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Gray and white matter imaging : A biomarker for cognitive impairment in early Parkinson's disease?

Duncan, Gordon W; Firbank, Michael J; Yarnall, Alison J; Khoo, Tien K; Brooks, David J; Barker, Roger A LU ; Burn, David J and O'Brien, John T (2016) In Movement Disorders 31(1). p.10-103
Abstract

BACKGROUND: The aim of this work was to investigate the cortical and white matter changes that underlie cognitive impairment in patients with incident Parkinson's disease (PD) disease using voxel-based morphometry and diffusion tensor imaging.

METHODS: Newly diagnosed nondemented PD (n = 125) and control subjects (n = 50) were recruited from the Incidence of Cognitive Impairment in Cohorts with Longitudinal Evaluation in Parkinson's Disease Study and completed cognitive assessments and 3T structural and diffusion tensor MR imaging. Voxel-based morphometry was performed to investigate the relationship between gray matter volume and cognitive ability. Microstructural white matter changes were assessed with diffusion tensor imaging... (More)

BACKGROUND: The aim of this work was to investigate the cortical and white matter changes that underlie cognitive impairment in patients with incident Parkinson's disease (PD) disease using voxel-based morphometry and diffusion tensor imaging.

METHODS: Newly diagnosed nondemented PD (n = 125) and control subjects (n = 50) were recruited from the Incidence of Cognitive Impairment in Cohorts with Longitudinal Evaluation in Parkinson's Disease Study and completed cognitive assessments and 3T structural and diffusion tensor MR imaging. Voxel-based morphometry was performed to investigate the relationship between gray matter volume and cognitive ability. Microstructural white matter changes were assessed with diffusion tensor imaging measures of fractional anisotropy and mean diffusivity using tract-based spatial statistics.

RESULTS: Increased mean diffusivity was observed bilaterally in subjects with PD, relative to controls (P = 0.019). Increased mean diffusivity was associated with performance on the semantic fluency and Tower of London tasks in frontal and parietal white matter tracts, including the cingulum, superior longitudinal fasciculus, inferior longitudinal fasciculus, and inferior fronto-occipital fasciculus. There was no difference in total gray matter volume between groups; however, bilateral reductions in frontal and parietal gray matter volume were associated with reduced performance on measures of executive function in PD subjects.

CONCLUSIONS: At the earliest stages of PD, regionally specific increases in central white matter mean diffusivity are present and suggest early axonal damage. Such changes are not accompanied by significant gray matter volume loss and are consistent with proposed models of pathological progression of the disease. Structural MRI, especially diffusion tensor imaging analysis, offers potential as a noninvasive biomarker reflecting cognitive impairment in PD.

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author
publishing date
type
Contribution to journal
publication status
published
keywords
Aged, Brain Mapping, Cognition Disorders, Cohort Studies, Diffusion Tensor Imaging, Female, Gray Matter, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Neuropsychological Tests, Parkinson Disease, Severity of Illness Index, White Matter, Journal Article, Research Support, Non-U.S. Gov't
in
Movement Disorders
volume
31
issue
1
pages
8 pages
publisher
John Wiley & Sons
external identifiers
  • scopus:84956813804
ISSN
0885-3185
DOI
10.1002/mds.26312
language
English
LU publication?
no
id
decef7df-a5ea-40aa-a876-d7b92bff9df2
date added to LUP
2016-11-23 13:30:39
date last changed
2017-11-19 04:35:09
@article{decef7df-a5ea-40aa-a876-d7b92bff9df2,
  abstract     = {<p>BACKGROUND: The aim of this work was to investigate the cortical and white matter changes that underlie cognitive impairment in patients with incident Parkinson's disease (PD) disease using voxel-based morphometry and diffusion tensor imaging.</p><p>METHODS: Newly diagnosed nondemented PD (n = 125) and control subjects (n = 50) were recruited from the Incidence of Cognitive Impairment in Cohorts with Longitudinal Evaluation in Parkinson's Disease Study and completed cognitive assessments and 3T structural and diffusion tensor MR imaging. Voxel-based morphometry was performed to investigate the relationship between gray matter volume and cognitive ability. Microstructural white matter changes were assessed with diffusion tensor imaging measures of fractional anisotropy and mean diffusivity using tract-based spatial statistics.</p><p>RESULTS: Increased mean diffusivity was observed bilaterally in subjects with PD, relative to controls (P = 0.019). Increased mean diffusivity was associated with performance on the semantic fluency and Tower of London tasks in frontal and parietal white matter tracts, including the cingulum, superior longitudinal fasciculus, inferior longitudinal fasciculus, and inferior fronto-occipital fasciculus. There was no difference in total gray matter volume between groups; however, bilateral reductions in frontal and parietal gray matter volume were associated with reduced performance on measures of executive function in PD subjects.</p><p>CONCLUSIONS: At the earliest stages of PD, regionally specific increases in central white matter mean diffusivity are present and suggest early axonal damage. Such changes are not accompanied by significant gray matter volume loss and are consistent with proposed models of pathological progression of the disease. Structural MRI, especially diffusion tensor imaging analysis, offers potential as a noninvasive biomarker reflecting cognitive impairment in PD.</p>},
  author       = {Duncan, Gordon W and Firbank, Michael J and Yarnall, Alison J and Khoo, Tien K and Brooks, David J and Barker, Roger A and Burn, David J and O'Brien, John T},
  issn         = {0885-3185},
  keyword      = {Aged,Brain Mapping,Cognition Disorders,Cohort Studies,Diffusion Tensor Imaging,Female,Gray Matter,Humans,Image Processing, Computer-Assisted,Magnetic Resonance Imaging,Male,Middle Aged,Neuropsychological Tests,Parkinson Disease,Severity of Illness Index,White Matter,Journal Article,Research Support, Non-U.S. Gov't},
  language     = {eng},
  number       = {1},
  pages        = {10--103},
  publisher    = {John Wiley & Sons},
  series       = {Movement Disorders},
  title        = {Gray and white matter imaging : A biomarker for cognitive impairment in early Parkinson's disease?},
  url          = {http://dx.doi.org/10.1002/mds.26312},
  volume       = {31},
  year         = {2016},
}