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

Figures & data

Table 1 Univariate Analysis Results Between PD Patients with MCI and Without MCI

	PD Patients (387)	MCI Group (195)	Non-MCI Group (192)	χ^2/t	P
Age(years, mean±SD)	63.68±8.12	65.74±8.32	61.59±7.91	5.029	<0.001
Male(n, %)	221(57.1%)	109(55.9%)	112(58.3%)	0.234	0.628
BMI(Kg/m^2, mean±SD)	23.86±3.42	23.95±3.39	23.77±3.46	0.517	0.618
Hypertension	173(44.7%)	99(50.8%)	74(38.5%)	5.851	0.016
Diabetes	67(17.3%)	39(20.9%)	28(14.7%)	1.983	0.159
Hyperlipidemia	190(49.1%)	105(53.8%)	85(44.3%)	3.549	0.060
Smoking	75(19.4%)	41(21.0%)	34(17.7%)	0.681	0.409
Disease duration(months, mean±SD)	13.06±7.75	12.18±7.33	13.96±8.17	−2.255	0.027
Duration of education(years, mean±SD)	10.74±4.06	10.17±3.98	11.32±4.15	−2.782	0.006
MDS-UPDRS part III score(mean±SD)	20.96±9.86	22.57±10.29	19.32±9.43	3.240	0.001
Hoehn and Yahr stage(mean±SD)	1.77±0.47	1.80±0.48	1.74±0.46	1.256	0.214
Levodopa equivalent daily dose(mg/d, mean±SD)	159.32±60.26	158.39±61.54	160.26±58.97	−0.305	0.774
Total brain WMHs(cm^3, mean±SD)	1.16±0.65	1.25±0.75	1.07±0.54	2.713	0.008
PWMHs(cm^3, mean±SD)	1.03±0.52	1.22±0.59	0.84±0.45	7.131	<0.001
Hcy(µmol/L, mean±SD)	14.94±4.95	16.18±4.76	13.69±5.15	4.937	<0.001
TC(mmol/L, mean±SD)	4.22±1.03	4.29±1.08	4.15±0.97	1.342	0.185
TG(mmol/L, mean±SD)	1.30±0.57	1.26±0.53	1.32±0.61	−1.032	0.315
Cys C(mg/L, mean±SD)	0.91±0.36	0.95±0.33	0.86±0.40	2.412	0.017
Apo B(g/L, mean±SD)	0.85±0.30	0.86±0.31	0.83±0.29	0.983	0.337
HDL-C(mmol/L, mean±SD)	1.27±0.57	1.24±0.53	1.31±0.62	−1.193	0.242
LDL-C(mmol/L, mean±SD)	2.66±1.10	2.70±1.15	2.62±1.04	0.718	0.475

Abbreviations: PD, Parkinson’s disease; MCI, mild cognitive impairment; BMI, body mass index; MDS-UPDRS, Movement Disorder Society Unified Parkinson’s Disease Rating Scale; WMHs, white matter hyperintensities; PWMHs, periventricular white matter hyperintensities; Hcy, homocysteine; TC, total cholesterol; TG, triglyceride; Cys C, cystatin C; Apo B, apolipoprotein B; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; SD, standard deviation.

Table 2 Clinical Utility Indexes of PWMHs, Hcy Levels and Their Combination for the Prediction of MCI in PD Patients

	Best Cut-Off	Sensitivity	Specificity	Accuracy	FPR	FNR	PPV	NPV
Combination prediction		85.1%	88.5%	86.8%	11.7%	14.6%	88.3%	85.4%
Periventricular WMHs	1.10 cm^3	67.2%	61.5%	64.3%	36.1%	35.2%	63.9%	64.8%
Hcy levels	15.23 µmol/L	57.4%	70.3%	63.8%	33.7%	38.1%	66.3%	61.9%

Abbreviations: WMHs, white matter hyperintensities; Hcy, homocysteine; FNR, false negative rate; FPR, false positive rate; NPV, negative predictive value; PPV, positive predictive value.

Figure 1 ROC curves of PWMHs, Hcy levels and their combination in predicting MCI in PD patients.