Association between white matter lesions and motor impairment in patients with Parkinson's disease

Objective To investigate the association between white matter lesions (WML) and motor impairment in patients with Parkinson's disease (PD). Methods A total of 281 patients with PD over 60 years old were enrolled in this study. Diagnosis of severity of motor impairment in patients with PD was based on Hoehn & Yahr staging scale. The patients with PD were divided into mild PD group and moderate/severe PD group according to the severity of motor impairment. The severity of WML was divided into 3 grades according to the modified visual scale of Fazekas. The association between WML and moderate/severe PD and main symptoms of motor impairment were analyzed. Results Multifactorial logistic regression analysis showed that the association between age, PD pathogenesis>3 years, hypertension, diabetes, metabolic syndrome, WML and moderate/severe PD was statistically significant (all P<0.05). Meanwhile, WML was significantly associated with tremor at rest, rigidity, and postural/gait instability (all P<0.05). In addition, moderate and severe WML were the independent risk factors for tremor at rest (all P<0.05), and different severities of WML were the independent risk factors for rigidity and postural/gait instability (all P<0.05). Conclusion WML might increase the risk of severe motor impairment in patients with PD, and WML was associated with major symptoms of motor impairment in patients with PD.