Abstract
There is increasing evidence to show that motor symptom lateralization in Parkinson’s disease (PD) is linked to non-motor features, progression, and prognosis of the disease. However, few studies have reported the difference in cortical complexity between patients with left-onset of PD (LPD) and right-onset of PD (RPD). This study aimed to investigate the differences in the cortical complexity between early-stage LPD and RPD. High-resolution T1-weighted magnetic resonance images of the brain were acquired in 24 patients with LPD, 34 patients with RPD, and 37 age- and sex-matched healthy controls (HCs). Cortical complexity including gyrification index, fractal dimension (FD), and sulcal depth was analyzed using surface-based morphometry via CAT12/SPM12. Familywise error (FWE) peak-level correction at p < 0.05 was performed for significance testing. In patients with RPD, we found decreased mean FD and mean sulcal depth in the banks of the left superior temporal sulcus (STS) compared with LPD and HCs. The mean FD in the left superior temporal gyrus (STG) was decreased in RPD compared with HCs. However, in patients with LPD, we did not identify significantly abnormal cortical complex change compared with HCs. Moreover, we observed that the mean FD in STG was negatively correlated with the 17-item Hamilton Depression Scale (HAMD) among the three groups. Our findings support the specific influence of asymmetrical motor symptoms in cortical complexity in early-stage PD and reveal that the banks of left STS and left STG might play a crucial role in RPD.
Highlights
The asymmetrical motor symptoms and signs found in patients with Parkinson’s disease (PD) commonly persist over the course of the disease (Barrett et al, 2011; Lee et al, 2015; MillerPatterson et al, 2018), which may contribute to distinguishing PD from other atypical Parkinsonian syndromes (Postuma et al, 2015)
We found that the mean fractal dimension (FD) in the left superior temporal gyrus (STG) was negatively correlated with Hamilton Depression Scale (HAMD) scores (r = –0.278, p = 0.006, Bonferroni corrected) among all three groups (Figure 3)
The mean FD and mean sulcal depth were lower in the banks of the left superior temporal sulcus (STS) of patients with right-onset PD (RPD) than patients with left-onset PD (LPD) and healthy controls (HCs)
Summary
The asymmetrical motor symptoms and signs found in patients with Parkinson’s disease (PD) commonly persist over the course of the disease (Barrett et al, 2011; Lee et al, 2015; MillerPatterson et al, 2018), which may contribute to distinguishing PD from other atypical Parkinsonian syndromes (Postuma et al, 2015). Right-onset PD (RPD) seems to be associated with language- (Amick et al, 2006) and verbal memory- (Verreyt et al, 2011) related cognitive impairment and was a risk factor for Cortical Complexity in Early PD developing impulsive compulsive behavior (Phillipps et al, 2020) and apathy (Harris et al, 2013), whereas, left-onset PD (LPD) typically performed worse in visuospatial tasks (Verreyt et al, 2011) and was found to endorse more sleep behavior disorders (Baumann et al, 2014) and hallucinations (Stavitsky et al, 2008). RPD is associated with worse treatment response (Hanna-Pladdy et al, 2015) and more severe complications (Bay et al, 2019) with levodopa treatment, as well as worse prognosis than LPD (Baumann et al, 2014). The plausible mechanisms include handedness (van der Hoorn et al, 2012) and susceptibilities of the left substantia nigra (Blesa et al, 2011; Prasad et al, 2018; Fiorenzato et al, 2021)
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