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Neurodegenerative disorders are progressive diseases that cause irreversible damage and loss to neurons in specific brain areas. Examples of these disorders include Parkinson's disease, Alzheimer's disease, Multiple Sclerosis (MS), and Amyotrophic Lateral Sclerosis (ALS). These disorders share characteristics such as proteinopathies, selective neuronal vulnerability, and a complex interplay between genetic and environmental factors. The primary therapeutic goal for these conditions is...
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Aberrant corticospinal tract characteristics in prodromal PD: A diffusion tensor imaging study.

Laura J Pimer1, Ronald A Leslie1, Gosia Phillips2

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Altered corticospinal tract (CST) diffusivity, specifically higher mean diffusivity (MD), is linked to REM sleep behaviour disorder (RBD) and hyposmia, potentially predicting Parkinson's disease (PD) risk in these individuals.

Keywords:
Corticospinal tractDiffusion tensor imagingParkinson’s diseaseREM sleep behaviour disorder

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Area of Science:

  • Neuroimaging
  • Neurology
  • Biomarkers

Background:

  • Parkinson's disease (PD) diagnosis often occurs late, after motor symptoms emerge.
  • Non-motor symptoms like REM sleep behaviour disorder (RBD) and hyposmia can precede PD diagnosis by years.
  • Identifying preclinical PD markers in at-risk individuals, such as those with hyposmic RBD, is crucial for early intervention.

Purpose of the Study:

  • To investigate whether abnormalities in the corticospinal tract (CST) can serve as a predictive marker for Parkinson's disease (PD) risk.
  • To assess CST structural characteristics using diffusion tensor imaging (DTI) in patients with hyposmic RBD, PD patients, and healthy controls.
  • To explore the association between CST alterations and the presence of RBD and hyposmia.

Main Methods:

  • Diffusion tensor imaging (DTI) was used to evaluate CST characteristics (FA, MD, AD, RD) in 20 hyposmic RBD patients, 31 PD patients, and 29 healthy controls (HCs).
  • Probabilistic tractography was employed with seed regions in the motor cortex and cerebral peduncles.
  • Olfactory function was assessed using the University of Pennsylvania Smell Identification Test (UPSIT).

Main Results:

  • Hyposmic RBD patients exhibited significantly higher mean diffusivity (MD) in the right CST compared to HCs.
  • No significant difference in CST MD was observed between hyposmic RBD patients and PD patients.
  • PD patients showed a trend towards higher CST MD values compared to HCs.

Conclusions:

  • Altered CST diffusivity, particularly increased MD, appears to be associated with RBD.
  • The combination of RBD, hyposmia, and CST alterations may indicate an increased risk for developing PD with comorbid RBD.
  • CST DTI measures show potential as a biomarker for identifying individuals at risk of developing PD, especially those with non-motor prodromal symptoms.