Objective: To assess the associations between the nucleus basalis of Meynert (NBM) and total grey matter atrophy with cognitive phenotype and gait measures in a group Parkinson’s disease (PD) and Lewy body dementia (LBD) patients with a range of cognitive deficits.

Background: In PD and LBD, mounting evidence implicates degeneration of basal forebrain cholinergic projections from the NBM in predicting cognitive and gait decline. Cognitive impairment has an impact on attentional aspects of gait performance which can formally be assessed with dual task gait.

Method: This was a cross-sectional study of subjects from the Comprehensive Assessment Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) cohort (20 cognitively unimpaired, 79 PD and LBD). Demographic, clinical, and MRI data were collected. Clinical measures of interest included cognitive diagnosis (MCI, dementia), MDS-UPDRS motor score, quantitative gait parameters, and dual task costs (DTC) to gait velocity when performing cognitive tasks (counting, animal fluency, serial 7s). Manual region of interest measurement of NBM volume was performed on T1 MRI scans. Total grey matter volume was measured through automated whole brain segmentation. Correlations between volumetric imaging measures and clinical measures were assessed through ANCOVA and multiple regression analyses.

Results: Smaller normalized NBM volume was associated with PD-MCI (mean difference 0.34, p=0.04) and PD-dementia/LBD (mean difference 0.55, p<0.001) phenotypes. Smaller normalized total grey matter volume was similarly associated with PD-MCI (mean difference 0.029, p=0.002) and PD-dementia/LBD mean difference 0.034, p<0.001). Total grey matter volume, but not NBM volume, was negatively correlated with DTC to gait velocity (counting DTC: β=-0.348, p=0.005; animal fluency DTC: β=-0.301, p=0.015; serial 7s DTC: β=-0.309, p=0.015). Total grey matter volume was also negatively correlated with swing time (β=-0.350, p=0.006), but not step length or step time variability.

Conclusion: Both NBM atrophy and total grey matter atrophy were associated with cognitive impairment in PD and LBD. Total grey matter but not NBM atrophy was correlated with attentional aspects of gait performance as seen with increased DTC to gait velocity. Our data suggests that changes in cognitive aspects of gait performance reflect global neurodegeneration in Lewy body disorders.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/nucleus-basalis-of-meynert-and-total-gray-matter-atrophy-are-related-to-cognitive-and-gait-decline-in-parkinsons-disease/