Application of Periventricular White Matter Hyperintensities Combined with Homocysteine into Predicting Mild Cognitive Impairment in Parkinson's Disease

作者全名："Zhang, Zuowen; Li, Shishuang; Wang, Shumei"

作者地址："[Zhang, Zuowen; Li, Shishuang] Chongqing Univ, Jiangjin Hosp, Dept Neurol, Chongqing, Peoples R China; [Wang, Shumei] Chongqing Med Univ, Coll Tradit Chinese Med, Chongqing, Peoples R China; [Wang, Shumei] Chongqing Med Univ, Coll Tradit Chinese Med, 1,Yixueyuan Rd, Chongqing 400046, Peoples R China"

通信作者："Wang, SM (通讯作者)，Chongqing Med Univ, Coll Tradit Chinese Med, 1,Yixueyuan Rd, Chongqing 400046, Peoples R China."

来源：INTERNATIONAL JOURNAL OF GENERAL MEDICINE

ESI学科分类：　

WOS号：WOS:000940537800001

JCR分区：Q2

影响因子：2.1

年份：2023

卷号：16

期号：　

开始页：785

结束页：792

文献类型：Article

关键词：Parkinson's disease; mild cognitive impairment; white matter hyperintensities; homocysteine; prediction

摘要："Purpose: To verify the associations between white matter hyperintensities (WMHs), plasma homocysteine (Hcy) levels, and mild cognitive impairment (MCI) in Parkinson's disease (PD) patients and evaluate the predictive value of combination of WMHs and plasma Hcy levels for MCI. Patients and methods: In this study, 387 patients with PD were divided into MCI group and non-MCI group. Their cognition was evaluated with a comprehensive neuropsychological evaluation including 10 tests. Five cognitive domains, including the memory, attention/working memory, visuospatial, executive and language domains, were evaluated using two tests for each domain. MCI was determined when at least two tests demonstrated abnormal results, either one impaired test in two different cognitive domains or two impaired tests in a single cognitive domain. Multivariate analysis was performed to determine risk factors for MCI in PD patients. The receiver operating characteristic (ROC) curve was employed to assess the predictive values, and the Z test was employed to compare the area under curve (AUC). Results: MCI was identified in 195 PD patients with an incidence of 50.4%. Multivariate analysis results showed that PWMHs (OR: 5.162, 95% CI: 2.318 similar to 9.527), Hcy levels (OR: 1.189, 95% CI: 1.071 similar to 1.405) and MDS-UPDRS part III score (OR: 1.173, 95% CI: 1.062 similar to 1.394) were independently correlated with MCI in PD patients after adjusting for confounders. ROC curves showed that the AUCs of PWMHs, Hcy levels and their combination were 0.701 (SE: 0.026, 95% CI: 0.647 similar to 0.752), 0.688 (SE: 0.027, 95% CI: 0.635 similar to 0.742) and 0.879 (SE: 0.018, 95% CI: 0.844 similar to 0.915), respectively. Z test showed that the AUC of combination prediction was significantly higher than those of individual predictions (0.879 vs 0.701, Z =5.629, P <0.001; 0.879 vs 0.688, Z=5.886, P<0.001). Conclusion: The combination of WMHs and plasma Hcy levels could be applied in the prediction of MCI in PD patients."

基金机构："Chongqing medical scientific research project (Joint project of Chongqing Health Commission and Science and Technology Bureau) TCM key project [ZY201801011]; Natural Science Foundation Project of Chongqing, China [cstc2021jcyj-msxmX0856]"

基金资助正文："This research was supported by Chongqing medical scientific research project (Joint project of Chongqing Health Commission and Science and Technology Bureau) TCM key project (ZY201801011) and Natural Science Foundation Project of Chongqing, China (cstc2021jcyj-msxmX0856) ."