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Xiao B, Deng X, Ng EYL, Lo YL, Xu Z, Tay KY, Au WL, Ng A, Tan LCS, Tan EK. Parkinson's disease genome-wide association study-linked PARK16 variant is associated with a lower risk of cognitive impairment: A 4-year observational study. Eur J Neurol 2023; 30:2874-2878. [PMID: 37227164 DOI: 10.1111/ene.15893] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 05/12/2023] [Accepted: 05/21/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND AND PURPOSE A genome-wide association study-linked variant (PARK16 rs6679073) modulates the risk of Parkinson's disease (PD). We postulate that there may be differences in clinical characteristics between PARK16 rs6679073 carriers and noncarriers. In a prospective study, we investigate the clinical characteristics between PARK16 rs6679073 A allele carriers and noncarriers over 4 years. METHODS A total of 204 PD patients, comprising 158 PARK16 rs6679073 A allele carriers and 46 noncarriers, were recruited. All patients underwent motor and nonmotor symptom and cognitive assessments yearly over 4 years. RESULTS PARK16 rs6679073 carriers were less likely to have mild cognitive impairment (MCI) compared to noncarriers at both baseline (48.1% vs. 67.4%, p = 0.027) and 4-year follow-up (29.3% vs. 58.6%, p = 0.007). CONCLUSIONS PD PARK16 rs6679073 carriers had significantly lower frequency of MCI in a 4-year follow-up study, suggesting that the variant may have a neuroprotective effect on cognitive functions.
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Affiliation(s)
- Bin Xiao
- Department of Neurology, National Neuroscience Institute, Singapore City, Singapore
- Duke-NUS Medical School, Singapore City, Singapore
| | - Xiao Deng
- Department of Neurology, National Neuroscience Institute, Singapore City, Singapore
- Duke-NUS Medical School, Singapore City, Singapore
| | - Ebonne Yu-Lin Ng
- Department of Neurology, National Neuroscience Institute, Singapore City, Singapore
| | - Yew-Long Lo
- Department of Neurology, National Neuroscience Institute, Singapore City, Singapore
| | - Zheyu Xu
- Department of Neurology, National Neuroscience Institute, Singapore City, Singapore
| | - Kay-Yaw Tay
- Department of Neurology, National Neuroscience Institute, Singapore City, Singapore
| | - Wing-Lok Au
- Department of Neurology, National Neuroscience Institute, Singapore City, Singapore
- Duke-NUS Medical School, Singapore City, Singapore
| | - Adeline Ng
- Department of Neurology, National Neuroscience Institute, Singapore City, Singapore
- Duke-NUS Medical School, Singapore City, Singapore
| | - Louis C S Tan
- Department of Neurology, National Neuroscience Institute, Singapore City, Singapore
- Duke-NUS Medical School, Singapore City, Singapore
| | - Eng-King Tan
- Department of Neurology, National Neuroscience Institute, Singapore City, Singapore
- Duke-NUS Medical School, Singapore City, Singapore
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Lu H, Li J, Chan SSM, Yue WWY, Lam LCW. Decoding the radiomic features of dorsolateral prefrontal cortex in individuals with accelerated cortical changes: implications for personalized transcranial magnetic stimulation. J Med Imaging (Bellingham) 2023; 10:015001. [PMID: 36619873 PMCID: PMC9811135 DOI: 10.1117/1.jmi.10.1.015001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 12/20/2022] [Indexed: 01/05/2023] Open
Abstract
Purpose Image-guided transcranial magnetic stimulation (TMS) is an emerging research field in neuroscience and rehabilitation medicine. Cortical morphometry, as a radiomic phenotype of aging, plays a vital role in developing personalized TMS model, yet few studies are afoot to examine the aging effects on region-specific morphometry and use it in the estimation of TMS-induced electric fields. Our study was aimed to investigate the radiomic features of bilateral dorsolateral prefrontal cortex (DLPFC) and quantify the TMS-induced electric fields during aging. Approach Baseline, 1-year and 3-year structural magnetic resonance imaging (MRI) scans from normal aging (NA) adults ( n = 32 ) and mild cognitive impairment (MCI) converters ( n = 22 ) were drawn from the Open Access Series of Imaging Studies. The quantitative measures of radiomics included cortical thickness, folding, and scalp-to-cortex distance. Realistic head models were developed to simulate the impacts of radiomic features on TMS-induced E-fields using the finite-element method. Results A pronounced aging-related decrease was found in the gyrification of left DLPFC in MCI converters ( t = 2.21 , p = 0.035 ), which could predict the decline of global cognition at 3-year follow up. Along with the decreased gyrification in left DLPFC, the magnitude of TMS-induced E-fields was rapidly decreased in MCI converters ( t = 2.56 , p = 0.018 ). Conclusions MRI-informed radiomic features of the treatment targets have significant effects on the intensity and distribution of the stimulation-induced electric fields in prodromal dementia patients. Our findings highlight the importance of region-specific radiomics when conducting the transcranial brain stimulation in individuals with accelerated cortical changes, such as Alzheimer's disease.
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Affiliation(s)
- Hanna Lu
- The Chinese University of Hong Kong, Department of Psychiatry, Hong Kong, China
- The Affiliated Brain Hospital of Guangzhou Medical University, Centre for Neuromodulation and Rehabilitation, Guangzhou, China
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jing Li
- The Chinese University of Hong Kong, Department of Psychiatry, Hong Kong, China
| | - Sandra Sau Man Chan
- The Chinese University of Hong Kong, Department of Psychiatry, Hong Kong, China
| | | | - Linda Chiu Wa Lam
- The Chinese University of Hong Kong, Department of Psychiatry, Hong Kong, China
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3
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Ay U, Gürvit İH. Alterations in Large-Scale Intrinsic Connectivity Networks in the Parkinson's Disease-Associated Cognitive Impairment Continuum: A Systematic Review. Noro Psikiyatr Ars 2022; 59:S57-S66. [PMID: 36578982 PMCID: PMC9767132 DOI: 10.29399/npa.28209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 06/08/2022] [Indexed: 12/31/2022] Open
Abstract
Introduction Cognitive impairment is common in the course of Parkinson's disease (PD) and displays a continuum from subjective cognitive impairment to dementia. Illuminating the pathophysiological processes associated with the continuum may help create follow-up and new treatment approaches. In this context, large-scale intrinsic connectivity networks are widely investigated to elucidate the neural processes underlying PD and are promising as non-invasive biomarkers. This systematic review aims to examine the alterations in large-scale intrinsic connectivity networks in the continuum of PD-associated cognitive impairment. Method ScienceDirect, Web of Science, and PubMed databases were searched with the specified keywords. The studies obtained as a result of this review were investigated by the PRISMA criteria, which were taken as a basis for the systematic review and writing of meta-analyses. Results A total of 974 studies were obtained from three databases. Twenty studies were included in the systematic review based on predetermined eligibility criteria. Among the large-scale connectivity networks examined in these studies, it was found that sensory-motor networks decreased their connectivity in the continuum of PD-associated cognitive impairment, and there were conflicting results in terms of cognitive networks. Conclusion Well-designed longitudinal studies are needed to clarify the alterations in the intrinsic connectivity networks in the PD cognitive impairment continuum. In these studies, it is necessary to define the cognitive disorder groups well, to control the connectivity changes that may occur due to dopaminergic treatment, and to evaluate Parkinson's patients with subjective cognitive impairment and dementia within the continuum.
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Affiliation(s)
- Ulaş Ay
- Neuroimaging Unit, Hulusi Behçet Life Sciences Research Laboratory, Istanbul University, Istanbul, Turkey,Department of Neuroscience, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey,Graduate School of Health Sciences, Istanbul University, Istanbul, Turkey,Correspondence Address: Ulaş Ay, İstanbul Üniversitesi, Hulusi Behçet Yaşam Bilimleri Araştırma Laboratuvarı, Nörogörüntüleme Birimi, Turgut Özal Millet Cd, 34093, Fatih, İstanbul, Turkey • E-mail:
| | - İ. Hakan Gürvit
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Zhu Y, Yang B, Zhou C, Gao C, Hu Y, Yin WF, Yin K, Zhu Y, Jiang G, Ren H, Pang A, Yang X. Cortical atrophy is associated with cognitive impairment in Parkinson's disease: a combined analysis of cortical thickness and functional connectivity. Brain Imaging Behav 2022; 16:2586-2600. [PMID: 36044168 DOI: 10.1007/s11682-022-00714-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/28/2022] [Accepted: 08/07/2022] [Indexed: 11/30/2022]
Abstract
We aimed to perform a combined analysis of cortical thickness and functional connectivity to explore their association with cognitive impairment in Parkinson's disease (PD). A total of 53 PD and 15 healthy control subjects were enrolled. PD patients were divided into PD with normal cognition (PD-NC, n = 25), PD with mild cognitive impairment (PD-MCI, n = 11), and PD with dementia (PDD, n = 17). In some analyses, the PD-MCI and PDD groups were aggregated to represent "PD patients with cognitive impairment". Cognitive status was assessed with the Mini-Mental State Examination (MMSE). Anatomical magnetic resonance imaging and resting-state functional connectivity analysis were performed in all subjects. First, surface-based morphometry measurements of cortical thickness and voxels with cortical thickness reduction were detected. Then, regions showing reduced thickness were analyzed for changes in resting-state functional connectivity in PD involving cognitive impairment. Our results showed that, compared with PD-NC, patients with cognitive impairment showed decreased cortical thickness in the left superior temporal, left lingual, right insula, and right fusiform regions. PD-MCI patients showed these alterations in the right lingual region. Widespread cortical thinning was detected in PDD subjects, including the left superior temporal, left fusiform, right insula, and right fusiform areas. We found that cortical thinning in the left superior temporal, left fusiform, and right temporal pole regions positively correlated with MMSE score. In the resting-state functional connectivity analysis, we found a decrease in functional connectivity between the cortical atrophic brain areas mentioned above and cognition-related brain networks, as well as an increase in functional connectivity between those region and the cerebellum. Alterations in cortical thickness may result in a dysfunction of resting-state functional connectivity, contributing to cognitive decline in patients with PD. However, it is more probable that the relation between structure and FC would be bidirectional,and needs more research to explore in PD cognitve decline.
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Affiliation(s)
- Yongyun Zhu
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, 650032, Kunming, Yunnan Province, P.R. China
| | - Baiyuan Yang
- Department of Neurology, Seventh People's Hospital of Chengdu, 690041, Chengdu, Sichuan Province, P.R. China
| | - Chuanbin Zhou
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, 650032, Kunming, Yunnan Province, P.R. China
| | - Chao Gao
- Department of medical imaging, First Affiliated Hospital of Kunming Medical University, 650032, Kunming, Yunnan Province, P.R. China
| | - Yanfei Hu
- Department of medical imaging, First Affiliated Hospital of Kunming Medical University, 650032, Kunming, Yunnan Province, P.R. China
| | - Wei Fang Yin
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, 650032, Kunming, Yunnan Province, P.R. China
| | - Kangfu Yin
- Department of Neurology, Qujing City First People's Hospital, 655099, Qujing, Yunnan Province, P.R. China
| | - Yangfan Zhu
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, 650032, Kunming, Yunnan Province, P.R. China
| | - Guoliang Jiang
- Department of neurosurgery, First Affiliated Hospital of Kunming Medical University, 650032, Kunming, Yunnan Province, P.R. China
| | - Hui Ren
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, 650032, Kunming, Yunnan Province, P.R. China
| | - Ailan Pang
- Department of Neurology, First Affiliated Hospital of Kunming Medical University, 650032, Kunming, Yunnan Province, P.R. China.
| | - Xinglong Yang
- Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, 650032, Kunming, Yunnan Province, P.R. China. .,Department of Geriatric Neurology, First Affiliated Hospital of Kunming Medical University, 650032, Kunming, Yunnan Province, P.R. China.
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Aarsland D, Batzu L, Halliday GM, Geurtsen GJ, Ballard C, Ray Chaudhuri K, Weintraub D. Parkinson disease-associated cognitive impairment. Nat Rev Dis Primers 2021; 7:47. [PMID: 34210995 DOI: 10.1038/s41572-021-00280-3] [Citation(s) in RCA: 359] [Impact Index Per Article: 119.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/27/2021] [Indexed: 02/08/2023]
Abstract
Parkinson disease (PD) is the second most common neurodegenerative disorder, affecting >1% of the population ≥65 years of age and with a prevalence set to double by 2030. In addition to the defining motor symptoms of PD, multiple non-motor symptoms occur; among them, cognitive impairment is common and can potentially occur at any disease stage. Cognitive decline is usually slow and insidious, but rapid in some cases. Recently, the focus has been on the early cognitive changes, where executive and visuospatial impairments are typical and can be accompanied by memory impairment, increasing the risk for early progression to dementia. Other risk factors for early progression to dementia include visual hallucinations, older age and biomarker changes such as cortical atrophy, as well as Alzheimer-type changes on functional imaging and in cerebrospinal fluid, and slowing and frequency variation on EEG. However, the mechanisms underlying cognitive decline in PD remain largely unclear. Cortical involvement of Lewy body and Alzheimer-type pathologies are key features, but multiple mechanisms are likely involved. Cholinesterase inhibition is the only high-level evidence-based treatment available, but other pharmacological and non-pharmacological strategies are being tested. Challenges include the identification of disease-modifying therapies as well as finding biomarkers to better predict cognitive decline and identify patients at high risk for early and rapid cognitive impairment.
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Affiliation(s)
- Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. .,Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.
| | - Lucia Batzu
- Parkinson's Foundation Centre of Excellence, King's College Hospital and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Glenda M Halliday
- Brain and Mind Centre and Faculty of Medicine and Health School of Medical Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Gert J Geurtsen
- Amsterdam UMC, University of Amsterdam, Department of Medical Psychology, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | | | - K Ray Chaudhuri
- Parkinson's Foundation Centre of Excellence, King's College Hospital and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Daniel Weintraub
- Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Parkinson's Disease Research, Education and Clinical Center (PADRECC), Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA
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Dorszewska J, Kowalska M, Prendecki M, Piekut T, Kozłowska J, Kozubski W. Oxidative stress factors in Parkinson's disease. Neural Regen Res 2021; 16:1383-1391. [PMID: 33318422 PMCID: PMC8284265 DOI: 10.4103/1673-5374.300980] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/24/2020] [Accepted: 10/21/2020] [Indexed: 01/01/2023] Open
Abstract
Parkinson's disease (PD) is the second most common cause of neurodegeneration. Over the last two decades, various hypotheses have been proposed to explain the etiology of PD. Among these is the oxidant-antioxidant theory, which asserts that local and systemic oxidative damage triggered by reactive oxygen species and other free radicals may promote dopaminergic neuron degeneration. Excessive reactive oxygen species formation, one of the underlying causes of pathology in the course of PD has been evidenced by various studies showing that oxidized macromolecules including lipids, proteins, and nucleic acids accumulate in brain tissues of PD patients. DNA oxidation may produce various lesions in the course of PD. Mutations incurred as a result of DNA oxidation may further enhance reactive oxygen species production in the brains of PD patients, exacerbating neuronal loss due to defects in the mitochondrial electron transport chain, antioxidant depletion, and exposure to toxic oxidized dopamine. The protein products of SNCA, PRKN, PINK1, DJ1, and LRRK2 genes are associated with disrupted oxidoreductive homeostasis in PD. SNCA is the first gene linked with familial PD and is currently known to be affected by six mutations correlated with the disorder: A53T, A30P, E46K, G51D, H50Q and A53E. PRKN encodes Parkin, an E3 ubiquitin ligase which mediates the proteasome degradation of redundant and disordered proteins such as glycosylated α-synuclein. Over 100 mutations have been found among the 12 exons of PRKN. PINK1, a mitochondrial kinase highly expressed in the brain, may undergo loss of function mutations which constitute approximately 1-8% of early onset PD cases. More than 50 PD-promoting mutations have been found in PINK1. Mutations in DJ-1, a neuroprotective protein, are a rare cause of early onset PD and constitute only 1% of cases. Around 20 mutations have been found in DJ1 among PD patients thus far. Mutations in the LRRK2 gene are the most common known cause of familial autosomal dominant PD and sporadic PD. Treatment of PD patients, especially in the advanced stages of the disease, is very difficult. The first step in managing progressive PD is to optimize dopaminergic therapy by increasing the doses of dopamine agonists and L-dopa. The next step is the introduction of advanced therapies, such as deep brain stimulation. Genetic factors may influence the response to L-dopa and deep brain stimulation therapy and the regulation of oxidative stress. Consequently, research into minimally invasive surgical interventions, as well as therapies that target the underlying etiology of PD is warranted.
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Affiliation(s)
- Jolanta Dorszewska
- Laboratory of Neurobiology, Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Marta Kowalska
- Laboratory of Neurobiology, Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Michał Prendecki
- Laboratory of Neurobiology, Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Thomas Piekut
- Laboratory of Neurobiology, Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Joanna Kozłowska
- Laboratory of Neurobiology, Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Wojciech Kozubski
- Chair and Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland
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7
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Lu H. Quantifying Age-Associated Cortical Complexity of Left Dorsolateral Prefrontal Cortex with Multiscale Measurements. J Alzheimers Dis 2021; 76:505-516. [PMID: 32538842 DOI: 10.3233/jad-200102] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cortical complexity plays a central role in the diagnosis and prognosis of age-related diseases. However, little is known about the regional cortical complexity in the context of brain atrophy. OBJECTIVE We aimed to systematically examine the age-related changes of the cortical complexity of left dorsolateral prefrontal cortex (DLPFC) and its subregions. METHODS Two hundred and fourteen cognitively normal adults drawn from the Open Access Series of Imaging Studies (OASIS) were divided into four age groups: young, middle-aged, young-old, and old-old. Based on structural magnetic resonance imaging (sMRI) scans, the multiscale measures of cortical complexity included cortical thickness (mm), surface area (mm2), grey matter volume (mm3), density, gyrification index (GI), and fractal dimension (FD). RESULTS Advancing age was associated with reduced grey matter volume, pial surface area, density, and FD of left DLPFC, but correlated with increased cortical thickness and GI. Volumetric measures, cerebrospinal fluid volume in particular, showed better performance to discriminate young-old adults from old-old adults, while FD was more sensitive than the volumetric measures to discriminate young adults and middle-aged adults. CONCLUSION This is the first demonstration that chronological age has a pronounced and differential effect on the cortical complexity of left DLPFC. Our findings suggest that surface-based measures of cortical region, thickness, and gyrification in particular, could be considered as valuable imaging markers for the studies of aging brain and neurodegenerative diseases.
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Affiliation(s)
- Hanna Lu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.,The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
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Rong S, Li Y, Li B, Nie K, Zhang P, Cai T, Mei M, Wang L, Zhang Y. Meynert nucleus-related cortical thinning in Parkinson's disease with mild cognitive impairment. Quant Imaging Med Surg 2021; 11:1554-1566. [PMID: 33816191 DOI: 10.21037/qims-20-444] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background Cognitive impairment in Parkinson's disease (PD) involves the cholinergic system and cholinergic neurons, especially the nucleus basalis of Meynert (NBM/Ch4) located in the basal forebrain (BF). We analyzed associations between NBM/Ch4 volume and cortical thickness to determine whether the NBM/Ch4-innervated neocortex shows parallel atrophy with the NBM/Ch4 as disease progresses in PD patients with cognitive impairment (PD-MCI). Methods We enrolled 35 PD-MCI patients, 48 PD patients with normal cognition (PD-NC), and 33 age- and education-matched healthy controls (HCs), with all participants undergoing neuropsychological assessment and structural magnetic resonance imaging (MRI). Correlation analyses between NBM/Ch4 volume and cortical thickness and correlation coefficient comparisons were conducted within and across groups. Results In the PD-MCI group, NBM/Ch4 volume was positively correlated with cortical thickness in the bilateral posterior cingulate, parietal, and frontal and left insular regions. Based on correlation coefficient comparisons, the atrophy of NBM/Ch4 was more correlated with the cortical thickness of right posterior cingulate and precuneus, anterior cingulate and medial orbitofrontal lobe in PD-MCI versus HC, and the right medial orbitofrontal lobe and anterior cingulate in PD-NC versus HC. Further partial correlations between cortical thickness and NBM/Ch4 volume were significant in the right medial orbitofrontal (PD-NC: r=0.3, P=0.045; PD-MCI: r=0.51, P=0.003) and anterior cingulate (PD-NC: r=0.41, P=0.006; PD-MCI: r=0.43, P=0.013) in the PD groups and in the right precuneus (r=0.37, P=0.04) and posterior cingulate (r=0.46, P=0.008) in the PD-MCI group. Conclusions The stronger correlation between NBM/Ch4 and cortical thinning in PD-MCI patients suggests that NBM/Ch4 volume loss may play an important role in PD cognitive impairment.
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Affiliation(s)
- Siming Rong
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yan Li
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Bing Li
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Kun Nie
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Piao Zhang
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Tongtong Cai
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Mingjin Mei
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Lijuan Wang
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yuhu Zhang
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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Zhou C, Gao T, Guo T, Wu J, Guan X, Zhou W, Huang P, Xuan M, Gu Q, Xu X, Xia S, Kong D, Wu J, Zhang M. Structural Covariance Network Disruption and Functional Compensation in Parkinson's Disease. Front Aging Neurosci 2020; 12:199. [PMID: 32714179 PMCID: PMC7351504 DOI: 10.3389/fnagi.2020.00199] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 06/08/2020] [Indexed: 12/27/2022] Open
Abstract
Purpose: To investigate the structural covariance network disruption in Parkinson’s disease (PD), and explore the functional alterations of disrupted structural covariance network. Methods: A cohort of 100 PD patients and 70 healthy participants underwent structural and functional magnetic resonance scanning. Independent component analysis (ICA) was applied separately to both deformation-based morphometry (DBM) maps and functional maps with the same calculating parameters (both decomposed into 20 independent components (ICs) and computed 20 times the Infomax algorithm in ICASSO). Disrupted structural covariance network in PD patients was identified, and then, we performed goodness of fit analysis to obtain the functional network that showed the highest spatial overlap with it. We investigated the relationship between structural covariance network and functional network alterations. Finally, to further understand the structural and functional alterations over time, we performed a longitudinal subgroup analysis (51 patients were followed up for 2 years) with the same procedures. Results: In a cross-sectional analysis, PD patients showed decreased structural covariance between anterior and posterior cingulate subnetworks. The functional components showed best overlap with anterior and posterior cingulate structural subnetworks were selected as anterior and posterior cingulate functional subnetworks. The functional connectivity between them was significantly increased [assessed by Functional Network Connectivity (FNC) toolbox]; and the increased functional connectivity was negatively correlated with cingulate structural covariance network integrity. Longitudinal subgroup analysis showed cingulate structural covariance network disruption was worse at follow-up, while the functional connectivity between anterior and posterior cingulate network was increased at baseline and decreased at follow-up. Conclusion: This study indicated that the cingulate structural covariance network displayed a high susceptibility in PD patients. This study indicated that the cingulate structural covariance network displayed a high susceptibility in PD patients. Considering that disrupted structural covariance network coexisted with enhanced/remained functional activity during disease development, enhanced functional activity underlying the disrupted cingulate structural covariance network might represent a temporal compensation for maintaining clinical performance.
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Affiliation(s)
- Cheng Zhou
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ting Gao
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Tao Guo
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingjing Wu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojun Guan
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weiwen Zhou
- Department of Radiation Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Peiyu Huang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Min Xuan
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Quanquan Gu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojun Xu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shunren Xia
- Zhejiang University City College, Hangzhou, China
| | - Dexing Kong
- School of Mathematical Sciences, Zhejiang University, Hangzhou, China
| | - Jian Wu
- AdvanCed Computing aNd SysTem Laboratory, College of Computer Science and Technology, Zhejiang University, Hangzhou, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Colloby SJ, Watson R, Blamire AM, O’Brien JT, Taylor JP. Cortical thinning in dementia with Lewy bodies and Parkinson disease dementia. Aust N Z J Psychiatry 2020; 54:633-643. [PMID: 31696728 PMCID: PMC7285984 DOI: 10.1177/0004867419885165] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND We investigated the structural changes associated with Alzheimer's disease, dementia with Lewy bodies and Parkinson disease dementia by means of cortical thickness analysis. METHODS Two hundred and forty-five participants: 76 Alzheimer's disease, 65 dementia with Lewy bodies, 29 Parkinson disease dementia and 76 cognitively normal controls underwent 3-T T1-weighted magnetic resonance imaging and clinical and cognitive assessments. We implemented FreeSurfer to obtain cortical thickness estimates to contrast patterns of cortical thinning across groups and their clinical correlates. RESULTS In Alzheimer's disease and dementia with Lewy bodies, a largely similar pattern of regional cortical thinning was observed relative to controls apart from a more severe loss within the entorhinal and parahippocampal structures in Alzheimer's disease. In Parkinson disease dementia, regional cortical thickness was indistinguishable from controls and dementia with Lewy bodies, suggesting an 'intermediate' pattern of regional cortical change. In terms of global cortical thickness, group profiles were controls > Parkinson disease dementia > dementia with Lewy bodies > Alzheimer's disease (F3, 241 ⩽ 123.2, p < 0.001), where percentage wise, the average difference compared to controls were -1.8%, -5.5% and -6.4%, respectively. In these samples, cortical thinning was also associated with cognitive decline in dementia with Lewy bodies but not in Parkinson disease dementia and Alzheimer's disease. CONCLUSION In a large and well-characterised cohort of people with dementia, regional cortical thinning in dementia with Lewy bodies was broadly similar to Alzheimer's disease. There was preservation of the medial temporal lobe structures in dementia with Lewy bodies compared with Alzheimer's disease, supporting its inclusion as a supportive biomarker in the revised clinical criteria for dementia with Lewy bodies. However, there was less global cortical thinning in Parkinson disease dementia, with no significant regional difference between Parkinson disease dementia and controls. These findings highlight the overlap across the Alzheimer's disease/Parkinson disease dementia spectrum and the potential for differing mechanisms underlying neurodegeneration and cognition in dementia with Lewy bodies and Parkinson disease dementia.
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Affiliation(s)
- Sean J Colloby
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK,Sean J Colloby, Institute of Neuroscience, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, UK.
| | - Rosie Watson
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia,The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia,Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Andrew M Blamire
- Institute of Cellular Medicine and Newcastle Magnetic Resonance Centre, Newcastle University, Newcastle upon Tyne, UK
| | - John T O’Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - John-Paul Taylor
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
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11
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Lu H, Chan SSM, Lam LCW. Localized Analysis of Normalized Distance from Scalp to Cortex and Personalized Evaluation (LANDSCAPE): Focusing on Age- and Dementia-Specific Changes. J Alzheimers Dis 2020; 67:1331-1341. [PMID: 30689573 DOI: 10.3233/jad-180732] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Scalp to cortex distance (SCD), as a key technological parameter, has been highlighted in the guidelines of non-invasive brain stimulation. However, in the context of age-related brain changes, the region-specific SCD and its impact on stimulation-induced electric field remain unclear. OBJECTIVE This study aimed to investigate the region-specific SCD and its relationship with morphometric features and cognitive function in age- and disease-specific populations. METHODS We analyzed the SCD and cortical thickness (CT) of left primary motor cortex (M1) and dorsolateral prefrontal cortex (DLPFC) in 214 cognitively normal adults and 43 dementia patients. CT-adjusted SCD was used to control the influence of CT on SCD. Head model was developed to simulate the impact of SCD on the electric field induced by transcranial electrical stimulation. RESULTS We found age-related increased SCD in the left DLPFC (p < 0.001), but not M1 (p = 0.134), and dementia-related increased SCD in both left DLPFC (p < 0.001) and M1 (p < 0.001). CT-adjusted SCD showed greater region-specific impact on left DLPFC rather than M1. The electric field induced by stimulation was consequently decreased with the increased SCD across normal aging and dementia groups. CONCLUSIONS Age and dementia have differential impacts on the SCDs of left DLPFC and M1. The findings suggest that it is important to be aware of region-specific distance measures when conducting neuromodulation in individuals with old age and dementia.
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Affiliation(s)
- Hanna Lu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.,The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Sandra S M Chan
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Linda C W Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
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12
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Serum neurofilament light chain levels reflect cortical neurodegeneration in de novo Parkinson's disease. Parkinsonism Relat Disord 2020; 74:43-49. [PMID: 32334380 DOI: 10.1016/j.parkreldis.2020.04.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Cognitive impairment and dementia are highly prevalent non-motor complications in Parkinson's disease (PD) with deleterious consequences for patients and caregivers. With no treatment currently available, finding and validating minimally-invasive biomarkers of neurodegeneration in this population represents an urgent need for clinical trials targeting its prevention or delay. Recently, serum neurofilament light chain (NfL) levels have been identified as a promising biomarker of neural loss, but whether they reflect cortical neurodegeneration in early PD stages has not been addressed. METHODS From the Parkinson's Progression Markers Initiative (PPMI), we selected 133 de novo PD patients and 56 healthy controls (HC) with available structural neuroimaging and serum NfL data. We then studied whether NfL levels were abnormal in the PD group with respect to HC, and whether they correlated with cognitive indicators and cortical macro (cortical thinning) and microstructural (increased intracortical mean diffusivity) degeneration. RESULTS Serum NfL levels were significantly increased in the PD group (p = 0.010), and were also related to worse cognitive performance and a cortical macro and microstructural compromise (p < 0.05 corrected). These associations were observed both cross-sectionally and longitudinally within a one-year follow-up period. Topographically, NfL levels reflected posterior-cortical deterioration rather than frontal damage. Importantly, NfL levels were not associated with striatal SPECT-DAT uptake or β-amyloid burden. DISCUSSION Our results show that serum NfL levels reflect cortical neurodegeneration from the very early stages of PD. Moreover, its brain structural correlates and its lack of relationship with dopaminergic depletion or amyloidosis suggests that NfL could track the underlying pathological process leading to PD dementia.
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13
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Waninger S, Berka C, Stevanovic Karic M, Korszen S, Mozley PD, Henchcliffe C, Kang Y, Hesterman J, Mangoubi T, Verma A. Neurophysiological Biomarkers of Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2020; 10:471-480. [PMID: 32116262 PMCID: PMC7242849 DOI: 10.3233/jpd-191844] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND There is a need for reliable and robust Parkinson's disease biomarkers that reflect severity and are sensitive to disease modifying investigational therapeutics. OBJECTIVE To demonstrate the utility of EEG as a reliable, quantitative biomarker with potential as a pharmacodynamic endpoint for use in clinical assessments of neuroprotective therapeutics for Parkison's disease. METHODS A multi modal study was performed including aquisition of resting state EEG data and dopamine transporter PET imaging from Parkinson's disease patients off medication and compared against age-matched controls. RESULTS Qualitative and test/retest analysis of the EEG data demonstrated the reliability of the methods. Source localization using low resolution brain electromagnetic tomography identified significant differences in Parkinson's patients versus control subjects in the anterior cingulate and temporal lobe, areas with established association to Parkinson's disease pathology. Changes in cortico-cortical and cortico-thalamic coupling were observed as excessive EEG beta coherence in Parkinson's disease patients, and correlated with UPDRS scores and dopamine transporter activity, supporting the potential for cortical EEG coherence to serve as a reliable measure of disease severity. Using machine learning approaches, an EEG discriminant function analysis classifier was identified that parallels the loss of dopamine synapses as measured by dopamine transporter PET. CONCLUSION Our results support the utility of EEG in characterizing alterations in neurophysiological oscillatory activity associated with Parkinson's disease and highlight potential as a reliable method for monitoring disease progression and as a pharmacodynamic endpoint for Parkinson's disease modification therapy.
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Affiliation(s)
- Shani Waninger
- Advanced Brain Monitoring Inc., Carlsbad, CA, USA,Correspondence to: Shani Waninger, Advanced Brain Monitoring, Inc., 2237 Faraday Avenue, Suite 100,
Carlsbad, CA 92008, USA. E-mail:
| | - Chris Berka
- Advanced Brain Monitoring Inc., Carlsbad, CA, USA
| | | | | | | | | | - Yeona Kang
- Weill Cornell Medical College, New York, NY, USA
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14
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Kubera KM, Schmitgen MM, Nagel S, Hess K, Herweh C, Hirjak D, Sambataro F, Wolf RC. A search for cortical correlates of trait impulsivity in Parkinson´s disease. Behav Brain Res 2019; 369:111911. [DOI: 10.1016/j.bbr.2019.111911] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/27/2019] [Accepted: 04/12/2019] [Indexed: 12/16/2022]
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15
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Lu H, Lam LCW, Ning Y. Scalp-to-cortex distance of left primary motor cortex and its computational head model: Implications for personalized neuromodulation. CNS Neurosci Ther 2019; 25:1270-1276. [PMID: 31420949 PMCID: PMC6834924 DOI: 10.1111/cns.13204] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/28/2019] [Accepted: 07/15/2019] [Indexed: 12/13/2022] Open
Abstract
Background Non‐invasive brain stimulation (NIBS) is increasingly used as a probe of function and therapeutics in experimental neuroscience and neurorehabilitation. Scalp‐to‐cortex distance (SCD), as a key parameter, has been shown to potentially impact on the electric field. This study aimed to examine the region‐specific SCD and its relationship with cognitive function in the context of age‐related brain atrophy. Methods We analyzed the SCD and cortical thickness (CT) of left primary motor cortex (M1) in 164 cognitively normal (CN) adults and 43 dementia patients drawn from the Open Access Series of Imaging Studies (OASIS). The degree of brain atrophy was measured by the volume of ventricular system. Computational head model was developed to simulate the impact of SCD on the electric field. Results Increased SCD of left M1 was only found in dementia patients (P < .001). When considering CT, the ratio of SCD to CT (F = 27.41, P < .001) showed better differential value than SCD. The SCD of left M1 was associated with worse global cognition (r = −.207, P = .011) and enlarged third ventricle (r = .241, P < .001). The electric field was consequently reduced with the increased SCD across cognitively normal elderly and dementia groups. Conclusions Scalable distance measures, including SCD and CT, are markedly correlated with reduced electric field in dementia patients. The findings suggest that it is important to be aware of region‐specific distance measures when conducting NIBS‐based rehabilitation in individuals with brain atrophy.
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Affiliation(s)
- Hanna Lu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.,The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Linda C W Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuping Ning
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.,The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
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16
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Weil RS, Hsu JK, Darby RR, Soussand L, Fox MD. Neuroimaging in Parkinson's disease dementia: connecting the dots. Brain Commun 2019; 1:fcz006. [PMID: 31608325 PMCID: PMC6777517 DOI: 10.1093/braincomms/fcz006] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 05/17/2019] [Accepted: 06/14/2019] [Indexed: 12/11/2022] Open
Abstract
Dementia is a common and devastating symptom of Parkinson's disease but the anatomical substrate remains unclear. Some evidence points towards hippocampal involvement but neuroimaging abnormalities have been reported throughout the brain and are largely inconsistent across studies. Here, we test whether these disparate neuroimaging findings for Parkinson's disease dementia localize to a common brain network. We used a literature search to identify studies reporting neuroimaging correlates of Parkinson's dementia (11 studies, 385 patients). We restricted our search to studies of brain atrophy and hypometabolism that compared Parkinson's patients with dementia to those without cognitive involvement. We used a standard coordinate-based activation likelihood estimation meta-analysis to assess for consistency in the neuroimaging findings. We then used a new approach, coordinate-based network mapping, to test whether neuroimaging findings localized to a common brain network. This approach uses resting-state functional connectivity from a large cohort of normative subjects (n = 1000) to identify the network of regions connected to a reported neuroimaging coordinate. Activation likelihood estimation meta-analysis failed to identify any brain regions consistently associated with Parkinson's dementia, showing major heterogeneity across studies. In contrast, coordinate-based network mapping found that these heterogeneous neuroimaging findings localized to a specific brain network centred on the hippocampus. Next, we tested whether this network showed symptom specificity and stage specificity by performing two further analyses. We tested symptom specificity by examining studies of Parkinson's hallucinations (9 studies, 402 patients) that are frequently co-morbid with Parkinson's dementia. We tested for stage specificity by using studies of mild cognitive impairment in Parkinson's disease (15 studies, 844 patients). Coordinate-based network mapping revealed that correlates of visual hallucinations fell within a network centred on bilateral lateral geniculate nucleus and correlates of mild cognitive impairment in Parkinson's disease fell within a network centred on posterior default mode network. In both cases, the identified networks were distinct from the hippocampal network of Parkinson's dementia. Our results link heterogeneous neuroimaging findings in Parkinson's dementia to a common network centred on the hippocampus. This finding was symptom and stage-specific, with implications for understanding Parkinson's dementia and heterogeneity of neuroimaging findings in general.
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Affiliation(s)
- Rimona S Weil
- Dementia Research Centre, UCL, London,Wellcome Centre for Human Neuroimaging, UCL, London,Berenson-Allen Center, Beth Israel Deaconess Medical Center, Harvard Medical Center, Boston, MA, USA,Correspondence to: Rimona S. Weil UCL Dementia Research Centre, 8-11 Queen Square, London WC1N 3BG UK E-mail:
| | - Joey K Hsu
- Berenson-Allen Center, Beth Israel Deaconess Medical Center, Harvard Medical Center, Boston, MA, USA
| | - Ryan R Darby
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Louis Soussand
- Berenson-Allen Center, Beth Israel Deaconess Medical Center, Harvard Medical Center, Boston, MA, USA
| | - Michael D Fox
- Berenson-Allen Center, Beth Israel Deaconess Medical Center, Harvard Medical Center, Boston, MA, USA,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
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17
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Xuan M, Guan X, Huang P, Shen Z, Gu Q, Yu X, Xu X, Luo W, Zhang M. Different patterns of gray matter density in early- and middle-late-onset Parkinson's disease: a voxel-based morphometry study. Brain Imaging Behav 2019; 13:172-179. [PMID: 28667375 DOI: 10.1007/s11682-017-9745-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Early-onset Parkinson's disease (EOPD) has a clinical course and characteristics distinct from middle-late-onset Parkinson's disease (M-LOPD). Although many studies have investigated these differences, the neural mechanisms of these characteristics remain unclear. This study aimed to investigate the morphological differences, and their related clinical significance, between EOPD and M-LOPD patients. We recruited two groups of patients, 28 EOPD patients and 37 M-LOPD patients, and two age- and sex-matched control groups (23 controls in each group). The voxel-based morphometry (VBM) technique was used to examine changes in gray matter (GM) density between patients and their corresponding controls. Compared with controls, EOPD patients had lower GM density in the left putamen, inferior frontal gyrus and insula, and higher GM density in the right occipital lobe and bilateral cerebellum posterior lobes. M-LOPD patients had lower GM density in the left cerebellum posterior lobe, occipital lobe and right supplementary motor area (SMA), and higher GM density in the left middle temporal gyrus. Correlation analyses showed that GM density values in the right cerebellum posterior lobe positively correlated with the Unified Parkinson's Disease Rating Scale (UPDRS) motor scores and the Hoehn-Yahr stages in EOPD patients. Our results reveal different patterns of structural changes in EOPD and M-LOPD patients. A probable compensatory effect of the cerebellum was observed and may partly explain the slower decline of motor function in EOPD patients.
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Affiliation(s)
- Min Xuan
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou, 310000, China
| | - Xiaojun Guan
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou, 310000, China
| | - Peiyu Huang
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou, 310000, China
| | - Zhujing Shen
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou, 310000, China
| | - Quanquan Gu
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou, 310000, China
| | - Xinfeng Yu
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou, 310000, China
| | - Xiaojun Xu
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou, 310000, China
| | - Wei Luo
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou, 310000, China
| | - Minming Zhang
- Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, Hangzhou, 310000, China.
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18
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Prell T, Witte OW, Grosskreutz J. Biomarkers for Dementia, Fatigue, and Depression in Parkinson's Disease. Front Neurol 2019; 10:195. [PMID: 30906277 PMCID: PMC6418014 DOI: 10.3389/fneur.2019.00195] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 02/15/2019] [Indexed: 12/26/2022] Open
Abstract
Parkinson's disease is a common multisystem neurodegenerative disorder characterized by typical motor and non-motor symptoms. There is an urgent need for biomarkers for assessment of disease severity, complications and prognosis. In addition, biomarkers reporting the underlying pathophysiology assist in understanding the disease and developing neuroprotective therapies. Ultimately, biomarkers could be used to develop a more efficient personalized approach for clinical trials and treatment strategies. With the goal to improve quality of life in Parkinson's disease it is essential to understand and objectively monitor non-motor symptoms. This narrative review provides an overview of recent developments of biomarkers (biofluid samples and imaging) for three common neuropsychological syndromes in Parkinson's disease: dementia, fatigue, and depression.
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Affiliation(s)
- Tino Prell
- Department of Neurology, Jena University Hospital, Jena, Germany.,Center for Healthy Ageing, Jena University Hospital, Jena, Germany
| | - Otto W Witte
- Department of Neurology, Jena University Hospital, Jena, Germany.,Center for Healthy Ageing, Jena University Hospital, Jena, Germany
| | - Julian Grosskreutz
- Department of Neurology, Jena University Hospital, Jena, Germany.,Center for Healthy Ageing, Jena University Hospital, Jena, Germany
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19
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Abstract
Once a diagnosis of Parkinson's disease (PD) has been made, even in its earliest prodromal form of subjective memory impairment, cognitive impairment has begun and involves anterior cingulate cortex (ACC). While the Braak staging scheme showed mid- to later-stage PD progression from cingulate allocortex adjacent to the corpus callosum and progressing into its neocortical moieties, the last decade has produced substantial information on the role of cingulate cortex in multiple symptoms, not just global measures of cognition. Voxel-based morphometry has been used in many studies of mild cognitive impairment (MCI) in PD to show reduced thickness in ACC and posterior cingulate cortex (PCC). Regional cerebral blood flow is altered in association with verbal IQ in all the PCC and anterior midcingulate cortex and executive impairments in ACC. Diffusion tensor imaging shows reduced fractional anisotropy throughout the entire cingulum bundle. Amnestic MCI is associated with reduced dopamine-2 receptor binding in ACC and, even in cognitively normal PD cases, dopaminergic pathways in ACC are impaired early in association with executive and language functions. The cholinergic system also has substantial changes in nicotinic and muscarinic receptor binding, and therapy with donepezil improves Mini-Mental State Exam scores and metabolism in pACC and dPCC. Cingulate cortex is also engaged in two critical symptoms: apathy and visual hallucinations. Finally, one can be optimistic that cingulate cortex will play an important role in developing new biomarkers of early PD. These methods have already been shown to be useful in cingulate cortex and include magnetic resonance spectroscopy, next-generation gene expression, and the new α-synuclein proximity ligation assay that specifically recognizes α-synuclein oligomers. Thus the future is bright for developing multivariate, multimodal biomarkers that include cingulate cortex.
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Affiliation(s)
- Brent A Vogt
- Cingulum Neurosciences Institute, Manlius, NY, United States; Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, United States.
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20
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Younce JR, Campbell MC, Perlmutter JS, Norris SA. Thalamic and ventricular volumes predict motor response to deep brain stimulation for Parkinson's disease. Parkinsonism Relat Disord 2018; 61:64-69. [PMID: 30527905 DOI: 10.1016/j.parkreldis.2018.11.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 11/27/2018] [Accepted: 11/27/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND Brain atrophy frequently occurs with Parkinson's disease (PD) and relates to increased motor symptoms of PD. The predictive value of neuroimaging-based measures of global and regional brain volume on motor outcomes in deep brain stimulation (DBS) remains unclear but potentially could improve patient selection and targeting. OBJECTIVES To determine the predictive value of preoperative volumetric MRI measures of cortical and subcortical brain volume on motor outcomes of subthalamic nucleus (STN) DBS in PD. METHODS Preoperative T1 3D MP-RAGE structural brain MRI images were analyzed for each participant to determine subcortical, ventricular, and cortical volume and thickness. Change in Unified Parkinson's Disease Rating Scale (UPDRS) scores for subsection 3, representing motor outcomes, was computed preoperatively and postoperatively following DBS programming in 86 participants. A multiple linear regression analysis was performed to investigate the relationship between volumetric data and the effect of DBS on UPDRS 3 scores. RESULTS Larger ventricular and smaller thalamic volumes predicted significantly less improvement of UPDRS 3 scores after STN DBS. CONCLUSIONS Our findings demonstrate in PD that regional brain volumes, in particular thalamic and ventricular volumes, predict motor outcomes after DBS. Differences in regional brain volumes may alter electrode targeting, reflect a specific disease trait such as postoperative progression of subclinical dementia, or directly interfere with the action of DBS.
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Affiliation(s)
- John R Younce
- Department of Neurology, Washington University in St Louis, 660 S Euclid Ave, Campus Box 8111, St Louis, MO, 63110, USA
| | - Meghan C Campbell
- Department of Neurology, Washington University in St Louis, 660 S Euclid Ave, Campus Box 8111, St Louis, MO, 63110, USA; Department of Radiology, Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8225, St. Louis, MO, 63110, USA
| | - Joel S Perlmutter
- Department of Neurology, Washington University in St Louis, 660 S Euclid Ave, Campus Box 8111, St Louis, MO, 63110, USA; Department of Radiology, Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8225, St. Louis, MO, 63110, USA; Department of Neuroscience, Washington University in St Louis, 660 S Euclid Ave, Campus Box 8108, St Louis, MO, 63110, USA; Program in Physical Therapy, Washington University in St Louis, 4444 Forest Park Ave, Campus Box 8508, St Louis, MO, 63108, USA; Program in Occupational Therapy, Washington University in St Louis, 4444 Forest Park Ave, Campus Box 8505, St Louis, MO, 63108, USA
| | - Scott A Norris
- Department of Neurology, Washington University in St Louis, 660 S Euclid Ave, Campus Box 8111, St Louis, MO, 63110, USA; Department of Radiology, Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8225, St. Louis, MO, 63110, USA.
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21
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Jellinger KA, Korczyn AD. Are dementia with Lewy bodies and Parkinson's disease dementia the same disease? BMC Med 2018; 16:34. [PMID: 29510692 PMCID: PMC5840831 DOI: 10.1186/s12916-018-1016-8] [Citation(s) in RCA: 191] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 01/30/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), which share many clinical, neurochemical, and morphological features, have been incorporated into DSM-5 as two separate entities of major neurocognitive disorders with Lewy bodies. Despite clinical overlap, their diagnosis is based on an arbitrary distinction concerning the time of onset of motor and cognitive symptoms, namely as early cognitive impairment in DLB and later onset following that of motor symptoms in PDD. Their morphological hallmarks - cortical and subcortical α-synuclein/Lewy body plus β-amyloid and tau pathologies - are similar, but clinical differences at onset suggest some dissimilar profiles. Based on recent publications, including the fourth consensus report of the DLB Consortium, a critical overview is provided herein. DISCUSSION The clinical constellations of DLB and PDD include cognitive impairment, parkinsonism, visual hallucinations, and fluctuating attention. Intravitam PET and postmortem studies have revealed a more pronounced cortical atrophy, elevated cortical and limbic Lewy body pathologies, higher Aβ and tau loads in cortex and striatum in DLB compared to PDD, and earlier cognitive defects in DLB. Conversely, multitracer PET studies have shown no differences in cortical and striatal cholinergic and dopaminergic deficits. Clinical management of both DLB and PDD includes cholinesterase inhibitors and other pharmacologic and non-drug strategies, yet with only mild symptomatic effects. Currently, no disease-modifying therapies are available. CONCLUSION DLB and PDD are important dementia syndromes that overlap in many clinical features, genetics, neuropathology, and management. They are currently considered as subtypes of an α-synuclein-associated disease spectrum (Lewy body diseases), from incidental Lewy body disease and non-demented Parkinson's disease to PDD, DLB, and DLB with Alzheimer's disease at the most severe end. Cognitive impairment in these disorders is induced not only by α-synuclein-related neurodegeneration but by multiple regional pathological scores. Both DLB and PDD show heterogeneous pathology and neurochemistry, suggesting that they share important common underlying molecular pathogenesis with Alzheimer's disease and other proteinopathies. While we prefer to view DLB and PDD as extremes on a continuum, there remains a pressing need to more clearly differentiate these syndromes and to understand the synucleinopathy processes leading to either one.
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Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, A-1150, Vienna, Austria.
| | - Amos D Korczyn
- Tel-Aviv University, Sackler Faculty of Medicine, Ramat Aviv, Israel
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22
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Silveira CRA, Roy EA, Intzandt BN, Almeida QJ. Aerobic exercise is more effective than goal-based exercise for the treatment of cognition in Parkinson's disease. Brain Cogn 2018; 122:1-8. [PMID: 29331916 DOI: 10.1016/j.bandc.2018.01.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 12/11/2017] [Accepted: 01/02/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Little is known about how different exercise modalities influence cognition in Parkinson's disease (PD). Moreover, the focus of previous investigations on examining the effects of exercise mainly on executive functions and the exclusion of individuals with cognitive impairment may limit the potential to define exercise as a treatment for cognitive decline in PD. OBJECTIVE The aim of this study was to compare the effects of aerobic and goal-based exercise on five cognitive domains in cognitively normal and impaired individuals with PD. METHODS Seventy-six individuals with PD were randomly allocated into three groups: Aerobic, Goal-based, and Control. Participants in the exercise groups attended 1-h sessions 3x/week for 12 weeks, while those in the Control group carried on with their regular activities. Changes in cognitive domains were assessed using paper-based neuropsychological tests. RESULTS Inhibitory control improved only in the Aerobic group (p = .04), irrespective of participants cognitive status at baseline. Moreover, participants with cognitive impairment in Aerobic group maintained their set-shifting ability, whereas those in the Control group were worse at post-test (p = .014). CONCLUSION This is the first study to show that aerobic exercise is more effective than goal-based exercise for the treatment of cognition in PD with and without cognitive impairment.
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Affiliation(s)
- Carolina R A Silveira
- Movement Disorders Research and Rehabilitation Centre, Wilfrid Laurier University, 75 University Avenue West, Waterloo, Ontario N2L 3C5, Canada; Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada.
| | - Eric A Roy
- Movement Disorders Research and Rehabilitation Centre, Wilfrid Laurier University, 75 University Avenue West, Waterloo, Ontario N2L 3C5, Canada; Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada.
| | - Brittany N Intzandt
- Movement Disorders Research and Rehabilitation Centre, Wilfrid Laurier University, 75 University Avenue West, Waterloo, Ontario N2L 3C5, Canada.
| | - Quincy J Almeida
- Movement Disorders Research and Rehabilitation Centre, Wilfrid Laurier University, 75 University Avenue West, Waterloo, Ontario N2L 3C5, Canada.
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Péran P, Nemmi F, Barbagallo G. Brain Morphometry: Parkinson’s Disease. NEUROMETHODS 2018:267-277. [DOI: 10.1007/978-1-4939-7647-8_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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24
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Jellinger KA. Dementia with Lewy bodies and Parkinson's disease-dementia: current concepts and controversies. J Neural Transm (Vienna) 2017; 125:615-650. [PMID: 29222591 DOI: 10.1007/s00702-017-1821-9] [Citation(s) in RCA: 172] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 11/28/2017] [Indexed: 12/15/2022]
Abstract
Dementia with Lewy bodies (DLB) and Parkinson's disease-dementia (PDD), although sharing many clinical, neurochemical and morphological features, according to DSM-5, are two entities of major neurocognitive disorders with Lewy bodies of unknown etiology. Despite considerable clinical overlap, their diagnosis is based on an arbitrary distinction between the time of onset of motor and cognitive symptoms: dementia often preceding parkinsonism in DLB and onset of cognitive impairment after onset of motor symptoms in PDD. Both are characterized morphologically by widespread cortical and subcortical α-synuclein/Lewy body plus β-amyloid and tau pathologies. Based on recent publications, including the fourth consensus report of the DLB Consortium, a critical overview is given. The clinical features of DLB and PDD include cognitive impairment, parkinsonism, visual hallucinations, and fluctuating attention. Intravitam PET and post-mortem studies revealed more pronounced cortical atrophy, elevated cortical and limbic Lewy pathologies (with APOE ε4), apart from higher prevalence of Alzheimer pathology in DLB than PDD. These changes may account for earlier onset and greater severity of cognitive defects in DLB, while multitracer PET studies showed no differences in cholinergic and dopaminergic deficits. DLB and PDD sharing genetic, neurochemical, and morphologic factors are likely to represent two subtypes of an α-synuclein-associated disease spectrum (Lewy body diseases), beginning with incidental Lewy body disease-PD-nondemented-PDD-DLB (no parkinsonism)-DLB with Alzheimer's disease (DLB-AD) at the most severe end, although DLB does not begin with PD/PDD and does not always progress to DLB-AD, while others consider them as the same disease. Both DLB and PDD show heterogeneous pathology and neurochemistry, suggesting that they share important common underlying molecular pathogenesis with AD and other proteinopathies. Cognitive impairment is not only induced by α-synuclein-caused neurodegeneration but by multiple regional pathological scores. Recent animal models and human post-mortem studies have provided important insights into the pathophysiology of DLB/PDD showing some differences, e.g., different spreading patterns of α-synuclein pathology, but the basic pathogenic mechanisms leading to the heterogeneity between both disorders deserve further elucidation. In view of the controversies about the nosology and pathogenesis of both syndromes, there remains a pressing need to differentiate them more clearly and to understand the processes leading these synucleinopathies to cause one disorder or the other. Clinical management of both disorders includes cholinesterase inhibitors, other pharmacologic and nonpharmacologic strategies, but these have only a mild symptomatic effect. Currently, no disease-modifying therapies are available.
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Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, 1150, Vienna, Austria.
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25
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Abstract
Cognitive decline is now recognized as a common nonmotor symptom of Parkinson's disease, and it has been the subject of increasing research in recent decades. Cognitive deficits in Parkinson's disease can be distinguished as dopaminergically mediated executive dysfunction seen in the milder stages vs a global dementia syndrome that can occur with disease progression. The neural basis of these deficits has been explored from the perspective of multimodal imaging techniques to measure the structural, functional, and metabolic correlates of cognitive decline in Parkinson's disease. Increasingly, changes in neurotransmitter systems beyond dopamine, including the noradrenergic, serotonergic, and cholinergic systems, are being recognized for their contribution to cognitive decline. The impact of certain genetic variations on cognitive function has also been established, including links between cognitive decline and polymorphisms affecting COMT, MAPT, APOE, and GBA genotypes. Although therapeutic options for cognitive decline are still far less established than for motor systems, both pharmacological and nonpharmacological strategies are continuing to develop.
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Abstract
Dementia is a frequent problem encountered in advanced stages of Parkinson disease (PD). In recent years, research has focused on the pre-dementia stages of cognitive impairment in PD, including mild cognitive impairment (MCI). Several longitudinal studies have shown that MCI is a harbinger of dementia in PD, although the course is variable, and stabilization of cognition - or even reversal to normal cognition - is not uncommon. In addition to limbic and cortical spread of Lewy pathology, several other mechanisms are likely to contribute to cognitive decline in PD, and a variety of biomarker studies, some using novel structural and functional imaging techniques, have documented in vivo brain changes associated with cognitive impairment. The evidence consistently suggests that low cerebrospinal fluid levels of amyloid-β42, a marker of comorbid Alzheimer disease (AD), predict future cognitive decline and dementia in PD. Emerging genetic evidence indicates that in addition to the APOE*ε4 allele (an established risk factor for AD), GBA mutations and SCNA mutations and triplications are associated with cognitive decline in PD, whereas the findings are mixed for MAPT polymorphisms. Cognitive enhancing medications have some effect in PD dementia, but no convincing evidence that progression from MCI to dementia can be delayed or prevented is available, although cognitive training has shown promising results.
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27
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Claassen DO, McDonell KE, Donahue M, Rawal S, Wylie SA, Neimat JS, Kang H, Hedera P, Zald D, Landman B, Dawant B, Rane S. Cortical asymmetry in Parkinson's disease: early susceptibility of the left hemisphere. Brain Behav 2016; 6:e00573. [PMID: 28031997 PMCID: PMC5167000 DOI: 10.1002/brb3.573] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 07/05/2016] [Accepted: 08/08/2016] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND PURPOSE Clinically, Parkinson's disease (PD) presents with asymmetric motor symptoms. The left nigrostriatal system appears more susceptible to early degeneration than the right, and a left-lateralized pattern of early neuropathological changes is also described in several neurodegenerative conditions, including Alzheimer's disease, frontotemporal dementia, and Huntington's disease. In this study, we evaluated hemispheric differences in estimated rates of atrophy in a large, well-characterized cohort of PD patients. METHODS Our cohort included 205 PD patients who underwent clinical assessments and T1-weighted brain MRI's. Patients were classified into Early (n = 109) and Late stage (n = 96) based on disease duration, defined as greater than or less than 10 years of motor symptoms. Cortical thickness was determined using FreeSurfer, and a bootstrapped linear regression model was used to estimate differences in rates of atrophy between Early and Late patients. RESULTS Our results show that patients classified as Early stage exhibit a greater estimated rate of cortical atrophy in left frontal regions, especially the left insula and olfactory sulcus. This pattern was replicated in left-handed patients, and was not influenced by the degree of motor symptom asymmetry (i.e., left-sided predominant motor symptoms). Patients classified as Late stage exhibited greater atrophy in the bilateral occipital, and right hemisphere-predominant cortical areas. CONCLUSIONS We show that cortical degeneration in PD differs between cerebral hemispheres, and findings suggest a pattern of early left, and late right hemisphere with posterior cortical atrophy. Further investigation is warranted to elucidate the underlying mechanisms of this asymmetry and pathologic implications.
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Affiliation(s)
| | | | - Manus Donahue
- Vanderbilt University Institute of Imaging Science Nashville TN USA
| | - Shiv Rawal
- Meharry Medical College Nashville TN USA
| | - Scott A Wylie
- Department of Neurology Vanderbilt University Nashville TN USA
| | - Joseph S Neimat
- Department of Neurosurgery University of Louisville Louisville KY USA
| | - Hakmook Kang
- Department of Biostatistics Vanderbilt University Nashville TN USA
| | - Peter Hedera
- Department of Neurology Vanderbilt University Nashville TN USA
| | - David Zald
- Department of Psychology Vanderbilt University Nashville TN USA
| | - Bennett Landman
- Department of Electrical Engineering Vanderbilt University Nashville TN USA
| | - Benoit Dawant
- Department of Electrical Engineering Vanderbilt University Nashville TN USA
| | - Swati Rane
- Vanderbilt University Institute of Imaging Science Nashville TN USA
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28
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Deng X, Tang CY, Zhang J, Zhu L, Xie ZC, Gong HH, Xiao XZ, Xu RS. The cortical thickness correlates of clinical manifestations in the mid-stage sporadic Parkinson's disease. Neurosci Lett 2016; 633:279-289. [PMID: 27721206 DOI: 10.1016/j.neulet.2016.09.042] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 09/25/2016] [Indexed: 10/20/2022]
Abstract
The cortical thickness has gained an extensive attention as a pathological alteration of sporadic Parkinson's disease (sPD), the alteration of pathological cortical thickness may distinctly contribute to the consistent clinical manifestations. Therefore, we investigated the cortical thickness correlates of clinical manifestations in the mid-stage sPD from the Han population of Chinese mainland (HPCM). A sample of 67 mid-stage sPD patients and 35 matched controls from HPCM were performed a corticometry of magnetic resonance imaging (MRI) and the assessment of clinical manifestations including the demographic and disease-related characteristics, and underwent the final analysis of the cortical thickness correlates with the clinical manifestations. In our result, we demonstrated that no significant differences in the demographic characteristics were found among the two groups. The tests of clinical disease-related characteristics demonstrated that the significant differences in the Hoehn and Yahr scale, the UPDRS Part I-IV, the symptom-dominant side (right/left/double), the tremor subscoree off (e), the tremor subscoref on (f), Webster, MMSE, HDS-R, DF, DB, SVFT, SDS, HAMD17, HAMD 24, CDT, CDR, LEDD and PDSI were observed between the mid-stage sPD patients and the controls. The analysis about the cortical thickness correlates with the clinical manifestations revealed that a significant correlation between UPDRS-I and Frontal-Sup-Orb-R and Rectus-R; DB and Frontal-Sup-Orb-R and Frontal-Inf-Orb-R; SDS and Frontal-Sup-Orb-R, Frontal-Mid-Orb-R, Rectus-R and Cingulum-Ant-R respectively in the mid-stage sPD patients from HPCM. Our data showed that the cortical thinning in the right frontal Orb, rectus and cingulum were the pathological base of some clinical manifestations including the cognitive impairment, hallucinations, psychosis, the depressed mood, the anxious mood, apathy, the sleep problems, the nighttime or/and daytime sleepiness, the short term memory stores and the central execution, as well as the sexual desire disorder in the mid-stage sPD patients, suggesting that the dysfunctions of brain regions of some cortical thinning are closely correlated with some clinical manifestations of the mid-stage sPD.
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Affiliation(s)
- Xia Deng
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China.
| | - Chun-Yan Tang
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China.
| | - Jie Zhang
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China; Department of Biochemistry and Molecular Biology, College of Basic Medical Science, Nanchang University, Nanchang 330006, Jiangxi, China.
| | - Lei Zhu
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China.
| | - Zun-Chun Xie
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China.
| | - Hong-Han Gong
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China.
| | - Xiang-Zuo Xiao
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China.
| | - Ren-Shi Xu
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China.
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29
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Cortical gray and subcortical white matter associations in Parkinson's disease. Neurobiol Aging 2016; 49:100-108. [PMID: 27776262 DOI: 10.1016/j.neurobiolaging.2016.09.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 09/19/2016] [Accepted: 09/21/2016] [Indexed: 11/23/2022]
Abstract
Cortical atrophy has been documented in both Parkinson's disease (PD) and healthy aging, but its relationship to changes in subcortical white matter is unknown. This was investigated by obtaining T1- and diffusion-weighted images from 76 PD and 70 controls at baseline and 18 and 36 months, from which cortical volumes and underlying subcortical white matter axial diffusivity (AD), radial diffusivity (RD), and fractional anisotropy (FA) were determined. Twelve of 69 cortical subregions had significant group differences, and for these, underlying subcortical white matter was explored. At baseline, higher cortical volumes were significantly correlated with lower underlying subcortical white matter AD, RD, and higher FA (ps ≤ 0.017) in PD. Longitudinally, higher rates of cortical atrophy in PD were associated with increased rates of change in AD RD, and FA values (ps ≤ 0.0013) in 2 subregions explored. The significant gray-white matter associations were not found in controls. Thus, unlike healthy aging, cortical atrophy and subcortical white matter changes may not be independent events in PD.
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30
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The effects of apolipoprotein ε 4 on aging brain in cognitively normal Chinese elderly: a surface-based morphometry study. Int Psychogeriatr 2016; 28:1503-11. [PMID: 27097839 DOI: 10.1017/s1041610216000624] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Default mode network (DMN) has been reported to be susceptible to APOE ε 4 genotype. However, the APOE ε 4-related brain changes in young carriers are different from the ones in elderly carriers. The current study aimed to evaluate the cortical morphometry of DMN subregions in cognitively normal elderly with APOE ε 4. METHOD 11 cognitively normal senior APOE ε 4 carriers and 27 matched healthy controls (HC) participated the neuropsychological tests, genotyping, and magnetic resonance imaging (MRI) scanning. Voxel-based morphometry (VBM) analysis was used to assess the global volumetric changes. Surface-based morphometry (SBM) analysis was performed to measure regional gray matter volume (GMV) and gray matter thickness (GMT). RESULTS Advancing age was associated with decreased GMV of DMN subregions. Compared to HC, APOE ε 4 carriers presented cortical atrophy in right cingulate gyrus (R_CG) (GMV: APOE carriers: 8475.23 ± 1940.73 mm3, HC: 9727.34 ± 1311.57 mm3, t = 2.314, p = 0.026, corrected) and left insular (GMT: APOE ε 4 carriers: 3.83 ± 0.37 mm, HC: 4.05 ± 0.25 mm, t = 2.197, p = 0.033, corrected). CONCLUSIONS Our results highlight the difference between different cortical measures and suggest that the cortical reduction of CG and insular maybe a potential neuroimaging marker for APOE 4 ε senior carriers, even in the context of relatively intact cognition.
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31
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Kincses ZT, Király A, Veréb D, Vécsei L. Structural Magnetic Resonance Imaging Markers of Alzheimer's Disease and Its Retranslation to Rodent Models. J Alzheimers Dis 2016; 47:277-90. [PMID: 26401552 DOI: 10.3233/jad-143195] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The importance of imaging biomarkers has been acknowledged in the diagnosis and in the follow-up of Alzheimer's disease (AD), one of the major causes of dementia. Next to the molecular biomarkers and PET imaging investigations, structural MRI approaches provide important information about the disease progression and about the pathomechanism. Furthermore,a growing body of literature retranslates these imaging biomarkers to various rodent models of the disease. The goal of this review is to provide an overview of the macro- and microstructural imaging biomarkers of AD, concentrating on atrophy measures and diffusion MRI alterations. A survey is also given of the imaging approaches used in rodent models of dementias that can promote drug development.
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Affiliation(s)
- Zsigmond Tamas Kincses
- Department of Neurology, University of Szeged, Szeged, Hungary.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - András Király
- Department of Neurology, University of Szeged, Szeged, Hungary
| | - Dániel Veréb
- Department of Neurology, University of Szeged, Szeged, Hungary
| | - László Vécsei
- Department of Neurology, University of Szeged, Szeged, Hungary.,MTA-SZTE Neuroscience Research Group, Szeged, Hungary
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32
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Sterling N, Lewis M, Du G, Huang X. Structural Imaging and Parkinson's Disease: Moving Toward Quantitative Markers of Disease Progression. JOURNAL OF PARKINSON'S DISEASE 2016; 6:557-67. [PMID: 27258697 PMCID: PMC5008231 DOI: 10.3233/jpd-160824] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 04/27/2016] [Indexed: 12/16/2022]
Abstract
Parkinson's disease (PD) is a progressive age-related neurodegenerative disorder. Although the pathological hallmark of PD is dopaminergic cell death in the substantia nigra pars compacta, widespread neurodegenerative changes occur throughout the brain as disease progresses. Postmortem studies, for example, have demonstrated the presence of Lewy pathology, apoptosis, and loss of neurotransmitters and interneurons in both cortical and subcortical regions of PD patients. Many in vivo structural imaging studies have attempted to gauge PD-related pathology, particularly in gray matter, with the hope of identifying an imaging biomarker. Reports of brain atrophy in PD, however, have been inconsistent, most likely due to differences in the studied populations (i.e. different disease stages and/or clinical subtypes), experimental designs (i.e. cross-sectional vs. longitudinal), and image analysis methodologies (i.e. automatic vs. manual segmentation). This review attempts to summarize the current state of gray matter structural imaging research in PD in relationship to disease progression, reconciling some of the differences in reported results, and to identify challenges and future avenues.
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Affiliation(s)
- N.W. Sterling
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - M.M. Lewis
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - G. Du
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - X. Huang
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Kinesiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
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33
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Delgado-Alvarado M, Gago B, Navalpotro-Gomez I, Jiménez-Urbieta H, Rodriguez-Oroz MC. Biomarkers for dementia and mild cognitive impairment in Parkinson's disease. Mov Disord 2016; 31:861-81. [PMID: 27193487 DOI: 10.1002/mds.26662] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 04/15/2016] [Accepted: 04/18/2016] [Indexed: 12/27/2022] Open
Abstract
Cognitive decline is one of the most frequent and disabling nonmotor features of Parkinson's disease. Around 30% of patients with Parkinson's disease experience mild cognitive impairment, a well-established risk factor for the development of dementia. However, mild cognitive impairment in patients with Parkinson's disease is a heterogeneous entity that involves different types and extents of cognitive deficits. Because it is not currently known which type of mild cognitive impairment confers a higher risk of progression to dementia, it would be useful to define biomarkers that could identify these patients to better study disease progression and possible interventions. In this sense, the identification among patients with Parkinson's disease and mild cognitive impairment of biomarkers associated with dementia would allow the early detection of this process. This review summarizes studies from the past 25 years that have assessed the potential biomarkers of dementia and mild cognitive impairment in Parkinson's disease patients. Despite the potential importance, no biomarker has as yet been validated. However, features such as low levels of epidermal and insulin-like growth factors or uric acid in plasma/serum and of Aß in CSF, reduction of cerebral cholinergic innervation and metabolism measured by PET mainly in posterior areas, and hippocampal atrophy in MRI might be indicative of distinct deficits with a distinct risk of dementia in subgroups of patients. Longitudinal studies combining the existing techniques and new approaches are needed to identify patients at higher risk of dementia. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Manuel Delgado-Alvarado
- Biodonostia Health Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Belén Gago
- Biodonostia Health Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Irene Navalpotro-Gomez
- Biodonostia Health Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Haritz Jiménez-Urbieta
- Biodonostia Health Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - María C Rodriguez-Oroz
- Biodonostia Health Research Institute, San Sebastián, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Neurology Department, University Hospital Donostia, San Sebastián, Spain.,Ikerbasque (Basque Foundation for Science), Bilbao, Spain.,Basque Center on Cognition, Brain and Language (BCBL), San Sebastián, Spain.,Physiology Department, Medical School University of Navarra, Pamplona, Spain
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34
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Mak E, Su L, Williams GB, Firbank MJ, Lawson RA, Yarnall AJ, Duncan GW, Owen AM, Khoo TK, Brooks DJ, Rowe JB, Barker RA, Burn DJ, O'Brien JT. Baseline and longitudinal grey matter changes in newly diagnosed Parkinson's disease: ICICLE-PD study. Brain 2015; 138:2974-86. [PMID: 26173861 PMCID: PMC4671477 DOI: 10.1093/brain/awv211] [Citation(s) in RCA: 171] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 05/12/2015] [Accepted: 06/05/2015] [Indexed: 12/12/2022] Open
Abstract
Mild cognitive impairment in Parkinson's disease is associated with progression to dementia (Parkinson's disease dementia) in a majority of patients. Determining structural imaging biomarkers associated with prodromal Parkinson's disease dementia may allow for the earlier identification of those at risk, and allow for targeted disease modifying therapies. One hundred and five non-demented subjects with newly diagnosed idiopathic Parkinson's disease and 37 healthy matched controls had serial 3 T structural magnetic resonance imaging scans with clinical and neuropsychological assessments at baseline, which were repeated after 18 months. The Movement Disorder Society Task Force criteria were used to classify the Parkinson's disease subjects into Parkinson's disease with mild cognitive impairment (n = 39) and Parkinson's disease with no cognitive impairment (n = 66). Freesurfer image processing software was used to measure cortical thickness and subcortical volumes at baseline and follow-up. We compared regional percentage change of cortical thinning and subcortical atrophy over 18 months. At baseline, cases with Parkinson's disease with mild cognitive impairment demonstrated widespread cortical thinning relative to controls and atrophy of the nucleus accumbens compared to both controls and subjects with Parkinson's disease with no cognitive impairment. Regional cortical thickness at baseline was correlated with global cognition in the combined Parkinson's disease cohort. Over 18 months, patients with Parkinson's disease with mild cognitive impairment demonstrated more severe cortical thinning in frontal and temporo-parietal cortices, including hippocampal atrophy, relative to those with Parkinson's disease and no cognitive impairment and healthy controls, whereas subjects with Parkinson's disease and no cognitive impairment showed more severe frontal cortical thinning compared to healthy controls. At baseline, Parkinson's disease with no cognitive impairment converters showed bilateral temporal cortex thinning relative to the Parkinson's disease with no cognitive impairment stable subjects. Although loss of both cortical and subcortical volume occurs in non-demented Parkinson's disease, our longitudinal analyses revealed that Parkinson's disease with mild cognitive impairment shows more extensive atrophy and greater percentage of cortical thinning compared to Parkinson's disease with no cognitive impairment. In particular, an extension of cortical thinning in the temporo-parietal regions in addition to frontal atrophy could be a biomarker in therapeutic studies of mild cognitive impairment in Parkinson's disease for progression towards dementia.
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Affiliation(s)
- Elijah Mak
- 1 Department of Psychiatry, University of Cambridge, UK
| | - Li Su
- 1 Department of Psychiatry, University of Cambridge, UK
| | - Guy B Williams
- 2 Wolfson Brain Imaging Centre, University of Cambridge, UK
| | | | - Rachael A Lawson
- 3 Institute of Neuroscience, Newcastle University, Newcastle, UK
| | - Alison J Yarnall
- 3 Institute of Neuroscience, Newcastle University, Newcastle, UK
| | - Gordon W Duncan
- 4 Medicine of the Elderly, Western General Hospital, Edinburgh, UK
| | - Adrian M Owen
- 5 Brain and Mind Institute, University of Western Ontario, London, Canada 6 Department of Psychology, University of Western Ontario, London, Canada
| | - Tien K Khoo
- 7 Griffith Health Institute and School of Medicine, Griffith University, Gold Coast, Australia
| | - David J Brooks
- 8 Division of Brain Sciences, Imperial College London, London, UK 9 Department of Clinical Medicine, Positron Emission Tomography Centre, Aarhus University, Denmark
| | - James B Rowe
- 10 Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK 11 Medical Research Council, Cognition and Brain Sciences Unit, Cambridge, UK 12 Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Roger A Barker
- 13 John van Geest Centre for Brain Repair, University of Cambridge, Cambridge, UK
| | - David J Burn
- 3 Institute of Neuroscience, Newcastle University, Newcastle, UK
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