Objective: To investigate depression in relation to medial temporal lobe atrophy (MTA), global cortical atrophy (GCA) and white matter hyperintensities (WMH) in neuropathologically confirmed patients with Parkinson’s disease (PD).

Background: Depression is commonly associated with PD and other synucleinopathies such as multiple system atrophy (MSA). Cortical atrophy is a general finding in advanced neurodegenerative diseases, but there is limited data on how early regional atrophy is related to depression in different forms of neuropathologically confirmed parkinsonian disorders. MTA has previously been connected to geriatric depression (1). Here, we investigated MTA, GCA and WMH in PD, progressive supranuclear palsy (PSP) and MSA with the focus on clinical depression.

Method: The sample consisted of 50 patients who had received neuropathological diagnostic confirmation postmortem (30 PD, 10 PSP and 10 MSA). Each patient had been scanned with brain computerized tomography (CT) antemortem (median disease duration at scanning = 3.0 years). MTA, GCA and WMH were evaluated computationally from CT scans using an image quantification tool based on convolutional neural networks (2,3).

Results: Depression was associated with increased MTA after controlling for diagnosis, age, symptom duration, and cognition (F(1,38)=8.39, p=0.006; estimated marginal means = depressed 2.29 [95%CI 1.51-3.07]; non-depressed 1.00 [0.44-1.56]). A similar finding was observed with CGA (p=0.017) but not with WMH (p=0.47). In PD patients alone, the result was confirmed for MTA (p=0.021) with the same covariates. There were no differences in MTA, GCA or WMH between patients with PD, PSP and MSA.

Conclusion: Early medial temporal and global brain atrophy may be associated with clinical depression in PD patients even when cognitive capacity is taken into account. These results, obtained after neuropathological confirmation, are in line with previous findings in patients with non-PD geriatric depression.

References: 1. Bell-McGinty S, et al. Am J Psychiatry. Aug 2002;159(8):1424-7.
2. Pitkänen J, et al. Neuroradiology. Oct 2020;62(10):1257-1263.
3. Kaipainen AL, et al. Neuroradiology. Dec 2021;63(12):2035-2046.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/early-cortical-atrophy-is-related-to-depression-in-parkinsons-disease/