White matter microstructural characteristics in newly diagnosed Parkinson’s disease: An unbiased whole-brain study

Objective: Application of diffusion tensor imaging (DTI) to explore the changes of FA value in patients with Parkinson's disease (PD) with mild cognitive impairment. Methods: 27 patients with PD were divided into PD with mild cognitive impairment (PD-MCI) group (n = 7) and PD group (n = 20). The original images were processed using voxel-based analysis (VBA) and tract-based spatial statistics (TBSS). Results: The average age of pd-mci group was longer than that of PD group, and the course of disease was longer than that of PD group. Compared with PD group, the voxel based analysis-fractional anisotropy (VBA-FA) values of PD-MCI group decreased in the following areas: bilateral frontal lobe, bilateral temporal lobe, bilateral parietal lobe, bilateral subthalamic nucleus, corpus callosum, and gyrus cingula. Tract-based spatial statistics-fractional anisotropy (TBSS-FA) values in PD-MCI group decreased in bilateral corticospinal tract, anterior cingulum, posterior cingulum, fornix tract, bilateral superior thalamic radiation, corpus callosum(genu, body and splenium), bilateral uncinate fasciculus, bilateral inferior longitudinal fasciculus, bilateral superior longitudinal fasciculus, bilateral superior fronto-occipital fasciculus, bilateral inferior fronto-occipital fasciculus, and bilateral parietal-occipital tracts. The mean age of onset in the PD-MCI group was greater than that in the PD group, and the disease course was longer than that in the PD group. Conclusion: DTI-based VBA and TBSS post-processing methods can detect abnormalities in multiple brain areas and white matter fiber tracts in PD-MCI patients. Impairment of multiple cerebral cortex and white matter fiber pathways may be an important causes of cognitive dysfunction in PD-MCI.

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Characteristics of Parkinson’s Disease in Patients with and without Cognitive Impairment

Journal of Parkinson s Disease ◽

10.3233/jpd-202190 ◽

2021 ◽

pp. 1-12

Author(s):

Julie Chandler ◽

Radhika Nair ◽

Kevin Biglan ◽

Erin A. Ferries ◽

Leanne Munsie ◽

...

Keyword(s):

Parkinson’S Disease ◽

Emergency Department ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Memory Loss ◽

Patient Characteristics ◽

Emergency Department Visits ◽

Administrative Claims ◽

Newly Diagnosed ◽

Comorbidity Burden

Background: Characterizing patients with Parkinson’s disease (PD) and cognitive impairment is important toward understanding their natural history. Objective: Understand clinical, treatment, and cost characteristics of patients with PD pre- and post-cognitive impairment (memory loss/mild cognitive impairment/dementia or dementia treatment) recognition. Methods: 2,711 patients with PD newly diagnosed with cognitive impairment (index) were identified using administrative claims data. They were matched (1:1) on age and gender to patients with PD and no cognitive impairment (controls). These two cohorts were compared on patient characteristics, healthcare resource utilization, and total median costs for 3 years pre- and post-index using Chi-square tests, t-tests, and Wilcoxon rank-sum tests. Logistic regression was used to identify factors predicting cognitive impairment. Results: Comorbidity indices for patients with cognitive impairment increased during the 6-year study period, especially after the index. Enrollment in Medicare Advantage Prescription Drug plans vs. commercial (OR = 1.60), dual Medicare/Medicaid eligibility (OR = 1.36), cerebrovascular disease (OR = 1.24), and PD medication use (OR = 1.46) were associated with a new cognitive impairment diagnosis (all p < 0.05). A greater proportion of patients with cognitive impairment had hospitalizations and emergency department visits and higher median total healthcare costs than controls for each year pre- and post-index. Conclusion: In patients with PD newly diagnosed with cognitive impairment, comorbidity burden, hospitalizations, emergency department visits, and total costs peaked 1-year pre- and post-identification. These data coupled with recommendations for annual screening for cognitive impairment in PD support the early diagnosis and management of cognitive impairment in order to optimize care for patients and their caregivers.

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Amnestic mild cognitive impairment in Parkinson’s disease: White matter structural changes and mechanisms

PLoS ONE ◽

10.1371/journal.pone.0226175 ◽

2019 ◽

Vol 14 (12) ◽

pp. e0226175

Author(s):

Fuyong Chen ◽

Tao Wu ◽

Yuejia Luo ◽

Zhihao Li ◽

Qing Guan ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

White Matter ◽

Structural Changes ◽

Amnestic Mild Cognitive Impairment

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White matter hyperintensities as a predictor of freezing of gait in Parkinson's disease

Parkinsonism & Related Disorders ◽

10.1016/j.parkreldis.2019.07.019 ◽

2019 ◽

Vol 66 ◽

pp. 105-109 ◽

Cited By ~ 6

Author(s):

Seok Jong Chung ◽

Yang Hyun Lee ◽

Han Soo Yoo ◽

Jungsu S. Oh ◽

Jae Seung Kim ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

White Matter ◽

White Matter Hyperintensities ◽

Freezing Of Gait

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Structural brain signature of cognitive decline in Parkinson’s disease: DTI-based evidence from the LANDSCAPE study

Therapeutic Advances in Neurological Disorders ◽

10.1177/1756286419843447 ◽

2019 ◽

Vol 12 ◽

pp. 175628641984344 ◽

Cited By ~ 3

Author(s):

Martin Gorges ◽

Hans-Peter Müller ◽

Inga Liepelt-Scarfone ◽

Alexander Storch ◽

Richard Dodel ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

White Matter ◽

Corpus Callosum ◽

Cognitive Decline ◽

Diffusion Tensor ◽

Structural Connectivity ◽

Structural Data ◽

The Body ◽

Normal Cognitive Function

Background: The nonmotor symptom spectrum of Parkinson’s disease (PD) includes progressive cognitive decline mainly in late stages of the disease. The aim of this study was to map the patterns of altered structural connectivity of patients with PD with different cognitive profiles ranging from cognitively unimpaired to PD-associated dementia. Methods: Diffusion tensor imaging and neuropsychological data from the observational multicentre LANDSCAPE study were analyzed. A total of 134 patients with PD with normal cognitive function (56 PD-N), mild cognitive impairment (67 PD-MCI), and dementia (11 PD-D) as well as 72 healthy controls were subjected to whole-brain-based fractional anisotropy mapping and covariance analysis with cognitive performance measures. Results: Structural data indicated subtle changes in the corpus callosum and thalamic radiation in PD-N, whereas severe white matter impairment was observed in both PD-MCI and PD-D patients including anterior and inferior fronto-occipital, uncinate, insular cortices, superior longitudinal fasciculi, corona radiata, and the body of the corpus callosum. These regional alterations were demonstrated for PD-MCI and were more pronounced in PD-D. The pattern of involved regions was significantly correlated with the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) total score. Conclusions: The findings in PD-N suggest impaired cross-hemispherical white matter connectivity that can apparently be compensated for. More pronounced involvement of the corpus callosum as demonstrated for PD-MCI together with affection of fronto-parieto-temporal structural connectivity seems to lead to gradual disruption of cognition-related cortico-cortical networks and to be associated with the onset of overt cognitive deficits. The increase of regional white matter damage appears to be associated with the development of PD-associated dementia.

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