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ABSTRACT: BACKGROUND AND PURPOSE:Previous studies have suggested that structural changes do occur in the brain of patients with schizophrenia compared with healthy control participants. However, findings from such studies are inconclusive, probably because of the different methodologic approaches, the clinical heterogeneity of patient samples, and also the fact that patients enrolled were treated with antipsychotic drugs. The aim of this study was to investigate brain GM volumes and intrinsic structural WM changes in first-contact, antipsychotic drug-naïve patients with schizophrenia.MATERIALS AND METHODS:A total of 43 first-contact, drug-naïve, patients with schizophrenia and 17 age-matched control participants were studied. All participants underwent T1-weighted MR imaging and DTI scans. Voxel-based morphometry and tract-based spatial statistics were used to compare GM volumes and WM DTI metrics between groups. MR imaging measures were correlated with the duration of the untreated psychosis and the clinical positive and negative symptoms.RESULTS:Compared with control participants, patients with schizophrenia showed smaller volumes of the temporal, parietal, and occipital GM, and a pattern of decreased mean diffusivity and increased fractional anisotropy in the brain stem and cerebellum bilaterally, interhemispheric and cortico-cortical connections bilaterally, and right anterior and posterior limb of the internal capsule. In patients, decreased mean diffusivity and increased fractional anisotropy in several brain regions were related to a longer duration of the untreated psychosis and the severity of positive symptoms.CONCLUSIONS:First-contact, drug-naïve, patients with schizophrenia present with volumetric and DTI changes, which correlated with their clinical features. This study increases our knowledge on the neural networks involved in the pathophysiologic mechanisms of schizophrenia.
American Journal of Neuroradiology 06/2013; · 2.93 Impact Factor
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ABSTRACT: Magnetic resonance imaging (MRI) is extremely sensitive in detecting multiple sclerosis (MS)-related abnormalities. As a consequence, it has become an established tool to diagnose the disease and to monitor its evolution. In patients at presentation with clinically isolated syndromes suggestive of MS, MRI has been formally included in the diagnostic work up and ad hoc criteria have been proposed and are updated on a regular basis. However, in patients with definite MS, the strength of the relationship between conventional MRI findings and subsequent clinical manifestations of the disease remains modest. This is likely due to the relatively lack of specificity of conventional MRI to the heterogeneous pathological substrates of the disease and its inability to provide accurate estimates of such a damage outside focal lesions as well as to define the mechanisms through which the central nervous system recovers after tissue injury has occurred. Non-conventional MRI techniques offer new biomarkers more closely linked to the pathological features of the disease, which are likely to contribute to overcome, at least partially, these limitations. This review summarizes how MRI has improved our ability to diagnose MS and to predict its course, as well as how it is changing our understanding of the factors associated with the accumulation of irreversible disability in this condition.
Journal of the neurological sciences 05/2013; · 2.32 Impact Factor
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A Ghezzi,
C Pozzilli,
Lme Grimaldi,
L Moiola,
V Brescia-Morra,
A Lugaresi,
G Lus,
F Rinaldi,
Ma Rocca,
M Trojano,
A Bianchi,
G Comi, M Filippi
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ABSTRACT: BACKGROUND: Limited information is available on the use of natalizumab (NA) in pediatric multiple sclerosis (ped-MS) patients. OBJECTIVE: The purpose of this study was to describe the long-term effects of NA in a large cohort of active ped-MS patients. METHODS: Patients with definite ped-MS were treated with NA if in the previous year they had experienced at least two relapses or a severe relapse with incomplete recovery while on immunomodulating treatment, or at least two relapses and new magnetic resonance imaging (MRI) lesions regardless of any prior treatment. RESULTS: The study included 55 patients (mean age: 14.4 years, mean number of relapses: 4.4, pre-treatment mean disease duration: 25.5 months). They received a median number of 26 infusions. Three relapses occurred during the follow-up, one female patient continued to deteriorate in cognitive functioning. Mean Expanded Disability Status Scale (EDSS) scores decreased from 2.7 to 1.9 at the last visit (p<0.001). During the follow-up the majority of patients remained free from MRI activity. Transient and mild clinical adverse events occurred in 20 patients. Mild hematological abnormalities occurred in seven patients. Anti-JCV antibodies were detected in 20/51 tested patients. CONCLUSIONS: NA was well tolerated in all patients. A strong suppression of disease activity was observed in the majority of patients during the follow-up.
Multiple Sclerosis 02/2013; · 4.26 Impact Factor
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ABSTRACT: An abnormal pattern of brain activations has been shown in patients with multiple sclerosis during the performance of several cognitive tasks. The aim of this study is to investigate abnormalities of the patterns of activation/deactivation in the functional networks related to "task-positive" and "task-negative" events during the execution of the Symbol Digit Modalities Test (SDMT) in patients with clinically isolated syndromes (CIS) and preserved cognitive abilities. Eighteen CIS patients within 3 months from their first clinical attack and 15 healthy controls (HC) underwent neuropsychological assessment and performed an adapted functional magnetic resonance imaging (fMRI) version of the SDMT. "Task-positive" responses to task execution and "task-negative" activity of the default mode network were compared between groups. A regression analysis was performed to investigate the correlation between fMRI results and T2 lesion load (T2 LL) and brain atrophy. Neuropsychological performance did not differ between groups. Compared to HC, CIS patients exhibited an enhanced deactivation of the "task-negative" network at the level of the posterior cingulate cortex, whereas no differences between groups were found when the patterns of "task-positive" events were compared. A regression analysis detected a correlation (p < 0.001,r ranging from 0.62 to 0.73) between T2 LL and "task-positive" activations of areas that are part of the attention network, comprising the anterior cingulate gyrus, left prefrontal gyrus and inferior parietal lobe. No correlation was found between patterns of functional modifications and brain atrophy. CIS patients experience an enhanced pattern of brain deactivations during cognitive performances, which might contribute to their normal neuropsychological status.
Experimental Brain Research 01/2013; · 2.39 Impact Factor
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H Vrenken,
M Jenkinson,
M A Horsfield,
M Battaglini,
R A van Schijndel,
E Rostrup,
J J G Geurts,
E Fisher,
A Zijdenbos,
J Ashburner,
D H Miller, M Filippi,
F Fazekas,
M Rovaris,
A Rovira,
F Barkhof,
N de Stefano
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ABSTRACT: Focal lesions and brain atrophy are the most extensively studied aspects of multiple sclerosis (MS), but the image acquisition and analysis techniques used can be further improved, especially those for studying within-patient changes of lesion load and atrophy longitudinally. Improved accuracy and sensitivity will reduce the numbers of patients required to detect a given treatment effect in a trial, and ultimately, will allow reliable characterization of individual patients for personalized treatment. Based on open issues in the field of MS research, and the current state of the art in magnetic resonance image analysis methods for assessing brain lesion load and atrophy, this paper makes recommendations to improve these measures for longitudinal studies of MS. Briefly, they are (1) images should be acquired using 3D pulse sequences, with near-isotropic spatial resolution and multiple image contrasts to allow more comprehensive analyses of lesion load and atrophy, across timepoints. Image artifacts need special attention given their effects on image analysis results. (2) Automated image segmentation methods integrating the assessment of lesion load and atrophy are desirable. (3) A standard dataset with benchmark results should be set up to facilitate development, calibration, and objective evaluation of image analysis methods for MS.
Journal of Neurology 12/2012; · 3.47 Impact Factor
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Journal of Neurology 11/2012; · 3.47 Impact Factor
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American Journal of Neuroradiology 08/2012; · 2.93 Impact Factor
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M Filippi,
F Agosta,
F Barkhof,
B Dubois,
N C Fox,
G B Frisoni,
C R Jack,
P Johannsen,
B L Miller,
P J Nestor,
P Scheltens,
S Sorbi,
S Teipel,
P M Thompson,
L-O Wahlund
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ABSTRACT: BACKGROUND AND PURPOSE: The European Federation of the Neurological Societies (EFNS) guidelines on the use of neuroimaging in the diagnosis and management of dementia are designed to revise and expand previous EFNS recommendations for the diagnosis and management of patients with Alzheimer's disease (AD) and to provide an overview of the evidence for the use of neuroimaging techniques in non-AD dementias, as well as general recommendations that apply to all types of dementia in clinical practice. METHODS: The task force working group reviewed evidence from original research articles, meta-analysis and systematic reviews, published before April 2012. The evidence was classified, and consensus recommendations were given and graded according to the EFNS guidance regulations. RESULTS: Structural imaging, which should be performed at least once in the diagnostic work-up of patients with cognitive impairment, serves to exclude other potentially treatable, diseases; to recognize vascular lesions and to identify specific findings to help distinguish different forms of neurodegenerative types of dementia. Although typical cases of dementia may not benefit from routine functional imaging, these tools are recommended in those cases where diagnosis remains in doubt after clinical and structural imaging work-up and in particular clinical settings. Amyloid imaging is likely to find clinical utility in several fields, including the stratification of patients with mild cognitive impairment into those with and without underlying AD and the evaluation of atypical AD presentations. CONCLUSIONS: A number of recommendations and good practice points are made to improve the diagnosis of AD and other dementias.
European Journal of Neurology 08/2012; · 3.69 Impact Factor
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M Filippi,
P Preziosa,
E Pagani,
M Copetti,
S Mesaros,
B Colombo,
Ma Horsfield,
A Falini,
G Comi,
H Lassmann,
Ma Rocca
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ABSTRACT: BACKGROUND: Pathologic and magnetic resonance imaging (MRI) studies have shown that cortical lesions (CLs) are a frequent finding in multiple sclerosis (MS). OBJECTIVE: To quantify microstructural damage in CLs and normal appearing (NA) cortex in relapse-onset MS patients at different stages of the disease. METHODS: Brain double inversion recovery (DIR), diffusion tensor (DT) MRI and 3D T(1)-weighted scans were acquired from 35 relapsing-remitting (RR) patients, 23 secondary progressive (SP) patients, 12 benign (B) MS patients and 41 healthy controls (HC). Diffusivity values in CLs, cortex, white matter (WM) lesions and normal-appearing white matter (NAWM) were assessed. RESULTS: Compared to HC, MS patients had a significantly lower fractional anisotropy (FA) and higher mean diffusivity (MD) in the cortex and NAWM. CLs had higher FA vs HC cortex and vs patients' cortex. Compared to RRMS patients, SPMS patients had higher WM lesion volume, higher MD in the cortex, and more severe damage to the NAWM and WM lesions. Compared to SPMS patients, BMS patients had lower MD and FA of CLs. Damage in other compartments was similar between SPMS and BMS patients. Damage in CLs had a high power to discriminate BMS from SPMS (area under the curve: 79-91%), with high specificity (85%), sensitivity (100%) and accuracy (90%). CONCLUSIONS: Microstructural imaging features of CLs differ from those of WM lesions and are likely to reflect neuronal damage and microglial activation. The nature and extent of CL damage can be used to help distinguish the different MS clinical phenotypes.
Multiple Sclerosis 08/2012; · 4.26 Impact Factor
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ABSTRACT: BACKGROUND AND PURPOSE:VBM is widely applied to characterize regional differences in brain volume among groups of subjects. The aim of this study was to develop and validate a method for voxelwise statistical analysis of cord volume and to test, with this method, the correlation between cord tissue loss and aging.MATERIALS AND METHODS:3D T1-weighted scans of the spinal cord were acquired from 90 healthy subjects spanning several decades of life. Using an AS method, we outlined the cord surface and created output images reformatted with image planes perpendicular to the estimated cord centerline. Unfolded cervical cord images were coregistered into a common standard space, and smoothed cord binary masks, produced by using the cord outlines estimated by the AS approach, were used as input images for spatial statistics.RESULTS:High spatial correlation between normalized images was observed. Averaging of the normalized scans allowed the creation of a cervical cord template and of a standardized region-of-interest atlas. VBM analysis showed some significant associations between a decreased probability of cord tissue and aging. Results were robust across different smoothing levels, but the use of an anisotropic Gaussian kernel gave the optimal trade-off between spatial resolution and the requirements of the Gaussian random field theory.CONCLUSIONS:VBM analysis of the cervical cord was feasible and holds great promise for accurate localization of regional cord atrophy in several neurologic conditions.
American Journal of Neuroradiology 06/2012; · 2.93 Impact Factor
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Multiple Sclerosis 05/2012; 18(5):557-8. · 4.26 Impact Factor
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ABSTRACT: To assess the value of clinical and MRI variables in predicting short-term brain atrophy accumulation and clinical evolution
in a large cohort of patients with RRMS, we studied a cohort of 548 patients, previously enrolled as a placebo arm of a 14-month,
double-blind trial of oral glatiramer acetate (GA). A logistic regression model with EDSS progression as the dependent variable
was built to assess baseline clinical and MRI variables associated with clinical worsening during follow-up. In 466 patients
with complete central brain atrophy assessment, another linear regression model with percentage central brain volume change
(PCBVC) as the dependent variable was built to assess baseline clinical and MRI variables associated with atrophy development.
A total of 80 patients (15 %) had EDSS progression over the follow-up period. Factors independently predicting the probability
to have a clinical progression were lower EDSS (OR = 0.78, 95 % CI = 0.62–0.97 p = 0.02) and higher T2 LL (OR = 1.022, 95
% CI = 1.006–1.038, p = 0.007) at baseline. In the 466 patients with atrophy assessment, PCBVC declined, on average, by –2.0
% (SD = 2.8) (p < 0.001) over the follow-up. The multivariate PCBVC analysis revealed that the PCBVC decrease was independently
correlated with higher EDSS (p = 0.03) and T2 LL (p = 0.005) at baseline. The squared correlation coefficients of the composite
scores made up of EDSS and T2 LL considered together were able to explain only 3 % of the variance in disability progression
and only 4 % of the variance of PCBVC.
In RRMS patients, clinical and conventional MRI findings at baseline only modestly predict shortterm accumulation of brain
atrophy and disability. These data confirm the need to develop clinical and MRI measures more sensitive towards the more disabling
aspects of the disease.
Journal of Neurology 04/2012; 255(9):1378-1383. · 3.47 Impact Factor
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A. Seewann,
C. Enzinger, M. Filippi,
F. Barkhof,
A. Rovira,
A. Gass,
D. Miller,
X. Montalban,
A. Thompson,
T. Yousry,
M. Tintore,
N. de Stefano,
J. Palace,
M. Rovaris,
C. Polman,
F. Fazekas,
for the MAGNIMS network
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ABSTRACT: Background
Idiopathic inflammatory demyelinating lesions (IIDL) of the brain usually present with a morphologic pattern characteristic
of multiple sclerosis (MS). Atypical appearances of IIDLs also exist, however, and can pose significant diagnostic problems
and uncertainty regarding prognosis and adequate therapy. We attempted to improve upon this situation by reviewing the literature.
Methods
We performed a PubMed search from January 1984 through December 2004 for articles in English reporting on IIDLs which had
been considered as morphologically atypical (66 articles; 270 cases reported). From these publications 69 individual patient
reports allowed the extraction of adequate information on magnetic resonance imaging (MRI) and associated disease characteristics.
Results
Reported atypical IIDLs most frequently manifested as large ring-like lesions (n = 27) which are now considered quite suggestive
of an antibodymediated form of MS. Truly atypical IIDLs were less common and exhibited appearances which we termed megacystic
(n = 8), Balolike (n = 11) and diffusely infiltrating (n = 11). Despite limitations imposed by the absence of original data
the inter-rater agreement in defining these subtypes of atypical IIDLs was moderate to substantial (kappa 0.48–0.68) and we
noted trends for their association with certain demographic, clinical and paraclinical variables.
Interpretation
We suggest that IIDLs reported as atypical in the literature can be segregated into several distinct subtypes based on their
MRI appearance. The recognition of these patterns may be useful for the differential diagnosis and for a future classification.
Because of the limitations inherent in our review this will have to be confirmed by a prospective registry.
Journal of Neurology 04/2012; 255(1):1-10. · 3.47 Impact Factor
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M Filippi,
F Agosta,
G B Frisoni,
N De Stefano,
A Bizzi,
M Bozzali,
A Falini,
M A Rocca,
S Sorbi,
C Caltagirone,
G Tedeschi
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ABSTRACT: Quantitative outcome variables in Alzheimer's disease (AD) are of interest because of their low longitudinal variability compared with that of repeated clinical and cognitive measurements. Conventional MR-based volumetry of structures within and beyond the medial temporal lobe has proven to be useful in the diagnostic work up of early AD patients, and measures of atrophy have the potential to monitor the efficacy of disease-modifying agents. The extensive application of new non-conventional MR-based techniques to the study of AD, such as proton magnetic resonance spectroscopic imaging, diffusion tensor MRI, and functional MRI, has undoubtedly improved our understanding of the pathophysiology of the disease, and might lead to the identification of additional useful markers of disease progression. This review summarizes the main results obtained from the application of conventional and non-conventional MRI in AD patients, and supports their more extensive use in studies of disease evolution and clinical trials.
Current Alzheimer research 04/2012; · 4.97 Impact Factor
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G. Comi,
L. Kappos,
M. Clanet,
G. Ebers,
A. Fassas,
F. Fazekas, M. Filippi,
H.P. Hartung,
B. Hertenstein,
D. Karussis,
G. Martino,
A. Tyndall,
F.G.A. van der Meché,
and the BMT-MS Study Group
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ABSTRACT: Recent reports suggest the possible beneficial effects of haemopoietic stem cell transplantation (HSCT) in autoimmune diseases
such as multiple sclerosis (MS). The definition of the risk/benefit ratio for such a treatment is perceived as a major issue
for the neurological community worldwide. The First Consensus Conference on Bone Marrow Transplantation in Patients with Multiple
Sclerosis was held in Milan, Italy on 21 February 1998. Participants from 16 European, North American, and South American
countries discussed the guidelines form performing HSCT in MS. This conference was organized in order to : (a) define criteria
for patient selection; (b) define transplantation procedures to maximize efficacy of the treatment and minimize its toxicity;
(c) standardize patient outcome evaluation; and (d) establish an international working group to evaluate the efficacy and
safety of HSCT in MS and to study the immunological changes related to HSCT in MS patients. During the meeting in Milan agreement
was reached on: (a) the preparation and distribution of a consensus report on HSCT in MS and (b) the design of an open trial
for an initial assessment of the safety and efficacy of HSCT in MS. The consensus reached during the meeting and the design
of the clinical trial are summarized in this contribution.
Journal of Neurology 04/2012; 247(5):376-382. · 3.47 Impact Factor
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ABSTRACT: Kinematic and functional magnetic resonance imaging were combined to investigate how movement complexity (in-phase vs. anti-phase) and rate (maximum rate vs. 1 Hz) influence the brain sensorimotor network of relapsing- remitting fatigued (F)
and notfatigued (NF) MS patients during the performance of coordinated hand and foot movements.
Kinematic measures did not differ between F and NF patients. Task and disease showed an interaction in the right precuneus
and posterior lobe of the cerebellum during in-phase/anti-phase conditions and in the right precuneus and posterior and anterior
lobes of the cerebellum during maximum vs. 1 Hz rate. Task, disease and fatigue showed an interaction in the right precentral
gyrus, the left postcentral gyrus, the left SII, the right precuneus, the right basal ganglia, the left lingual gyrus, and
the posterior lobe of the cerebellum, bilaterally, during in-phase/ anti-phase conditions and the left postcentral gyrus,
the left SII, the right anterior lobe of the cerebellum, and the posterior lobe of the cerebellum, bilaterally during maximum
vs. 1 Hz rate.
Investigations of motor task performance in MS patients require careful control of several variables, including task complexity,
movement rate, and the presence of “subtle” clinical disturbances, such as fatigue, which might be underestimated at a standard
neurological assessment.
Journal of Neurology 04/2012; 256(3):470-482. · 3.47 Impact Factor
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ABSTRACT: Magnetic resonance (MR) imaging is an extremely sensitive modality for detecting focal changes to the white matter (WM) in patients with multiple sclerosis (MS). For this reason, it has become an integral part of the diagnostic workup of patients with clinically isolated syndromes who are at risk of developing definite MS, and it is always recommended in patients with definite MS to confirm the diagnosis and monitor the disease course. Crucial to the use of MR imaging for diagnostic purposes is the identification of lesion features - in terms of site, shape and size - that may be considered suggestive or typical for MS, and thus help in the differential diagnosis with other neurological diseases with similar clinical presentation to MS. This need has led to the publication of several guidelines for characterising MS lesions on both dualecho (T2 and proton density) and T1-weighted sequences after administration of contrast material. Developments in clinical research into MS have highlighted the need to formulate a diagnosis as far as possible on the basis of objective and reproducible criteria. Currently, when making a clinical diagnosis and monitoring patients with suspected MS, neurologists and neuroradiologists make use of specific diagnostic criteria that have changed over the years and will probably continue to be updated. It is therefore crucial for radiologists to become familiar with these criteria in order to improve the quality of their diagnostic assessment. In patients with a definite diagnosis of MS, on the other hand, the main problem is to define standard procedures for monitoring the course of the disease and response to pharmacological treatments. even though no guidelines currently exist, it is possible to suggest some strategies to improve the assessment in this setting.
La radiologia medica 03/2012; · 1.44 Impact Factor
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ABSTRACT: BACKGROUND/OBJECTIVE We aimed to investigate whether cervical cord damage and dysfunction is associated with the presence and severity of fatigue in multiple sclerosis (MS) using a multiparametric magnetic resonance (MR) approach.
Cervical cord functional magnetic resonance imaging (fMRI) during a tactile stimulation of the right hand, and structural brain and cord MRI were acquired from 20 controls, 15 MS patients without fatigue (NF) and 20 MS patients with fatigue (F). Between-group differences in the extent of focal lesions and diffusivity abnormalities in the brain and cord, cord-normalized cross-sectional area (CSAn) and fMRI activity were assessed.
All structural MRI measures differed significantly among groups, except for cord lesion number and CSAn. Compared with controls, NF-MS patients experienced higher cord recruitment (p=0.04). Compared with F-MS, NF-MS patients had a lower brain normal-appearing white matter average fractional anisotropy (p=0.001) and increased cord recruitment (p=0.02). In patients with MS, the extent of cord recruitment was correlated with the severity of fatigue (r=-0.34, p=0.04). Compared with the other two groups, F-MS patients had a more diffuse recruitment of cord quadrants on the axial and longitudinal planes.
Abnormalities of function, but not of structure, of the cervical cord are likely to contribute to the pathogenesis of fatigue in MS.
Multiple Sclerosis 03/2012; 18(11):1552-9. · 4.26 Impact Factor
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S Mesaros,
M A Rocca,
K Kacar,
J Kostic,
M Copetti,
T Stosic-Opincal,
P Preziosa,
S Sala,
G Riccitelli,
M A Horsfield,
J Drulovic,
G Comi, M Filippi
[show abstract]
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ABSTRACT: To assess the correlation between cognitive impairment and overall vs regional CNS damage, quantified using conventional and diffusion tensor (DT) MRI tractography in multiple sclerosis (MS).
Brain dual-echo, T1-weighted, and DT MRI data were acquired from 82 patients with MS. DT tractography was used to produce maps of white matter (WM) tracts involved in cognition. The sensory thalamocortical projections and optic radiations were studied as "control" WM tracts. The contribution of global brain damage (T2 lesion volume, normalized brain volume, gray matter [GM] volume, WM volume, DT MRI measures of normal-appearing WM and GM damage) and damage to selected WM tracts to overall cognitive impairment and to impairment at individual neuropsychological tests was assessed using a random forest (RF) analysis.
Thirty-three patients had cognitive impairment. The majority of MRI measures differed significantly between cognitively impaired and cognitively preserved (CP) patients. Significant correlations were found between performance in the majority of neuropsychological tests and global or regional brain damage (r ranging from -0.60 to 0.57). The RF analysis showed a high performance in classifying cognitively impaired vs CP patients, with a classification (C)-index = 76.8, as well as in classifying patients' impairment in individual neuropsychological tests (C-index between 75.6% and 86.6%). Measures of lesional damage in cognitive-related tracts, rather than measures of normal-appearing WM damage in the same tracts or global brain/WM/GM damage, resulted in the highest classification accuracy.
Lesions in strategic brain WM tracts contribute to cognitive impairment in MS through a multisystem disconnection syndrome.
Neurology 02/2012; 78(13):969-75. · 8.31 Impact Factor
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ABSTRACT: To investigate whether a specific pattern of gray matter (GM) tissue loss is associated with freezing of gait (FOG) in patients with Parkinson disease (PD).
Seventeen patients with PD with FOG (PD-FOG), 20 patients with PD with no FOG (PD-noFOG), and 34 healthy control subjects were recruited. PD-FOG and PD-noFOG patients were matched on an individual basis for age, disease duration, and Hoehn and Yahr stage. Patients were also administered a comprehensive neuropsychological battery focused on executive functions. The extent and distribution of GM atrophy were assessed using voxel-based morphometry.
In patients with PD, the severity of FOG correlated with frontal executive deficits. Compared with healthy control subjects, PD-FOG patients showed a distributed pattern of GM atrophy including the dorsolateral prefrontal, medial, and lateral temporal, inferior parietal, and occipital cortices. PD-noFOG patients showed only small regions of GM atrophy in the bilateral frontal and temporal cortex. The left inferior frontal gyrus, left precentral gyrus, and left inferior parietal gyrus were more atrophic in PD-FOG patients relative to both healthy control subjects and PD-noFOG patients. In PD-FOG patients, the severity of FOG was associated with GM volumes of the frontal and parietal cortices bilaterally.
GM frontal and parietal atrophy occur in PD-FOG patients. FOG in PD seems to share with executive dysfunction and perception deficits a common pattern of structural damage to the frontal and parietal cortices.
Neurology 02/2012; 78(6):409-16. · 8.31 Impact Factor
