Objective: To assess volumetric, morphological and tractometric features associated with the fronto-striatal and posterior cortical cognitive profiles in Parkinson’s Disease (PD)

Background: The dual syndrome hypothesis suggests that two distinct cognitive profiles exist in PD: a fronto-striatal one and a posterior cortical one. How these profiles relate to specific anatomical changes has not been characterized yet

Method: 144 non-demented PD patients underwent a comprehensive neuropsychological assessment and 3T MRI in two different centers (Lille, France and Maastricht, Netherlands). Depending on their cognitive performance, patients were divided into four groups: (a) without cognitive disorders, (b) fronto-striatal syndrome, (c) posterior cortical syndrome, (d) mixed (fronto-striatal and posterior cortical) syndrome. Groups were compared for demographic and clinical variables. Volumetry, voxel-based morphometry (VBM), cortical thickness, shape-analysis and tractometry were also performed

Results: The four profiles were observed with different frequency (36,11% without cognitive disorders, 14,58% with fronto-striatal syndrome, 22,92% with posterior cortical syndrome, 26,39% with a mixed syndrome). Groups differed according to sex, education duration, overall cognition, severity of neuropsychiatric symptoms and ongoing treatment with benzodiazepines. MRI analyses were adjusted on age, sex, center and education duration. No volumetric, VBM and frequency of white matter lesions differences were found. In group with a mixed syndrome, we observed a reduction of cortical thickness in various frontal areas and extended deformation fields for caudate nuclei and hippocampi compared to the other groups. Tractometric analyses showed significant between-group differences for several white matter tracts

Conclusion: Our results confirm the clinical relevance of the dual syndrome hypothesis. Deficits in attentional and executive functions are often considered as the hallmark of cognitive deficits in PD. Our study shows that a high proportion of non-demented patients have a cognitive profile characterized by visuospatial and memory deficits. Some have a mixed syndrome. We found that these syndromes were associated to specific clinical features as well as neuroimaging markers

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-dual-cognitive-syndrome-in-parkinsons-disease-volumetric-morphological-and-tractometric-features/