White Matter Hyperintensity in Parkinson’s Disease Patients in Addis Ababa, Ethiopia

Abstract

\n Background: The clinical significance of white matter hyperintensity (WMH) on brain magnetic resonance image (MRI) in Parkinson’s disease (PD) patients was not sufficiently understood. Little is known about WMH in PD patients in sub Saharan Africa (SSA). The objectives of this study were to determine white matter hyperintensity and associated factors in Ethiopian PD patients.Method: A cross-sectional observational study was conducted in 42 PD patients with WMH and 42 PD patients with normal MRI in Addis Ababa, Ethiopia. Both descriptive and analytical statistics were used to analyze the data. Results: Total of 84 patients with PD was included in the analysis. The overall mean age was 61.5 (11.6) years. Young onset PD (≤ 50 years) accounted 16.7%. Males accounted 67.9%. Tremor dominant PD accounted 88.1%. Forgetfulness and hallucination was reported by 8.3% and 13.1% respectively. The median serum vitamin D and the mean hemoglobin level was 14.9 (8.3 – 20.2) ng/mL and 14.8 (13.8) g/L respectively. Hypovitaminosis D was observed in 40.5% of PD patients; similarly, anemia was observed in 27.4%. Negative correlation was observed between participant’s age and their respective hemoglobin level. The prevalence of hypertension, diabetes, and dyslipidemia was 29.8%, 13.1%, and 20.2% respectively. No association was observed between white matter hyperintensity and young onset PD, hypovitaminosis D, hypertension, and diabetes. Age and dyslipidemia were found to be independent predictor of white matter hyperintensity, when adjusted for the covariates.Conclusion: The present study indicates advanced age and dyslipidemia were associated with increased risk of having white matter hyperintensity on brain MRI of Ethiopian PD patients compared to those patients with normal MRI. Even though non-significant, the trend of vascular risk factors was in line with WMH.