Subtyping Early Parkinson's Disease by Mapping Cognitive Profiles to Brain Atrophy with Visual MRI Ratings

Area of Science:

• Neuroscience
• Neurology
• Radiology

Background:

• Cognitive heterogeneity presents a significant challenge in diagnosing and predicting outcomes for Parkinson's disease (PD), especially in its early stages.
• Identifying distinct cognitive subtypes is crucial for understanding disease progression and tailoring treatments.

Purpose of the Study:

• To identify clinically relevant cognitive subtypes in early Parkinson's disease (PD).
• To integrate neuropsychological profiles with regional brain atrophy assessed via visual MRI scales in de novo PD patients.

Main Methods:

• Cross-sectional study involving 81 de novo Parkinson's disease (PD) patients and 20 healthy controls.
• Utilized 3T MRI with visual atrophy ratings and an extensive neuropsychological battery.
• Employed a mixed a priori-a posteriori approach to define anatomocognitive subtypes.

Main Results:

• Eight anatomocognitive subtypes were defined, reflecting frontosubcortical, posterior cortical, hippocampal, global, and preserved cognition patterns.
• Specific MRI markers correlated with cognitive deficits in executive, visuospatial, memory, and language domains.
• Cluster analyses confirmed the validity of the identified subtypes (AUC range: 0.68-0.95).

Conclusions:

• The study proposes a practical classification model linking cognitive performance to structural brain changes in early Parkinson's disease (PD).
• This scalable approach can enhance early patient stratification and inform personalized management strategies.
• Further longitudinal studies are recommended to evaluate progression patterns and therapeutic implications.