A magnetic resonance imaging study of patients with Parkinson's disease with mild cognitive impairment and dementia using voxel-based morphometry
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Mona K Beyer1, Carmen C Janvin, Jan P Larsen
1Department of Radiology, Stavanger University Hospital, PO Box 8100, N-4068 Stavanger, Norway. bemk@sus.no
Background:
Dementia is common in Parkinson's disease, but the underlying brain pathology is not yet fully understood.
Aim:
To examine the changes in the brain of patients with Parkinson's disease with mild cognitive impairment (MCI) and dementia, using structural magnetic resonance imaging.
Methods:
Using voxel-based morphometry, the grey matter atrophy on brain images of patients with Parkinson's disease and dementia (PDD; n = 16) and Parkinson's disease without dementia (PDND; n = 20), and healthy elderly subjects (n = 20) was studied. In the PDND group, 12 subjects had normal cognitive status and 8 had MCI. Standardised rating scales for motor, cognitive and psychiatric symptoms were used.
Results:
Widespread areas of cortical atrophy were found in patients with PDD compared with normal controls (in both temporal and frontal lobes and in the left parietal lobe). Grey matter reductions were found in frontal, parietal, limbic and temporal lobes in patients with PDD compared with those with PDND. In patients with PDND with MCI, areas of reduced grey matter in the left frontal and both temporal lobes were found.
Conclusion:
These findings show that dementia in Parkinson's disease is associated with structural neocortical changes in the brain, and that cognitive impairment in patients with PDND may be associated with structural changes in the brain. Further studies with larger groups of patients are needed to confirm these findings.
Insights
Dementia in Parkinson's disease (PDD) is linked to widespread cortical atrophy. Cognitive impairment in Parkinson's disease without dementia (PDND) also shows brain structural changes, particularly in the frontal and temporal lobes.
Area of Science:
- Neuroimaging
- Neuropathology
- Cognitive Neurology
Background:
- Dementia is a frequent complication of Parkinson's disease.
- The precise brain pathology driving dementia in Parkinson's disease remains unclear.
Purpose of the Study:
- To investigate brain structural changes in Parkinson's disease patients with mild cognitive impairment (MCI) and dementia.
- Utilizing structural magnetic resonance imaging to compare brain morphology across patient groups.
Main Methods:
- Voxel-based morphometry (VBM) was employed to analyze grey matter atrophy.
- Compared brain images of Parkinson's disease dementia (PDD), Parkinson's disease without dementia (PDND), and healthy elderly controls.
- PDND group included individuals with normal cognition and MCI; standardized scales assessed motor, cognitive, and psychiatric symptoms.
Main Results:
- PDD patients exhibited widespread cortical atrophy in temporal, frontal, and parietal lobes compared to controls.
- Significant grey matter reductions were observed in frontal, parietal, limbic, and temporal lobes in PDD versus PDND.
- PDND patients with MCI showed grey matter reductions in the left frontal and bilateral temporal lobes.
Conclusions:
- Dementia in Parkinson's disease is associated with structural neocortical alterations.
- Cognitive impairment in PDND may also stem from underlying structural brain changes.
- Larger studies are recommended to validate these neuroimaging findings.
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