Abstract
Background: Sarcopenia is critically associated with morbidity and mortality in the progression of Parkinson’s disease (PD). However, analyses of clinical severity and brain changes, such as white matter (WM) alterations in PD patients with sarcopenia are limited. Further understanding of the factors associated with sarcopenia may provide a focused screen and potential for early intervention in PD patients. Methods: 52 PD patients and 19 healthy participants accepted dual-energy X-ray absorptiometry to measure the body composition. Using diffusion tensor imaging, the difference of WM integrity was measured between PD patients with sarcopenia (PDSa) and without sarcopenia (PDNSa). Multivariate analysis was performed to explore the relationships between clinical factors, WM integrity, and sarcopenia in PD patients. Results: 21 PD patients (40.4%) had sarcopenia. PDSa had a higher Unified Parkinson’s Disease Rating Scale (UPDRS III) score, lower body mass index (BMI) and lower fat weight compared with the PDNSa. Additionally, PDSa patients exhibited lower fractional anisotropy accompanied by higher radial diffusivity and/or higher mean diffusivity in the fronto-striato-thalamic circuits, including bilateral cingulum, left superior longitudinal fasciculus, left genu of corpus callosum, and right anterior thalamic radiation, which participate in the executive function. In addition, decreased muscle mass was associated with worse WM integrity in these regions. Multiple linear regression analysis revealed that WM integrity in the left cingulum, right anterior thalamic radiation, together with gender (male) significantly predicted muscle mass in PD patients. Conclusions: WM alterations in the executive network, such as the fronto-striato-thalamic circuits, may indicate a risk factor for ongoing sarcopenia in PD patients. The effectiveness of using executive function to serve as a prodromal marker of sarcopenia in PD patients should be evaluated in future studies.
Highlights
Parkinson’s disease (PD) is a neurodegenerative movement disorder, which presents with motor and non-motor symptoms, such as cognitive declined and physical frailty, declining clinical conditions and quality of life [1]
This study reveals that the PDSa group has a higher UPDRS III score and lower body mass index (BMI) compared with the PDNSa group
Our result indicates that sarcopenia in PD patients is associated with diminished the PDNSa group, this score is used to evaluate motor skills, including limb movement, gait, and body bradykinesia [11]
Summary
Parkinson’s disease (PD) is a neurodegenerative movement disorder, which presents with motor and non-motor symptoms, such as cognitive declined and physical frailty, declining clinical conditions and quality of life [1]. Patients presenting advanced age, longer disease duration, and higher disease severity demonstrate susceptibility to developing sarcopenia [2]. Occurring features, such as motor impairment, difficulty in swallowing and malnutrition, are risk factors that may accelerate the progression of sarcopenia [3]. Further understanding of the factors associated with sarcopenia may provide a focused screen and potential for early intervention in PD patients. The difference of WM integrity was measured between PD patients with sarcopenia (PDSa) and without sarcopenia (PDNSa). Multivariate analysis was performed to explore the relationships between clinical factors, WM integrity, and sarcopenia in PD patients. PDSa had a higher Unified Parkinson’s Disease Rating Scale (UPDRS III) score, lower body mass index (BMI) and lower fat weight compared with the PDNSa
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