Diagnostic Value of Carotid Intima-Media Thickness Combined with Periventricular White Matter Hyperintensities for Mild Cognitive Impairment in Parkinson’s Disease
Year: 2025
Type: article
Study design: Observational Study
Abstract: Shishuang Li, Fuyou Che, Zuowen Zhang Department of Neurology, Chongqing University Jiangjin Hospital, Chongqing, People’s Republic of ChinaCorrespondence: Zuowen Zhang, Department of Neurology, Chongqing University Jiangjin Hospital, No. 725, Jiangzhou Road, Dingshan Street, Jiangjin District, Chongqing, 402260, People’s Republic of China, Tel +86-15823472901, Email [email protected]: To determine the independent association of carotid intima-media thickness (CIMT) and periventricular white matter hyperintensities (PWMHs) with mild cognitive impairment in Parkinson’s disease (PD-MCI) and evaluate the diagnostic value of CIMT combined with PWMHs for PD-MCI.Patients and Methods: A prospective cohort of 541 PD patients was enrolled, and all patients underwent carotid artery ultrasound for mean CIMT measurement and 3T brain MRI for PWMH volume quantification. PD-MCI was diagnosed via comprehensive neuropsychological assessment (10 tests across 5 domains) based on established criteria, ie, 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 conducted to determine the independent association, and the receiver operating characteristic (ROC) curve was employed to assess the diagnostic values, and the Z test was employed to compare the area under curve (AUC).Results: PD-MCI prevalence was 45.5% (246/541). Multivariate analysis, adjusting for education duration, Cys C levels, disease duration, total brain WMHs, hypertension, hyperlipidemia, and age, identified PWMHs [odds ratio (OR): 2.114, 95% confidence interval (CI): 1.391– 4.586], CIMT (OR: 2.027, 95% CI: 1.485– 4.281), homocysteine (OR: 1.551, 95% CI: 1.172– 2.680), Hoehn and Yahr stage (OR: 2.243, 95% CI: 1.534– 4.736), and MDS-UPDRS part III score (OR: 1.416, 95% CI: 1.158– 2.465) as independent PD-MCI predictors. ROC analysis demonstrated significantly higher diagnostic value for the combination of CIMT and PWMHs (AUC: 0.908, 95% CI: 0.882– 0.934) compared to either marker alone (AUC: 0.705, 95% CI: 0.661– 0.750 for PWMHs; AUC: 0.722, 95% CI: 0.678– 0.765 for CIMT; both P < 0.001).Conclusion: The combination of CIMT and PWMHs provides significantly superior diagnostic value for PD-MCI compared to either marker individually, and this integrated model suggests a potential tool for identifying PD patients at high risk for cognitive decline.Keywords: Parkinson’s disease, mild cognitive impairment, carotid intima-media thickness, periventricular white matter hyperintensities, prediction
Authors: Li,Shishuang, Che,Fuyou, Zhang,Zuowen
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7111647254
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