Abstract
MRI brain changes in Parkinson's disease (PD) are controversial. We aimed to describe structural and functional changes in PD. Sixty-six patients with PD (57.94 ± 10.25 years) diagnosed according to the UK Brain Bank criteria were included. We performed a whole brain analysis using voxel-based morphometry (VBM-SPM 8 software), cortical thickness (CT) using CIVET, and resting-state fMRI using the Neuroimaging Analysis Kit software to compare patients and controls. For VBM and CT we classified subjects into three groups according to disease severity: mild PD [Hoehn and Yahr scale (HY) 1-1.5], moderate PD (HY 2-2.5), and severe PD (HY 3-5). We observed gray matter atrophy in the insula and inferior frontal gyrus in the moderate PD and in the insula, frontal gyrus, putamen, cingulated, and paracingulate gyri in the severe groups. In the CT analysis, in mild PD, cortical thinning was restricted to the superior temporal gyrus, gyrus rectus, and olfactory cortex; in the moderate group, the postcentral gyrus, supplementary motor area, and inferior frontal gyrus were also affected; in the severe PD, areas such as the precentral and postentral gyrus, temporal pole, fusiform, and occipital gyrus had reduced cortical thinning. We observed altered connectivity at the default mode, visual, sensorimotor, and cerebellar networks. Subjects with mild symptoms already have cortical involvement; however, further cerebral involvement seems to follow Braak's proposed mechanism. Similar regions are affected both structurally and functionally. We believe the combination of different MRI techniques may be useful in evaluating progressive brain involvement and they may eventually be used as surrogate markers of disease progression.
Highlights
Parkinson’s disease (PD) is a progressive neurodegenerative disorder [1]
All images were acquired at UNICAMP University Hospital and MRI analysis was performed at Montreal Neurological Institute (MNI)
We found a negative correlation between Unified Parkinson Disease Rating Scale (UPDRS) and CT in superior temporal gyrus, pre and post central gyrus, superior and inferior frontal gyrus, supplementary motor area (SMA), occipital gyrus, and gyrus rectus
Summary
Parkinson’s disease (PD) is a progressive neurodegenerative disorder [1]. Considering the variability of symptoms and the still unknown etiology, MRI-based studies are important to better understand disease physiopathology.Voxel-based morphometry (VBM) [2] assesses gray matter (GM) density or volume, voxel by voxel. Parkinson’s disease (PD) is a progressive neurodegenerative disorder [1]. Considering the variability of symptoms and the still unknown etiology, MRI-based studies are important to better understand disease physiopathology. Voxel-based morphometry (VBM) [2] assesses gray matter (GM) density or volume, voxel by voxel. A meta-analysis revealed GM atrophy in the left inferior frontal gyrus, left superior temporal gyrus and left insula in patients with idiopathic PD [3]. Two studies evaluated disease progression as measured by the Hoehn and Yahr scale (HY), and their outcomes differed. One revealed minimal statistically significant GM reduction [4], while the other described atrophy in olfactory-related regions [5]. MRI brain changes in Parkinson’s disease (PD) are controversial
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