Department of Radiology, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
Nat Rev Neurol. 2011 Apr;7(4):229-36. doi: 10.1038/nrneurol.2011.21. Epub 2011 Feb 22.
Pure vascular parkinsonism without evidence of nigral Lewy body pathology may occur as a distinct clinicopathological entity, but a much more frequent occurrence is the comorbid presence of age-associated white matter lesions (WMLs) in idiopathic Parkinson disease (PD). WMLs are associated with motor and cognitive symptoms in otherwise normal elderly individuals. Comorbid WMLs are, therefore, expected to contribute to clinical symptoms in PD. Studies of WMLs in PD differ with regard to methods of assessment of WML burden and the patient populations selected for analysis, but converging evidence suggests that postural stability and gait motor functions are predominantly affected. WMLs are described to contribute to dementia in Alzheimer disease, and emerging but inconclusive evidence indicates similar effects in PD. In this article, we review the literature addressing the occurrence and impact of WMLs in PD, and suggest that WMLs may exacerbate or contribute to some motor and cognitive deficits associated with PD. We review existing and emerging methods for studying white matter pathology in vivo, and propose future research directions.
无黑质路易体病理证据的单纯血管性帕金森病可能作为一种独特的临床病理实体存在，但更常见的情况是特发性帕金森病（PD）患者合并存在与年龄相关的脑白质病变（WML）。在其他方面正常的老年人中，WML 与运动和认知症状有关。因此，合并存在的 WML 预计会导致 PD 的临床症状。PD 中 WML 的研究在 WML 负担的评估方法和选择进行分析的患者人群方面存在差异，但趋同的证据表明，姿势稳定性和步态运动功能受到的影响最大。WML 被认为会导致阿尔茨海默病患者出现痴呆，而新出现但尚无定论的证据表明在 PD 中也有类似的影响。在本文中，我们回顾了关于 PD 中 WML 的发生和影响的文献，并提出 WML 可能会加重或导致与 PD 相关的一些运动和认知缺陷。我们回顾了现有的和新兴的用于研究活体脑白质病变的方法，并提出了未来的研究方向。
