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. 2025 Jul;46(7):3107-3115.
doi: 10.1007/s10072-025-08029-6. Epub 2025 Mar 18.

Nighttime systolic blood pressure reduction rate and periventricular white matter hyperintensity were associated with cognitive function in Parkinson's disease

Lanlan Chen  1 , Tingting Qiao  1 , Cancan Ma  1 , Chunfeng Liu  2 , Yingzhu Chen  3 , Hongying Zhang  4 , Yao Xu  5
Affiliations

Nighttime systolic blood pressure reduction rate and periventricular white matter hyperintensity were associated with cognitive function in Parkinson's disease

Lanlan Chen et al. Neurol Sci. 2025 Jul.

Abstract

Introduction: This study aimed to investigate the relationship between nighttime systolic blood pressure (NSBP) reduction rate, white matter hyperintensity (WMH), and cognitive function in Parkinson's disease (PD) patients.

Methods: All PD participants underwent 24-hour ambulatory blood pressure monitor and MRI, with the volumes of WMHs quantified. Participants were categorized into normal dipping and non-dipping groups based on dipping patterns, as well as dementia and non-dementia groups according to a Montreal Cognitive Assessment (MoCA) score of less than 20. Multivariate linear regression analysis was performed to identify independent risk factors for cognitive function.

Results: Compared to normal dippers (n = 13), non-dippers (n = 39) showed significantly lower MoCA scores, higher volumes of periventricular WMH, ratios of periventricular WMH to white matter (WM), and ratios of deep WMH to WM (P = 0.027; 0.015; 0.011; 0.023). Moreover, the ratios of juxtaventricular WMH to WM, periventricular WMH to WM, and deep WMH to WM in the dementia group were significantly higher than those in the non-dementia group (P = 0.003; 0.001; 0.011). Regression analysis revealed that education and NSBP reduction rate were independent protective factors (OR = 4.107, P < 0.001; OR = 2.062, P = 0.045), whereas ratio of periventricular WMH to WM was an independent risk factor (OR= -2.640; P = 0.011) for cognitive function in PD patients.

Conclusions: NSBP reduction rate and ratio of periventricular WMH to periventricular WM were associated with cognitive function in PD patients. Reduced NSBP reduction may contribute to the development of WMH and consequent cognitive impairment in PD patients.

Keywords: Cognitive function; Nighttime blood pressure reduction rate; Non-dipping status; Parkinson’s disease; White matter hyperintensity.

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Conflict of interest statement

Declarations. Ethics approval: The study was approved by the Ethics Committee of the Northern Jiangsu People’s Hospital. Consent to participate: All participants provided written consent. Competing interests: The authors have no relevant financial or non-financial interests to disclose.

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