Highlights
- •Progressive cortical thinning and subcortical volumetric loss with increasing disease severity in PD.
- •Morphometric changes are associated with disease duration and motor symptom severity.
- •Morphometric changes are associated with lower MMSE scores.
- •Subclinical changes could contribute towards future development of cognitive decline.
- •Topographic patterns of cortical thinning could act as marker of disease severity and cognitive dysfunction.
Abstract
Background
Imaging studies have revealed cortical thinning and subcortical atrophy occurring
in Parkinson's disease (PD); however, the topographical distribution and clinical
associations related to advancing stages of PD remains unclear.
Objective
We aimed to investigate the topographical distribution of cortical and subcortical
morphometric changes, and their clinical associations, related to increasing disease
severity.
Methods
In this cross-sectional imaging study, T1-weighted structural magnetic resonance imaging
data for 80 non-demented PD patients and 30 age-matched healthy controls were analysed
using FreeSurfer software suite to derive morphometric changes using whole-brain vertex-wise
analysis, and surface-based (cortical) and volume-based (subcortical) parcellation
maps. PD patients were divided into three groups of mild (n = 27), moderate (n = 27), and severe (n = 26) PD based disease duration and Hoehn and Yahr and Unified Parkinson's Disease
Rating Scale Part-III motor severity scores.
Results
Whole-brain vertex-wise analysis revealed cortical thinning in the orbitofrontal cortex
in early PD (P = .011), and in the superior frontal (P = .002), caudal middle frontal gyrus (P = .001) and inferior parietal cortex (P = .006) in moderate PD. Severe PD patients showed additional cortical thinning in
temporal and occipital cortices (P < .005). Subcortical volume loss was detected in the thalamus (P = .012) and hippocampus (P = .032) in moderate PD, which extended to the caudate (P = .012), putamen (P = .042) and amygdala (P = .008) in severe PD. Increasing disease duration and motor severity scores, correlated
with cortical thinning in frontal, temporal, parietal and occipital cortices, and
subcortical volumetric loss in the thalamus, caudate, putamen, amygdala and hippocampus.
Lower global cognitive status, measured with MMSE, correlated with cortical thinning
in temporal, parietal, frontal and cingulate cortices, and with volumetric loss in
the hippocampus (r = 0.31; P = .009); suggesting subclinical pathogenic changes occur prior to the onset of cognitive
impairment.
Conclusion
In conclusion, in more severe disease stages PD patients exhibit progressive cortical
thinning and subcortical volume loss which could have relevance to the development
of cognitive impairment.
Keywords
Abbreviations:
H&Y (Hoehn and Yahr), MRI (magnetic resonance imaging), MMSE (Mini Mental State Examination), PD (Parkinson's disease), UPDRS (Unified Parkinson's Disease Rating Scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 17, 2019
Accepted:
January 14,
2019
Received in revised form:
December 20,
2018
Received:
July 22,
2018
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
