Objective: To explore the relationship between cognitive impairment in Parkinson’s Disease(PD) and the microstructure changes of brain region of interest(ROI) in diffusion tensor imaging(DTI).

Background: The current mainstream view is that organic changes exist in the nervous system of PD-depressive patients. DTI is a new magnetic resonance technique that can reflect the microscopic structure of white matter. In this study, we compared the differences of fractional anisotropy (FA) in DTI mesencephalic tissue ROI between PD-depressive patients and PD non-depressive patients to explore the changes of white matter microstructure in patients with PD depression, with a view to provide an objective basis for the early clinical diagnosis of PD depression.

Methods: 50 PD patients studied by the DSM-IV to diagnose Depression and DTI to measure the microstructure changes of ROI. Depending on DSM-IV, 50 PD patients were divided into DPD(Depression of Parkinson’s disease) group and PDND(Parkinson’s disease without depression ) group. DPD group were studied by HAMD to assess the depression. ROIs were drawn in frontal white matter (FWM), temporal white matter(TWM), parietal white matter(PWM),occipital white matter(OWM), genu of corpus callosum(CCg), splenium of corpus callosum(CCs), anterior of cingulated bundles (ACLB) and posterior of cingulated bundles (PCLB) by two blinded raters. Compare the gender, age of two group with independent t text and χ2 test. The FA values of ROIs were obtained from above two groups and analyzed with independent t test. All the significant factors were analyzed in Logistic Regression. FA values and the scores of HAMD in DPD group were analyzed with Spearman rank-sum test.

Results: 19 patients were diagnosed of Depression, which means the relevance ratio of DPD is 38%. The relevance ratio of mild-middle depression is 30.5%(HAMD score between 21~35) while the relevance ratio of major depression is 7.5%(HAMD score greater than 35). The PD group showed significant FA reduction in FWM, ACLB(0.317±0.034, 0.301±0.05 VS 0.380=7±0.43, 0.332±0.02; P<0.05). In the Logistic Regression analysis, FA in FWM and ACLB show significant correlation to DPD(OR=0.00，OR=0.00，P<0.05). The scores of HAMD in DPD group was negatively correlated with the FA values of FWM and ACLB(r=-0.667, r=-0.554，P<0.05).

Conclusions: The microstructural damage in FWM and ACLB is positively correlated with cognitive impairment in PD patients. The FA reduction of FWN and ACLB has the potential to serve as a noninvasive early biomarker for DPD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/preliminary-study-of-depression-in-parkinsons-disease-with-diffusion-tensor-imaging/