Zappia, Roberto Monastero

Published in: Journal of Neurology | Issue 2/2021

Abstract

Background

Vascular risk factors (VRFs) may be associated with cognitive decline in early Parkinson’s disease (PD) but results are inconclusive. The identification of modifiable risk factors is relevant for prevention and treatment.

Methods

Parkinson’s disease (PD) patients of the PACOS cohort who underwent a baseline and follow-up neuropsychological evaluation were enrolled in the study. PD with Mild Cognitive Impairment (MCI) and dementia (PDD) were diagnosed according to the MDS criteria. A Baseline 1.5 T brain MRI was used to calculate the white matter lesions (WMLs) burden using the Wahlund visual scale. Laboratory data, presence of hypertension, diabetes and use of anti-hypertensive drugs were collected and the Framingham Risk (FR) score was calculated. VRFs predicting PD-MCI and PDD were evaluated using Cox proportional hazard regression model.

Results

Out of 139 enrolled patients, 84 (60.4%) were classified as normal cognition (NC) and 55 (39.6%) as MCI at baseline. At follow-up 28 (33.3%) PD-NC developed MCI and 4 (4.8%) PDD (follow-up time 23.5 ± 10.3 months). Out of 55 PD-MCI patients at baseline, 14 (25.4%) converted to PDD. At multivariate analysis among PD-NC a systolic blood pressure (SBP) > 140 mmHg was the stronger predictor of MCI (adjHR 4.04; 95% CI 1.41–11.3) while the presence of MCI at baseline (adj HR 7.55; 95% CI 1.76–32.3) and a severe WMLs burden (adj HR 2.80; 95% CI 0.86–9.04) were the strongest predictors of PDD, even if this latter association has a trend towards significance.

Conclusion

Hypertension represents the most important modifiable risk factor for PD-MCI in the PACOS cohort, increasing the risk of about four times.

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Title: Vascular risk factors, white matter lesions and cognitive impairment in Parkinson’s disease: the PACOS longitudinal study
Authors: Alessandra Nicoletti
Antonina Luca
Roberta Baschi
Calogero Edoardo Cicero
Giovanni Mostile
Marco Davì
Giuseppe La Bianca
Vincenzo Restivo
Mario Zappia
Roberto Monastero
Publication date: 01-02-2021
Publisher: Springer Berlin Heidelberg
Keywords: Parkinson's Disease
Hypertension
Mild Cognitive Impairment
Hypertension
Published in: Journal of Neurology / Issue 2/2021
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-020-10189-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Vascular risk factors, white matter lesions and cognitive impairment in Parkinson’s disease: the PACOS longitudinal study

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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