ArticleMovement disorders clinical practice2020
White Matter Hyperintensities Mediate Impact of Dysautonomia on Cognition in Parkinson's Disease.
Article in Movement disorders clinical practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- A systematic review and meta-analysis on the association between orthostatic hypotension and mild cognitive impairment and dementia in Parkinson's disease.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2023Pooled it
- Orthostatic hypotension and acute cognitive dysfunction in Parkinson's disease: insights from functional near-infrared spectroscopy.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2026Article
- Revealing Non-Motor Symptom Profiles of Orthostatic Hypotension Subtypes in Parkinson's Disease: Insights From a Multidimensional Case-Control Study.Clinical and translational science · 2026Article
- Characteristics and mechanisms of cognitive impairment in Parkinson disease.Nature reviews. Neurology · 2026Review
- Hallucinations and cognitive impairment are associated with blood pressure fluctuations in Parkinson's disease.BMJ neurology open · 2026Article
- Evidence of central autonomic dysfunction in orthostatic hypotension of Parkinson's disease.Parkinsonism & related disorders · 2025Article
- Sex differences in vulnerability to tau pathology: Impact on cognitive decline.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- A reset on our reclined position-a call to prioritize neurogenic supine hypertension in the synucleinopathies.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2025Review
- Distinct Longitudinal Clinical-Neuroanatomical Trajectories in Parkinson's Disease Clinical Subtypes: Insight toward Precision Medicine.Movement disorders : official journal of the Movement Disorder Society · 2025Article
- Correlation between cerebral small vessel disease and postural instability/gait difficulty subtype in Parkinson's disease patients.Frontiers in aging neuroscience · 2025Article
- Cognitive function in Parkinson's disease: associations with perivascular space in basal ganglia.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024Article
- Orthostatic Hypotension and Risk of Mild Cognitive Impairment and Dementia in Parkinson's Disease.Movement disorders clinical practice · 2024Article
- Non-motor symptoms of Parkinson`s disease-insights from genetics.Journal of neural transmission (Vienna, Austria : 1996) · 2024Review
- Beyond Hypertension: Examining Variable Blood Pressure's Role in Cognition and Brain Structure.The journals of gerontology. Series B, Psychological sciences and social sciences · 2024Article
- Longitudinal prevalence of neurogenic orthostatic hypotension in the idiopathic Parkinson Progression Marker Initiative (PPMI) cohort.Autonomic neuroscience : basic & clinical · 2024Article
- Tackling vascular risk factors as a possible disease modifying intervention in Parkinson's disease.NPJ Parkinson's disease · 2024Article
- Differences in Alzheimer's Disease-Related Pathology Profiles Across Apolipoprotein Groups.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Article
- Sex differences in risk factors, burden, and outcomes of cerebrovascular disease in Alzheimer's disease populations.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- Genetics of Neurogenic Orthostatic Hypotension in Parkinson's Disease, Results from a Cross-Sectional In Silico Study.Brain sciences · 2023Article
- Association Between Orthostatic Hypotension and Dementia in Patients With Parkinson Disease and Multiple System Atrophy.Neurology · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with Parkinson's disease (PD) present with a broad spectrum of nonmotor features including autonomic disorders. More severe autonomic dysfunction in PD is associated with increased cognitive deficits. The presence of cerebral small-vessel disease, measured by T2-weighted magnetic resonance imaging white matter hyperintensity (WMH) burden, is also observed in patients with PD with faster cognitive decline.
objectiveTo investigate whether baseline orthostatic hypotension and autonomic dysfunction in early-stage PD affect later cognitive decline via mediation through cerebral small-vessel disease.
methodsDe novo PD patients (N = 365) and age-matched controls (N = 174) with baseline T2-weighted/ fluid-attenuated inversion recovery scans were selected from the Parkinson's Progression Markers Initiative. WMHs were automatically segmented. Mediation analysis was used to assess whether WMH load mediates the effect of orthostatic hypotension and autonomic dysfunction (measured by Scales for Outcomes in Parkinson's Disease-Autonomic) on future cognitive decline (measured by Montreal Cognitive Assessment) in an average of 4 years of follow-up.
resultsMediation analysis supported the existence of a full mediation of WMHs on the effect of diastolic orthostatic hypotension in patients with PD and future cognitive decline (average causal mediation effect: ab = -0.032, 95% confidence interval = -0.064 to -0.01,
conclusionsWMHs fully mediate the effect of diastolic orthostatic hypotension and partially mediate the effect of autonomic dysregulation on future cognitive decline in patients with PD. Our findings support the hypothesis that autonomic dysfunction in early clinical stages predisposes the brain to WMHs through dysregulation of the blood flow in the small vessels. This in turn increases the risk of future cognitive impairment in early PD.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.