Abstract
BackgroundDementia is a frequent and devastating complication in Parkinson’s disease (PD). There is an intensive search for biomarkers that may predict the progression from normal cognition (PD-NC) to dementia (PDD) in PD. Mild cognitive impairment in PD (PD-MCI) seems to represent a transitional state between PD-NC and PDD. Few studies have explored the structural changes that differentiate PD-NC from PD-MCI and PDD patients.Objectives and MethodsWe aimed to analyze changes in cortical thickness on 3.0T Magnetic Resonance Imaging (MRI) across stages of cognitive decline in a prospective sample of PD-NC (n = 26), PD-MCI (n = 26) and PDD (n = 20) patients, compared to a group of healthy subjects (HC) (n = 18). Cortical thickness measurements were made using the automatic software Freesurfer.ResultsIn a sample of 72 PD patients, a pattern of linear and progressive cortical thinning was observed between cognitive groups in cortical areas functionally specialized in declarative memory (entorhinal cortex, anterior temporal pole), semantic knowledge (parahippocampus, fusiform gyrus), and visuoperceptive integration (banks of the superior temporal sulcus, lingual gyrus, cuneus and precuneus). Positive correlation was observed between confrontation naming and thinning in the fusiform gyrus, parahippocampal gyrus and anterior temporal pole; clock copy with thinning of the precuneus, parahippocampal and lingual gyrus; and delayed memory with thinning of the bilateral anteromedial temporal cortex.ConclusionsThe pattern of regional decreased cortical thickness that relates to cognitive deterioration is present in PD-MCI patients, involving areas that play a central role in the storage of prior experiences, integration of external perceptions, and semantic processing.
Highlights
Cognitive decline and dementia have been widely described in Parkinson’s disease (PD)
In a sample of 72 PD patients, a pattern of linear and progressive cortical thinning was observed between cognitive groups in cortical areas functionally specialized in declarative memory, semantic knowledge, and visuoperceptive integration
The pattern of regional decreased cortical thickness that relates to cognitive deterioration is present in PD-MCI patients, involving areas that play a central role in the storage of prior experiences, integration of external perceptions, and semantic processing
Summary
Cognitive decline and dementia have been widely described in Parkinson’s disease (PD). Subtle cognitive defects satisfying criteria for mild cognitive impairment (PD-MCI) are present in up to 25% of PD patients from the early to mid stages of the disease [1,2]. Depending on the age of PD onset, the presence of hallucinations, REM behavior disorder, PIGD motor phenotype, specific genotypes [5,6], or the development of posterior cortical cognitive defects (e.g., semantic fluency, figure copying) [6,7], some patients progress more rapidly to dementia [3,6]. In patients developing dementia within the first 10 years of the disease, PDD has been associated with shorter overall survival and more severe cortical a-synuclein pathology in limbic and neocortical areas [3,8,9]. Few studies have explored the structural changes that differentiate PD-NC from PD-MCI and PDD patients
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