Voxel-based morphometry reveals extra-nigral atrophy patterns associated with dopamine refractory cognitive and motor impairment in Parkinsonism

Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Parkinsonism & Related Disorders (Impact Factor: 3.97). 07/2008; 15(3):187-95. DOI: 10.1016/j.parkreldis.2008.05.002
Source: PubMed


To determine overall patterns of brain atrophy associated with memory, executive function (EF) and dopamine non-responsive motor measures in older parkinsonian patients.
Forty-three older PD patients (>or=65 years) and matched controls underwent a neurological examination (Unified Parkinson's Disease Rating Scale, separated into dopamine responsive and dopamine non-responsive signs) and neuropsychological testing (memory: California Verbal Learning Test (CVLT)) and a composite of index of executive function (EF): Stroop Interference, Trail Making Test Part B, and digit ordering. All underwent volumetric MRI scans analyzed using voxel-based morphometry (VBM). Group comparisons, and the correlations between MRI gray and white matter volume and motor and cognitive measures were controlled for age, sex and intracranial volume. Cerebellar volume was independently measured using a validated extraction method.
Patients and controls were matched for demographics and global cognitive measures. VBM indicated significant gray matter (GM) atrophy in the cerebellum in PD and was confirmed independently. Poor memory was associated with GM atrophy in the left (uncus, middle temporal and fusiform gyri) and right temporal lobes and left putamen. Dopamine non-responsive motor signs and EF were associated with caudate atrophy. EF was also associated with GM atrophy in the middle temporal gyri, the left precuneus and cerebellum.
Cortical and striatal atrophy were associated with dopamine non-responsive motor signs and cognitive impairment and provide a morphologic correlate for progression of PD. Cerebellar atrophy was found in older PD patients.

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    • "In contrast , most VBM studies in cognitively intact PD have reported no significant volumetric changes [Beyer et al., 2007; Brenneis et al., 2003; Dalaker et al., 2010; Melzer et al., 2012; Menke et al., 2014; Price et al., 2004; Prodoehl et al., 2013; Tessitore et al., 2012] or reduced volume in only a few areas that vary across studies [Camicioli et al., 2009; Cordato et al., 2005; Martin et al., 2009; Nagano-Saito et al., 2005; Pereira et al., 2012; Summerfield et al., 2005; Tir et al., 2009]. To date, no studies in MSAp and only one in PD have normalized VBM data to a cerebellum-specific template [Camicioli et al., 2009], thus making it unclear how the macrostructure of this important motor control area is affected in these diseases. "
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    • "Thirty-two studies were identified in the meta-analysis (Figure 1) and a total of 24 studies on PD were included (Burton et al., 2004; Cordato et al., 2005; Nagano-Saito et al., 2005; Beyer et al., 2007; Ramirez-Ruiz et al., 2007; Feldmann et al., 2008; Karagulle Kendi et al., 2008; Camicioli et al., 2009; Jubault et al., 2009; Martin et al., 2009; Pereira et al., 2009; Sanchez-Castaneda et al., 2009; Tir et al., 2009; Dalaker et al., 2010; Kostic et al., 2010; Lee et al., 2010; Cerasa et al., 2011; Focke et al., 2011; Meppelink et al., 2011; Compta et al., 2012; Fernández-Seara et al., 2012; Hong et al., 2012; Ibarretxe-Bilbao et al., 2012; Tessitore et al., 2012). Seven hundred and sixteen PD patients and 535 HC subjects met the inclusion criteria for meta-analysis. "
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