Objective: Studying white matter changes in Parkinson’s disease patients using diffusion tensor imaging; and its relation to cognition and motor symptoms impairment.

Background: Cognitive dysfunction is a common non-motor manifestation in PD. There were six-fold increased risk for developing cognitive impairment accompanies PD Patients with older age those with age above 60 years at disease onset, increased severity and long duration of the disease are risk factors for development of dementia in PD. Parkinson’s disease dementia is usually subcortical with altered personality, psychomotor retardation, and memory problems. Executive dysfunction is one of the most common cognitive impairment reported in PD. It is considered as an  early sign of cognitive dysfunction that involves the prefrontal cortex of the brain and the dopamine system. DTI as a novel functional MRI sequence has been applied in PD to understand the mechanisms of various clinical manifestations, it is valuable for assessing the clinical severity based on an investigation of the correlation between FA in the corpus callosum and cognitive dysfunction .DTI provides promising biomarkers for the clinical manifestations of PD.

Method: 50 patients with idiopathic Parkinson’s disease with cognitive impairment (M: F = 41:9 ; age: 62.72±9.07 years) and 20 Parkinson’s disease with normal cognition as a control (M:F =13:7 ; age 58.95±11.22) underwent cognitive testing with Mini-Mental State Examination(MMSE) and Montreal cognitive assessment, disease severity with Modified Hoehn and Yahr Scale and Unified Parkinson disease rating scale and Diffusion tensor imaging (DTI) where the corpus callosum was divided into three regions and the cingulum into two regions bilaterally to define tract. Statistical Package for the Social Sciences (SPSS) vs.21 was used for statistical analysis. A ‘p’ b 0.05 was considered as statistically significant.

Results: There were FA or MD differences between groups in both the corpus callosum and cingulum pathways. In PD with cognitive impairment subjects, the MOCA score correlated with DTI parameters of the corpus callosum and cingulum. These findings were independent of age, sex and total white matter volume.

Conclusion: Early cognitive impairment in PD patients are associated with tractography changes of the corpus callosum and cingulum.

References: Aarsland, D., Andersen, K., Larsen, J. P., & Lolk, A. (2003). Prevalence and characteristics of dementia in Parkinson disease: an 8-year prospective study. Archives of neurology, 60(3), 387-392. Emre, M. (2004). Dementia in Parkinson’s disease: cause and treatment. Current opinion in neurology, 17(4), 399-404. Lenfeldt N, Hansson W, Larsson A, Nyberg L, Birgander R, Forsgren L. (2013) Diffusion tensor imaging and correlations to Parkinson rating scales. J Neurol 2013;260:2823-2830. Fahn S, Elton RL and Members of the UPDRS Development Committee (1987) Unified Parkinson’s disease rating scale. In: Fahn S, Marsden CD, Calne D, Goldstein M (eds) Recent developments in Parkinson’s disease, vol 2. Mac Millian Healthcare Information, Florham Park NJ, pp 153–163 Goetz CG, Poewe W, Rascol O, Sampaio C, Stebbins GT, Counsell C, Giladi N, Holloway RG, Moore CG, Wenning GK, Yahr MD, Seidl L (2004). “Movement Disorder Society Task Force Report on the Hoehn and Yahr Staging Scale: Status and Recommendations. The Movement Disorder Society Task Force on Rating Scales for Parkinson’s Disease”. Movement Disorders. 19 (9): 1020–1028. Folstein,M.F.,Folstein,S.E.andMcHugh,P.R.(1975)Mini Mental State, a practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res.12,189±98 Pangman, VC; Sloan, J; Guse, L. (2000). “An Examination of Psychometric Properties of the Mini-Mental Status Examination and the Standardized Mini-Mental Status Examination: Implications for Clinical Practice”. Applied Nursing Research. 13 (4): 209–213.  Nasreddine, Z. S., Phillips, N. A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I., Cummings, J. L., & Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53(4), 695-699. Yu, Z., Tao, L., Qian, Z., Wu, J., Liu, H., Yu, Y., … Sun, J., (2016). Altered brain anatomical networks and disturbed connection density in brain tumor patients revealed by diffusion tensor tractography. Int. J. Comput. Assist. Radiol. Surg. 11 (11), 2007–2019. http://dx.doi.org/10.1007/s11548-015-1330-y. Williams-Gray CH, Evans JR, Goris A, Foltynie T, Ban M, Robbins TW, et al. (2009) The distinct cognitive syndromes of Parkinson’s disease: 5 year follow-up of the CamPaIGN cohort. Brain.;132: 2958–2969. 10.1093/brain/awp245 . Thais Minett . Li Su . Elijah Mak ·Guy Williams · Michael Firbank · Rachael A. Lawson · Alison J. Yarnall · Gordon W. Duncan · Adrian M. Owen · Tien K. Khoo · David J. Brook · James B. Rowe · Roger A. Barker· David Burn · John T. O’Brien (2018) . Longitudinal diffusion tensor imaging changes in early Parkinson’s disease: ICICLE-PD Katie Wiltshire, Luis Concha ,Myrlene Gee ,Thomas Bouchard, Christian Beaulieu ,Richard Camicioli. (2015) Corpus Callosum and Cingulum Tractography in Parkinson’s Disease The Canadian journal of neurological science. Le journal canadien des sciences neurologiques · September DOI:10.1017/S0317167100010751 Beaulieu C. (2002)The basis of anisotropic water diffusion in the nervous system-a technical review .NMR Biomed .;15(7-8): 435-55. Rebecca J.Theilmann, Jason D. Reed, David D. Song, Mingxiong X. Huang, Roland R. Lee, Irene Litvan and Deborah L. Harrington.(2013). White-matter changes correlate with cognitive functioning in Parkinson’s disease DOI: 10.3389/fneur.2013.00037 · Source: PubMed Kamagata K., Tomiyama H., Motoi Y., Kano M., Abe O., Ito K., Shimoji K., Suzuki M., Hori M., Nakanishi A., Kuwatsuru R., Sasai K., Aoki S., Hattori N. (2013) Diffusional kurtosis imaging of cingulate fibers in Parkinson disease: comparison with conventional diffusion tensor imaging. Magn. Reson. Imaging. ;31(9):1501–1506. Zheng Z., Shemmassian S., Wijekoon C., Kim W., Bookheimer S.Y., Pouratian N. (2014) DTI correlates of distinct cognitive impairments in Parkinson’s disease: DTI measures of cognitive impairment in PD. Hum. Brain Mapp.;35(4):1325–1333

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