Brain-Area Specific White Matter Hyperintensities: Associations to Falls in Parkinson’s Disease

Article type: Research Article

Authors: Ciliz, Meltem^{a; b} | Sartor, Jennifer^{a; b} | Lindig, Tobias^c | Pilotto, Andrea^{a; b} | Schäffer, Eva^d | Weiss, Michael^d | Scheltens, Philip^e | Becker, Sara^{a; b} | Hobert, Markus A.^{a; b; d} | Berg, Daniela^{a; b; d} | Liepelt-Scarfone, Inga^{a; b} | Maetzler, Walter^{a; b; d; *}

Affiliations: [a] Department of Neurodegeneration, Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany | [b] DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany | [c] Department of Diagnostic and Interventional Neuroradiology, University of Tuebingen, Tuebingen, Germany | [d] Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany | [e] Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands

Correspondence: [*] Correspondence to: Walter Maetzler, Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Arnold Heller Strasse 3, 24118 Kiel, Germany. Tel.: +49431 500 23981; E-mail: w.maetzler@neurologie.uni-kiel.de.

Abstract: Background:Falls are common among people with idiopathic Parkinson’s disease (IPD) and are suggested to be associated with white matter hyperintensities (WMH) of the brain. Objective:To investigate the contribution of brain area-specific WMH to the risk of falls in IPD. Methods:In fifty participants with IPD, occurrence and severity of WMH in specific brain areas were determined using Scheltens (without lateralization) and Age-related white matter changes (ARWMC) (with lateralization) scores. Falls were evaluated with the fall item of the Unified PD Rating Scale (UPDRS). Correlations between area-specific WMH and falls were tested with stepwise backward regression and multivariate regression analyses. Results:In this cohort of participants with IPD, left temporal WMH were associated with occurrence of falls. Frontal WMH of both hemispheres showed tendencies towards significance for the association with falls. Conclusion:According to our study, WMH in the left temporal area are significantly associated with falls in IPD. Potential reasons for this association could be deficits in memory, navigation, orientation, auditory processing, and fear conditioning, which are all associated with pathologies of the left temporal lobe.

Keywords: Accidental falls, leukoencephalopathies, temporal lobe

DOI: 10.3233/JPD-181351

Journal: Journal of Parkinson's Disease, vol. 8, no. 3, pp. 455-462, 2018