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Elan D. Louis, MD, MSc; Adam M. Brickman, PhD; Charles DeCarli, MD; Scott A. Small, MD; Karen Marder, MD, MPH; Nicole Schupf, PhD; Truman R. Brown, PhD

Arch Neurol. 2008;65(12):1649-1654.

Background  Mild parkinsonian signs (MPS) are a marker of incident dementia. They have been linked with cerebrovascular disease, which can be evaluated using magnetic resonance imaging (MRI). Also, if MPS are a marker for developing Alzheimer-type changes, hippocampal volume on MRI might be diminished in individuals with MPS.

Objective  To examine white matter hyperintensity (WMH) volume and total hippocampal volume in elderly individuals with and without MPS.

Methods  Community-dwelling elderly persons in northern Manhattan (New York), New York, underwent neurologic examination and brain MRI. The WMH volume (derived from fluid-attenuated inversion recovery–weighted MRIs using a semiautomated thresholding approach) and total hippocampal volume (derived manually) were expressed relative to total cranial volume.

Results  Mild parkinsonian signs were present in 111 of 666 participants (16.7%). Mean (SD) relative WMH volume was larger in participants with MPS vs those without MPS (1.70 [1.28] vs 1.17 [1.18]; P < .001). In a multivariate logistic regression analysis adjusting for age, sex, race/ethnicity, years of educational achievement, and depression, relative WMH volume was associated with MPS (odds ratio, 1.26; 95% confidence interval, 1.08-1.47; P = .004). In both unadjusted and adjusted analyses, total relative hippocampal volume was similar in participants with MPS vs those without MPS regardless of cognitive status.

Conclusions  In this MRI study of community-dwelling elderly persons, WMH volume was associated with MPS and total relative hippocampal volume was not. These data raise the possibility that vascular disease could have a role in the development of MPS.

Author Affiliations: Gertrude H. Sergievsky Center (Drs Louis, Brickman, Small, Marder, and Schupf), Department of Neurology, and Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Drs Louis, Brickman, Small, and Marder), Departments of Psychiatry (Dr Marder) and Radiology (Dr Brown), College of Physicians and Surgeons, Department of Epidemiology (Dr Schupf), Mailman School of Public Health (Drs Louis and Schupf), and Department of Biomedical Engineering (Dr Brown), Columbia University, New York, New York; Laboratory of Epidemiology, New York State Institute for Basic Research in Developmental Disabilities, Staten Island (Dr Schupf); and Department of Neurology, and Center for Neuroscience (Dr DeCarli), University of California at Davis.

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