Objective: To investigate structural and microstructural pathology in early de novo Parkinson’s Disease (PD) patients with depression, using Magnetic Resonance Imaging (MRI).
Background: Depression is a frequent non-motor symptom appearing early in the course of PD. The underlying pathophysiology is still unclear and is thought to reflect complex pathophysiology in various areas of the brain.

Background: Depression is a frequent non-motor symptom appearing early in the course of PD. The underlying pathophysiology is still unclear and is thought to reflect complex pathophysiology in various areas of the brain.

Method: The Parkinson’s Progression Markers Initiative database was utilised to identify 389 patients with PD. Presence of Depression was investigated with the Geriatric Depression Scale (GDS), and a cut-off score of 5 was used to separate depressed from non-depressed patients. Structural MRI was used to analyse grey matter volumetric loss, and cortical thickness. Diffusion Tensor Imaging (DTI) was used to assess microstructural alterations. Fractional Anisotropy (FA) and Mean diffusivity (MD) were calculated. The CIC Atlas was used as mask to define Regions of Interest. Differences between depressed and non-depressed PD patients were assessed with Student’s t test with correction for False Discovery Rate. Pearson’s partial correlation was used to assess correlations between anxiety levels and structural and microstructural alterations in brain areas associated with depression.

Results: Depression was present in 53 de novo PD patients (13.6%). In PD patients with depression, decreased FA was found in right anterior Inferior Temporal Gyrus (0.21±0.02 vs 0.195±0.02, P=0.02), Insula (0.21±0.01 vs 0.192±0.01, P=0.007), Anterior Cingulate (0.174±0.01 vs 0.168±0.009, P=0.018), and Dorsal Cerebellum (0.163±0.02 vs 0.157±0.009, P=0.03) compared to PD patients without depression. Also, in depressed PD, we found loss of volume in Amygdala compared to PD patients without depression (0.54±0.09 vs 0.51±0.09, P= 0.05). Moreover, in depressed PD patients, decreased FA in Insula correlated with increased Geriatric Depression Scale scores (rho= -0.434, P=0.024).

Conclusion: Our findings suggest that presence of depression in patients with early de novo PD is associated with structural and microstructural pathology, in regions associated with the limbic system.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/structural-and-microstructural-pathology-in-early-de-novo-parkinsons-disease-patients-with-depression-an-mri-study/