White Matter Hyperintensities Associated with Parkinsonism in Aging

Elevated levels of white matter hyperintensities (WMH), along with indices of cerebrovascular disease pathologies, in aging brains were associated with faster development of progressive parkinsonism, according to a study published November 1, 2021, in JAMA Neurology.

“This community-based cohort study included participants recruited in 3 ongoing cohorts that began enrollment in 1994, 1997, and 2004. Prior to death, participants were observed for a mean of 7.5 years, with annual clinical assessments. From 4427 participants enrolled in the 3 cohorts, 2134 died. Postmortem autopsy was performed in 1725 decedents, and 598 also had ex vivo brain magnetic resonance imaging. Participants were excluded if they were missing any of the 9 postmortem pathology indices (n = 22) or repeated parkinsonism assessment (n = 41) or had received a clinical diagnosis of Parkinson disease at any point before or during the study (n = 19). Data were analyzed from April 2020 to August 2021,” wrote the team, led by Dr. Shahram Oveisgharan from Rush Alzheimer’s Disease Center at Rush University Medical Center in Chicago.

The study found “Higher WMH was associated with faster progressive parkinsonism (estimate, 0.024; SE, 0.008; P = .002). The attenuation of this association was greater when controlling for indices of cerebrovascular disease pathologies than when controlling for neurodegenerative pathologies (cerebrovascular disease: estimate, 0.019; SE, 0.008; P = .02; neurodegenerative: estimate, 0.022; SE, 0.008; P = .003), but both remained significant.”

“‘These longitudinal findings support a notion that both WMH and cerebrovascular disease pathologies may be underestimated independent contributors to progressive parkinsonism, which is common in older adults,’ [Oveisgharan] and his colleagues wrote,” reported Moan.


Oveisgharan S, Yu L, Poole VN, et al. Association of White Matter Hyperintensities With Pathology and Progression of Parkinsonism in Aging. JAMA Neurol. Published online November 01, 2021. doi:10.1001/jamaneurol.2021.3996. Published online November 1, 2021, at https://jamanetwork.com/journals/jamaneurology/article-abstract/2785850. Accessed November 15, 2021.

Moan, Rebekah. More white-matter hyperintensity equals greater parkinsonism risk. AuntMinnie.com. Published online November 2, 2021, at https://www.auntminnie.com/index.aspx?sec=sup&sub=mri&pag=dis&ItemID=133921. Accessed November 15, 2021.

Stock image, in no way associated with the study referenced.