White matter hyperintensities associated with impulse control disorders in Parkinson’s Disease

Abstract

Impulse control disorders (ICDs) in Parkinson's disease (PD) are increasingly recognized as clinically significant non-motor features that potentially impair the quality of life. White matter hyperintensities (WMHs), detected by magnetic resonance imaging, are frequently observed in PD and can be associated with both motor- and certain non-motor symptoms. Given the limited number of non-motor features studied in this context, our aim was to reveal the potential association between the severity of WMHs and ICDs in PD. Fluid-attenuated inversion recovery magnetic resonance images were retrospectively evaluated in 70 patients with PD (48 males; 59.3 ± 10.1 years). The severity of WMHs was assessed by Fazekas scores and by the volume and number of supratentorial WMHs. ICDs were evaluated using the modified Minnesota Impulsive Disorders Interview. Significant interaction between age and the severity of WMHs was present for ICDs. In our younger patients (< 60.5 years), severity of WMHs was positively associated with ICDs (p = 0.004, p = 0.021, p < 0.001 and p < 0.001, respectively for periventricular white matter and total Fazekas scores and the volume and number of WMHs). Our study supports the hypothesis that WMHs of presumed vascular origin may contribute to ICDs in PD. Future prospective studies are needed to assess the prognostic relevance of this finding.

Different impulse control disorder evolution patterns and white matter microstructural damage in the progression of Parkinson’s disease

“…Multiple imaging studies have found that changes in brain structure, function, and metabolism prior to drug therapy in PD patients increase the risk of developing an ICD (Ray and Strafella, 2013;Aracil-Bolanos and Strafella, 2016;Mojtahed Zadeh et al, 2018;Santangelo et al, 2019;Baagil et al, 2023;Hernadi et al, 2023). Yoo et al (2015), using DTI technology, found that in the anterior corpus callosum, right internal capsule posterior limbs, right posterior cingulum, and right thalamic radiations, FA levels in the PD-ICD were significantly higher than in PD-non-ICD patients (corrected p < 0.05).…”