Objective: Aim of this study was to determine whether structural imaging features present at disease onset or over disease course predict the development of ICB in patients with de novo PD

Background: Previous studies have reported structural brain abnormalities in Parkinson’s disease (PD) patients with impulsive compulsive behavior (ICB). Yet, it is not clear whether these structural abnormalities underlie the predisposition to develop ICB or if they are secondary phenomena associated with established ICB

Methods: From a cohort of 1116 subjects (PD=629; healthy controls, HC=195) from the Parkinson’s Progression Marker Initiative (PPMI) database, we built a MRI dataset selecting those who underwent 3T-MRI and had a T1-MPRAGE acquisition at baseline. This provided 421 subjects (253 PD, 121 HC). For the purpose of this study, we included de-novo, drug-naive PD patients who screened negative for ICB at baseline and converted to positive screening at any follow-up time. We identified 42 PD patients converting to ICB (PD-ICB) who were matched by age, gender and disease duration with 42 PD patients who did not develop ICB at follow-up (PD-no-ICB); 42 HC matched by age and gender were also included.

Grey matter (GM) and white matter (WM) voxel-based morphometry (VBM) and cortical thickness voxel-based quantification (VBQ) were compared among the three groups at baseline using SPM 12 (cross-sectional analysis). For the longitudinal analysis, MRI scans obtained after the onset of ICB were available from 27 PD-ICB; these scans were compared with those of 32 PD-no-ICB and 35 HC performed at time-points to match the ICB group

Results:  At baseline, no significant difference was observed between HC and PD and between PD-no-ICB and PD-ICB in any of the analysis. In the longitudinal analysis, significant differences were found between HC and PD in the rate of grey and white matter atrophy, particularly in the hippocampus and striatum bilaterally. 

Conclusions: When comparing PD groups, a region of increased atrophy in the anterior limb of the left internal capsule adjacent to the head of the left caudate nucleus was found in PD-ICB, not surviving correction for multiple comparison.

Our study suggests that standard structural imaging is not sensitive to demonstrate structural brain abnormalities to identify patients at risk at the time of PD diagnosis.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/prospective-analysis-of-morphological-markers-of-development-of-impulsive-compulsive-behaviors-in-de-novo-parkinsons-disease/