Lacunes may worsen cognition but not motor function in Parkinson's disease

BackgroundAs one of the imaging markers of cerebral small vessel disease, lacunes has received little attention. The objective of this study was to investigate the associations of lacunes, cognition and motor function in patients with Parkinson's disease (PD) and whether these associations are independent of other imaging markers. MethodsPatients were consecutively included from April 2019 to July 2022 in (Beijing Rehabilitation Hospital.) All patients underwent brain magnetic resonance imaging scans, clinical scale evaluations, and neuropsychological tests, as well as quantitative evaluation of postural control. To eliminate the possible factors contributing to cognition and motor dysfunction in patients with PD, in particular white matter hyperintensities and enlarged perivascular space in the basal ganglia, multivariate linear regression models were constructed to sort out the effect of lacunes. ResultsNinety-four patients were included in this study, 56 without lacunes and 38 with lacunes. Patients with lacunes showed shorter disease duration, slower gait speed and spent more time on Trail-Making Test part A (TMT-A) than those without lacunes. The number of lacunes were positively correlated with the time to complete the TMT-A and negatively related to gait speed. Multivariate linear regression models showed that the presence of lacunes was associated with longer TMT-A time after adjusting for potential confounders. ConclusionsLacunes were independently associated with worse visual scanning, attention, and processing speed in patients with PD. In addition, lacunes may accelerate the course of PD. Early treatment of vascular disease provides an alternate way to mitigate some motor and cognitive dysfunction in patients with PD.

Automated summary

This study investigated the associations between lacunes, cognition, and motor function in patients with Parkinson's disease (PD) and found that lacunes were independently associated with worse visual scanning, attention, and processing speed. The presence of lacunes was also found to be related to longer completion time of the Trail-Making Test part A (TMT-A) and slower gait speed in PD patients. Early treatment of vascular disease may mitigate motor and cognitive dysfunction in PD patients and potentially slow down the progression of the disease.