Objective: To investigate patterns of cortical and white matter (WM) changes associated with progression to mild cognitive impairment (MCI) or dementia in patients with Parkinson’s disease (PD).

Background: Many people with PD will eventually develop cognitive impairment as the disease progresses. Multimodal magnetic resonance imaging (MRI) might contribute predicting cognitive decline in PD.

Methods: We enrolled 84 PD patients and 41 healthy controls. At study entry, all subjects underwent clinical and cognitive evaluations, and MRI including 3D T1-weighted and diffusion tensor imaging (DTI). Patients were followed clinically and neuropsychologically for 2 years and classified as cognitive progressors (from normal cognition to MCI, or from MCI to dementia) or non-progressors (stable cognition over two years). Measures of cortical thickness and WM tract microstructure were obtained by surface-based morphometry and probabilistic tractography, respectively.

Results: Thirty-one patients were classified as cognitive progressors. Compared with controls, both groups did not show cortical thinning, non-progressors showed microstructural changes in the cerebellar peduncles, while progressors had alterations in corpus callosum, cingulum, corticospinal and peduncolopontine tracts. Progressors did not show significant cortical thinning compared to non-progressors. Conversely, they demonstrated reduced fractional anisotropy of the body of the corpus callosum, right inferior longitudinal fasciculus (ILF), bilateral middle cerebellar and superior cerebellar peduncles (SCP) bilaterally, and right uncinate fasciculus, and increased mean diffusivity of the genu of the corpus callosum, cingulum, ILF, corticospinal tract, SCP bilaterally, as well as left superior longitudinal fasciculus and right uncinate fasciculus.

Conclusions: Our results suggest that the presence of microstructural white matter alterations at baseline may be associated with the development or worsening of cognitive deficits in PD patients over two years. DTI offers new tools to identify PD patients at-risk for cognitive impairment.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/white-matter-microstructural-damage-as-predictor-of-cognitive-decline-in-parkinsons-disease/