The effects of silent cerebral ischemic lesions on the prognosis of idiopathic Parkinson's disease

Introduction: Recent studies have shown that the presence of cerebrovascular lesions may play an important role in determining the presence and severity of neurodegenerative disease. However, the relationship between cerebrovascular disease and idiopathic Parkinson's disease (IPD) has received little attention. Several reports on the impact of cerebrovascular disease on the clinical status of patients with IPD remain controversial. We conducted a 2-year follow-up study to evaluate whether or not silent cerebral ischemic lesions (SIL) contribute to the progression of IPD. Methods: Thirty IPD patients without SIL (only-IPD) and twenty-six IPD patients with SIL (IPDS) were enrolled in this study. All patients underwent brain magnetic resonance imaging (MRI) twice, once at baseline and again at 2-years, to evaluate brain lesions including SIL. The progression of motor severity between the two groups was compared and analyzed. Results: Two years after the first visit, there was no significant difference in the daily dose of dopamine agonist and levodopa between only-IPD and IPDS patients. Changes in motor severity during the 2-year period were not significantly different between the only-IPD and IPDS group. Conclusions: The results of our study suggest that minor cerebral ischemic changes in patients with IPD do not have significant effects on the progression of motor severity in IPD. However, to verify and strengthen these findings, brain MRI and clinicopathological studies involving a large cohort of IPD patients to explore further the relative contribution of vascular and neurodegenerative factors to the prognosis of IPD.