Quantitative Brain Measures in the Community-Dwelling Elderly with Mild Parkinsonian Signs

Background—Mild Parkinsonian signs (MPS) are a marker for incident dementia. MPS have been linked with cerebrovascular disease, which can be evaluated using magnetic resonance imaging (MRI). Also, if MPS are a marker for developing Alzheimer's type changes, hippocampal volume on MRI might be diminished among individuals with MPS. Objective—To examine white matter hyperintensity (WMH) volume and total hippocampal volume in elderly with vs. without MPS. Methods—Community-dwelling elderly in northern Manhattan had a neurological examination and brain MRI. WMH volume (derived on FLAIR-weighted MRI scans using a semi-automated thresholding approach) and total hippocampal volume (manually-derived) were expressed relative to total cranial volume. Results—MPS were present in 111/666 (16.7%) participants. Relative WMH volume was larger in participants with vs. without MPS (1.70 ± 1.28 vs. 1.17 ± 1.18, p < 0.001) and, in a multivariate logistic regression analysis adjusting for age, gender, years of education, ethnicity, and depression, relative WMH volume was associated with MPS (OR = 1.26, 95% CI = 1.08 ! 1.47, p = 0.004). In both unadjusted and adjusted analyses, total relative hippocampal volume was similar in participants with vs. without MPS, regardless of cognitive status. Correspondence: Dr. Elan Louis, Unit 198, Neurological Institute, 710 West, 168th Street, New York, New York, 10032, USA. Telephone: (212) 305-9194, FAX: (212) 305-1304, Email: E-mail: [email protected]. NIH Public Access Author Manuscript Arch Neurol. Author manuscript; available in PMC 2009 May 4. Published in final edited form as: Arch Neurol. 2008 December ; 65(12): 1649–1654. doi:10.1001/archneurol.2008.504. N IH -P A A uhor M anscript N IH -P A A uhor M anscript N IH -P A A uhor M anscript Conclusions—In this MRI study of the community-dwelling elderly, WMH volume was associated with MPS and total relative hippocampal volume was not. These data raise the possibility that vascular disease could play a role in the development of MPS.