Abstract
Gray/white matter contrast (GWC) decreases with aging and has been found to be a useful MRI biomarker in Alzheimer’s disease (AD), but its utility in Parkinson’s disease (PD) patients has not been investigated. The aims of the study were to test whether GWC is sensitive to aging changes in PD patients, if PD patients differ from healthy controls (HCs) in GWC, and whether the use of GWC data would improve the sensitivity of cortical thickness analyses to differentiate PD patients from controls. Using T1-weighted structural images, we obtained individual cortical thickness and GWC values from a sample of 90 PD patients and 27 controls. Images were processed with the automated FreeSurfer stream. GWC was computed by dividing the white matter (WM) by the gray matter (GM) values and projecting the ratios onto a common surface. The sample characteristics were: 52 patients and 14 controls were males; mean age of 64.4 ± 10.6 years in PD and 64.7 ± 8.6 years in controls; 8.0 ± 5.6 years of disease evolution; 15.6 ± 9.8 UPDRS; and a range of 1.5–3 in Hoehn and Yahr (H&Y) stage. In both PD and controls we observed significant correlations between GWC and age involving almost the entire cortex. When applying a stringent cluster-forming threshold of p < 0.0001, the correlation between GWC and age also involved the entire cortex in the PD group; in the control group, the correlation was found in the parahippocampal gyrus and widespread frontal and parietal areas. The GWC of PD patients did not differ from controls’, whereas cortical thickness analyses showed thinning in temporal and parietal cortices in the PD group. Cortical thinning remained unchanged after adjusting for GWC. GWC is a very sensitive measure for detecting aging effects, but did not provide additional information over other parameters of atrophy in PD.
Highlights
Gray/white matter contrast (GWC) extracted from T1-weighted magnetic resonance imaging (MRI) images is a measure of blurring between the boundaries of these brain compartments
The aims of our study were to test: (1) whether GWC is sensitive to aging changes in Parkinson’s disease (PD) patients; (2) whether PD patients differ from healthy controls (HCs) in GWC; and (3) whether GWC data would improve the sensitivity of cortical thickness analyses to differentiate between PD patients and controls
The exclusion criteria were: (1) presence of dementia according to the Movement Disorders Society criteria for PD (Emre et al, 2007); (2) Hoehn and Yahr (H&Y) scale (Hoehn and Yahr, 1967) score greater than 3; (3) juvenile-onset PD; (4) presence of psychiatric or neurological comorbidity; (5) low global intelligence quotient estimated by the Vocabulary subtest of the Wechsler Adult Intelligence Scale, 3rd edition; (6) Mini-Mental state examination (Folstein et al, 1975) score below 25; (7) presence of claustrophobia; (8) pathological MRI findings other than mild white matter (WM) hyperintensities in long-TR sequences; and (9) MRI artifacts
Summary
Gray/white matter contrast (GWC) extracted from T1-weighted MRI images is a measure of blurring between the boundaries of these brain compartments. Even though the neurobiological bases of this measure are not well understood, several studies suggested that the GWC could be an indicator of local variations in tissue integrity and myelin degradation (Koenig, 1991), increasing. An early study that measured T1 and T2 signal intensities in gray matter (GM) and white matter (WM) of elderly subjects suggested that these measures could be reflecting an increase in water content in the WM and neuronal loss in GM (Magnaldi et al, 1993). The authors proposed that GWC might be a useful technique to track myelin breakdown in critical brain areas in clinical populations
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