Abstract

ABSTRACTBackgroundClinical variability in the Parkinson's disease phenotype suggests the existence of disease subtypes. We investigated whether distinct anatomical patterns of atrophy can be identified in Parkinson's disease using a hypothesis‐free, data‐driven approach based on cortical thickness data.MethodsT1‐weighted 3‐tesla MRI and a comprehensive neuropsychological assessment were performed in a sample of 88 nondemented Parkinson's disease patients and 31 healthy controls. We performed a hierarchical cluster analysis of imaging data using Ward's linkage method. A general linear model with cortical thickness data was used to compare clustering groups.ResultsWe observed 3 patterns of cortical thinning in patients when compared with healthy controls. Pattern 1 (n = 30, 34.09%) consisted of cortical atrophy in bilateral precentral gyrus, inferior and superior parietal lobules, cuneus, posterior cingulate, and parahippocampal gyrus. These patients showed worse cognitive performance when compared with controls and the other 2 patterns. Pattern 2 (n = 29, 32.95%) consisted of cortical atrophy involving occipital and frontal as well as superior parietal areas and included patients with younger age at onset. Finally, in pattern 3 (n = 29, 32.95%), there was no detectable cortical thinning. Patients in the 3 patterns did not differ in disease duration, motor severity, dopaminergic medication doses, or presence of mild cognitive impairment.ConclusionsThree cortical atrophy subtypes were identified in nondemented Parkinson's disease patients: (1) parieto‐temporal pattern of atrophy with worse cognitive performance, (2) occipital and frontal cortical atrophy and younger disease onset, and (3) patients without detectable cortical atrophy. These findings may help identify prognosis markers in Parkinson's disease. © 2016 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society

Highlights

  • Parkinson’s disease (PD) is associated with progressive cognitive impairment and cortical atrophy.[1]

  • Exclusion criteria for all participants were (i) dementia according to Movement Disorders Society criteria,[6] (ii) Hoehn and Yahr (H&Y) scale[7] score > 3, (iii) youngonset PD, (iv) age < 50 years, (v) severe psychiatric or neurological comorbidity, (vi) low global intelligence quotient estimated by the Vocabulary subtest of the Wechsler Adult Intelligence Scale 3rd edition, (vii) Mini Mental State Examination (MMSE)[8] score below 25, (viii) claustrophobia, (ix) pathological magnetic resonance imaging (MRI) findings other than mild whitematter hyperintensities in the FLAIR sequence, and (x) MRI artifacts

  • The main finding of this study is that data-driven analysis can classify PD according to patterns of cortical degeneration

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Summary

Introduction

Parkinson’s disease (PD) is associated with progressive cognitive impairment and cortical atrophy.[1].

Objectives
Methods
Results
Conclusion

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