Progression of subcortical atrophy in mild Parkinson's disease and its impact on cognition
Background And Purpose:
Mild cognitive impairment (MCI) is associated with pronounced grey matter atrophy in various brain regions. However, the association between atrophy patterns and progression from no cognitive impairment (NCI) to Parkinson's disease (PD)-MCI is not clearly known. We investigated the pattern and progression of atrophy in subcortical structures and its impact on cognition in patients with mild PD.
Methods:
Sixty-five patients with mild PD with baseline and longitudinal clinical and neuropsychological assessments, and structural magnetic resonance imaging scans were studied. Movement Disorder Society Task Force criteria were used to classify patients with PD into PD-NCI (n = 54) and PD-MCI (n = 11). Based on progression over time, those who remained without cognitive impairment were classified as PD-stable (n = 42) and those who converted to MCI over 18 months were classified as PD-converters (n = 12). FreeSurfer was used to measure cortical thickness and subcortical volumes at baseline and follow-up.
Results:
Parkinson's disease-MCI showed baseline thalamus atrophy and progressive atrophy in the thalamus, caudate, presubiculum, cornu ammonis 1 and 2-3, and significant memory and executive dysfunction compared with PD-NCI. PD-converters had greater accumbens atrophy at baseline and progressive atrophy in the thalamus, caudate and accumbens with dysfunctions in memory and executive domains.
Conclusions:
Progression of cognitive impairment in non-demented PD is associated with a specific pattern of subcortical atrophy. Findings from this study will allow future studies to investigate in the role of subcortical structures as a biomarker for PD dementia.
Insights
Parkinson's disease patients with cognitive decline show specific patterns of brain atrophy, particularly in the thalamus and caudate nucleus. This subcortical atrophy is linked to memory and executive function deficits, potentially serving as a biomarker for future dementia.
Area of Science:
- Neuroscience
- Neurology
- Radiology
Background:
- Mild cognitive impairment (MCI) is linked to brain atrophy.
- The relationship between atrophy patterns and the progression from no cognitive impairment (NCI) to Parkinson's disease MCI (PD-MCI) requires further investigation.
Purpose of the Study:
- To investigate the pattern and progression of subcortical atrophy in patients with mild Parkinson's disease (PD).
- To determine the impact of this atrophy on cognitive function in PD patients.
Main Methods:
- Structural MRI scans and longitudinal clinical/neuropsychological assessments were used for 65 mild PD patients.
- Patients were classified as PD-NCI (n=54) or PD-MCI (n=11), and further categorized into PD-stable (n=42) or PD-converters (n=12) over 18 months.
- FreeSurfer software analyzed cortical thickness and subcortical volumes at baseline and follow-up.
Main Results:
- PD-MCI patients exhibited baseline thalamus atrophy and progressive atrophy in the thalamus, caudate, and hippocampal subfields, correlating with memory and executive dysfunction.
- PD-converters showed greater baseline accumbens atrophy and progressive atrophy in the thalamus, caudate, and accumbens, accompanied by cognitive deficits.
Conclusions:
- Cognitive impairment progression in non-demented PD is associated with distinct subcortical atrophy patterns.
- Subcortical structures may serve as potential biomarkers for predicting Parkinson's disease dementia.
Related Concept Videos
01:15Parkinson's Disease: Overview
01:26Alzheimer's Disease: Overview
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
01:24Parkinson's Disease: Treatment
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
01:37Neural Regulation
01:30Dementia
The progression of dementia is generally gradual....
01:30Cognitive Development During Adulthood