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Microstructural Connectivity is More Related to Cognition than Conventional MRI in Parkinson's Disease
Yang Hyun Lee1, Wha Jin Lee2, Seok Jong Chung1
1Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
Background:
The different effects of white matter hyperintensity (WMH) severity and WMH-associated microstructural connectivity on cognition in the early stages of Parkinson's disease (PD) have not been investigated.
Objective:
To investigate the differential effect of WMH severity and WMH-associated microstructural connectivity on cognition in early stages of PD.
Methods:
A total of 136 de novo PD patients were enrolled and divided into groups based on total WMH visual rating scores as follows: mild, moderate, and severe. Microstructural connectivity was measured using graph theoretical analysis according to WMH severity. Additionally, correlation coefficients between WMH-associated microstructural connectivity or WMH scores and cognitive performance were assessed.
Results:
Patients with severe WMHs demonstrated poorer performance in language function than those with moderate WMHs, and in frontal/executive and visual memory function than those with mild WMHs. Areas of microstructural connectivity were more extensive in patients with severe WMHs compared to those with mild and moderate WMHs, involving frontal and parieto-temporal regions. WMH-associated right fronto-temporo-parietal microstructural disintegration was correlated with cognitive dysfunction in attention, frontal/executive, and memory domains, whereas there was no correlation between WMH scores and any cognitive domains.
Conclusion:
These data suggest that disruption of microstructural networks by WMHs, rather than WMH burden itself, contributed more to cognitive impairment in PD.
Insights
In early Parkinson's disease (PD), white matter hyperintensity (WMH) disruption of brain networks, not just severity, significantly impacts cognition. This network damage is linked to attention, executive function, and memory deficits.
Area of Science:
- Neuroimaging
- Neurology
- Cognitive Science
Background:
- White matter hyperintensities (WMH) are common in Parkinson's disease (PD).
- The distinct roles of WMH severity and associated network disruption on early PD cognition remain unclear.
Purpose of the Study:
- To differentiate the effects of WMH severity and WMH-associated microstructural connectivity on cognitive function in early PD.
Main Methods:
- 136 de novo PD patients were categorized by WMH severity (mild, moderate, severe).
- Graph theoretical analysis assessed microstructural connectivity relative to WMH severity.
- Correlations between WMH metrics, connectivity, and cognitive performance were analyzed.
Main Results:
- Severe WMHs correlated with poorer language, executive function, and visual memory.
- Extensive microstructural connectivity changes, particularly in frontal and parieto-temporal regions, were observed with increasing WMH severity.
- WMH-associated network disintegration, not WMH burden, correlated with cognitive deficits in attention, executive function, and memory.
Conclusions:
- Disruption of white matter networks by WMHs is a key driver of cognitive impairment in early PD.
- Network integrity, rather than the sheer volume of WMHs, is critical for preserving cognitive function in PD.
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