Adverse effects of hypertension, supine hypertension, and perivascular space on cognition and motor function in PD

Abstract Dilated perivascular space (dPVS) has recently been reported as a biomarker for cognitive impairment in Parkinson’s disease (PD). However, comprehensive interrelationships between various clinical risk factors, dPVS, white-matter hyperintensities (WMH), cognition, and motor function in PD h...

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Autores principales:	Na-Young Shin, Yae Won Park, Sang-Won Yoo, Ji-Yeon Yoo, Yangsean Choi, Jinhee Jang, Kook-Jin Ahn, Bum-soo Kim, Joong-Seok Kim
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/8d453d4304024b5ca63b154d40a1c23e
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spelling	oai:doaj.org-article:8d453d4304024b5ca63b154d40a1c23e2021-12-02T16:27:55ZAdverse effects of hypertension, supine hypertension, and perivascular space on cognition and motor function in PD10.1038/s41531-021-00214-62373-8057https://doaj.org/article/8d453d4304024b5ca63b154d40a1c23e2021-08-01T00:00:00Zhttps://doi.org/10.1038/s41531-021-00214-6https://doaj.org/toc/2373-8057Abstract Dilated perivascular space (dPVS) has recently been reported as a biomarker for cognitive impairment in Parkinson’s disease (PD). However, comprehensive interrelationships between various clinical risk factors, dPVS, white-matter hyperintensities (WMH), cognition, and motor function in PD have not been studied yet. The purpose of this study was to test whether dPVS might mediate the effect of clinical risk factors on WMH, cognition, and motor symptoms in PD patients. A total of 154 PD patients were assessed for vascular risk factors (hypertension, diabetes mellitus, and dyslipidemia), autonomic dysfunction (orthostatic hypotension and supine hypertension [SH]), APOE ε4 genotype, rapid eye movement sleep-behavior disorder, motor symptoms, and cognition status. The degree of dPVS was evaluated in the basal ganglia (BG) and white matter using a 5-point visual scale. Periventricular, deep, and total WMH severity was also assessed. Path analysis was performed to evaluate the associations of these clinical factors and imaging markers with cognitive status and motor symptoms. Hypertension and SH were significantly associated with more severe BGdPVS, which was further associated with higher total WMH, consequently leading to lower cognitive status. More severe BGdPVS was also associated with worse motor symptoms, but without mediation of total WMH. Similar associations were seen when using periventricular WMH as a variable, but not when using deep WMH as a variable. In conclusion, BGdPVS mediates the effect of hypertension and SH on cognitive impairment via total and periventricular WMH, while being directly associated with more severe motor symptoms.Na-Young ShinYae Won ParkSang-Won YooJi-Yeon YooYangsean ChoiJinhee JangKook-Jin AhnBum-soo KimJoong-Seok KimNature PortfolioarticleNeurology. Diseases of the nervous systemRC346-429ENnpj Parkinson's Disease, Vol 7, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurology. Diseases of the nervous system RC346-429 Na-Young Shin Yae Won Park Sang-Won Yoo Ji-Yeon Yoo Yangsean Choi Jinhee Jang Kook-Jin Ahn Bum-soo Kim Joong-Seok Kim Adverse effects of hypertension, supine hypertension, and perivascular space on cognition and motor function in PD
description	Abstract Dilated perivascular space (dPVS) has recently been reported as a biomarker for cognitive impairment in Parkinson’s disease (PD). However, comprehensive interrelationships between various clinical risk factors, dPVS, white-matter hyperintensities (WMH), cognition, and motor function in PD have not been studied yet. The purpose of this study was to test whether dPVS might mediate the effect of clinical risk factors on WMH, cognition, and motor symptoms in PD patients. A total of 154 PD patients were assessed for vascular risk factors (hypertension, diabetes mellitus, and dyslipidemia), autonomic dysfunction (orthostatic hypotension and supine hypertension [SH]), APOE ε4 genotype, rapid eye movement sleep-behavior disorder, motor symptoms, and cognition status. The degree of dPVS was evaluated in the basal ganglia (BG) and white matter using a 5-point visual scale. Periventricular, deep, and total WMH severity was also assessed. Path analysis was performed to evaluate the associations of these clinical factors and imaging markers with cognitive status and motor symptoms. Hypertension and SH were significantly associated with more severe BGdPVS, which was further associated with higher total WMH, consequently leading to lower cognitive status. More severe BGdPVS was also associated with worse motor symptoms, but without mediation of total WMH. Similar associations were seen when using periventricular WMH as a variable, but not when using deep WMH as a variable. In conclusion, BGdPVS mediates the effect of hypertension and SH on cognitive impairment via total and periventricular WMH, while being directly associated with more severe motor symptoms.
format	article
author	Na-Young Shin Yae Won Park Sang-Won Yoo Ji-Yeon Yoo Yangsean Choi Jinhee Jang Kook-Jin Ahn Bum-soo Kim Joong-Seok Kim
author_facet	Na-Young Shin Yae Won Park Sang-Won Yoo Ji-Yeon Yoo Yangsean Choi Jinhee Jang Kook-Jin Ahn Bum-soo Kim Joong-Seok Kim
author_sort	Na-Young Shin
title	Adverse effects of hypertension, supine hypertension, and perivascular space on cognition and motor function in PD
title_short	Adverse effects of hypertension, supine hypertension, and perivascular space on cognition and motor function in PD
title_full	Adverse effects of hypertension, supine hypertension, and perivascular space on cognition and motor function in PD
title_fullStr	Adverse effects of hypertension, supine hypertension, and perivascular space on cognition and motor function in PD
title_full_unstemmed	Adverse effects of hypertension, supine hypertension, and perivascular space on cognition and motor function in PD
title_sort	adverse effects of hypertension, supine hypertension, and perivascular space on cognition and motor function in pd
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/8d453d4304024b5ca63b154d40a1c23e
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Adverse effects of hypertension, supine hypertension, and perivascular space on cognition and motor function in PD

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