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Mild cognitive impairment in Parkinson's disease is associated with a distributed pattern of brain white matter

Federica Agosta1, Elisa Canu, Elka Stefanova

  • 1Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.

Human Brain Mapping
|July 12, 2013
PubMed

Insights

Parkinson's disease with mild cognitive impairment (PD-MCI) is linked to white matter (WM) damage, not gray matter (GM) loss. Diffusion tensor MRI may detect these early WM changes in PD-MCI patients.

Area of Science:

  • Neuroimaging
  • Neurology
  • Neuroscience

Background:

  • Parkinson's disease (PD) can affect cognition, leading to mild cognitive impairment (PD-MCI).
  • Understanding the underlying brain changes in PD-MCI is crucial for early diagnosis and intervention.
  • Distinguishing between gray matter (GM) and white matter (WM) damage is key to understanding PD-related cognitive decline.

Purpose of the Study:

  • To investigate patterns of GM and WM damage in PD-MCI patients.
  • To compare brain structure in PD-MCI patients with healthy controls and cognitively unimpaired PD patients (PD-Cu).
  • To explore the relationship between subtle cognitive decline and specific brain abnormalities in PD.

Main Methods:

  • Utilized 3D T1-weighted and diffusion tensor (DT) magnetic resonance imaging (MRI) scans.
  • Employed tract-based spatial statistics and voxel-based morphometry for data analysis.
  • Assessed cognition using a comprehensive neuropsychological battery.

Main Results:

  • No significant GM atrophy was observed in PD-Cu or PD-MCI patients compared to controls.
  • PD-Cu patients showed no WM damage relative to healthy controls.
  • PD-MCI patients exhibited widespread WM abnormalities in specific tracts, including the corona radiata, corpus callosum, and fronto-occipital fasciculi, bilaterally.

Conclusions:

  • Subtle cognitive decline in PD is associated with WM connection abnormalities, particularly in frontal and interhemispheric pathways.
  • GM atrophy is not a primary feature of early cognitive impairment in PD.
  • DT MRI shows potential for identifying structural WM changes in PD-MCI, possibly preceding dementia development.
Keywords:
MRIParkinson's diseasediffusion tensor MRImild cognitive impairmentwhite matter damage

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