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J Neurol Neurosurg Psychiatry 83:188-194 doi:10.1136/jnnp-2011-300828
  • Cognitive disorders
  • Research paper

Grey matter atrophy in cognitively impaired Parkinson's disease

  1. Tim J Anderson1,2,6
  1. 1Van der Veer Institute for Parkinson's and Brain Research, Christchurch, New Zealand
  2. 2Department of Medicine, University of Otago, Christchurch, New Zealand
  3. 3Department of Physics and Astronomy, University of Canterbury, Christchurch, New Zealand
  4. 4Christchurch Radiology Group, Christchurch, New Zealand
  5. 5Department of Psychology, University of Canterbury, New Zealand
  6. 6Department of Neurology, Christchurch Hospital, Christchurch, New Zealand
  1. Correspondence to Dr T R Melzer, Van der Veer Institute for Parkinson's and Brain Research, 66 Stewart St, Christchurch 8011, New Zealand; tracy.melzer{at}vanderveer.org.nz
  1. Contributors All named authors meet the requirements for authorship. TRM acquired the data, performed the analysis and interpretation of the data, drafted and revised the manuscript and gave final approval of the article. TRM is responsible for the overall content as guarantor. RW made substantial contributions to conception and design and acquired and interpreted the data, revised the manuscript and gave final approval of the version. MRM made substantial contributions to the conception and design, interpreted the data and gave final approval of the version. TLP analysed and interpreted the data, revised the manuscript and gave final approval of the version. LL acquired and interpreted the data, revised the manuscript and gave final approval of this version. RJK interpreted the data, revised the manuscript and gave final approval of this version. JCD-A provided substantial contributions to the conception and design and interpretation of the data, revised the manuscript and gave final approval of this version. TJA provided substantial contributions to the conception and design and interpretation of the data, revised the manuscript and gave final approval of this version.

  • Received 24 June 2011
  • Revised 19 July 2011
  • Accepted 24 July 2011
  • Published Online First 2 September 2011

Abstract

Objective Mild cognitive impairment and dementia are common non-motor features of Parkinson's disease (PD). The aim of this study was to characterise grey matter changes associated with clearly defined stages of cognitive impairment in PD using structural MRI.

Methods 96 PD subjects were classified using detailed cognitive testing as PD with normal cognition (PD-N, n=57), PD with mild cognitive impairment (PD-MCI, n=23) or PD with dementia (PD-D, n=16); 34 controls matched for mean age and sex ratio also participated. Grey matter volume differences were evaluated using voxel based morphometry of grey matter segments derived from T1 weighted 3 T MRI, and multiple linear regression assessed the relationship between cognitive and motor impairments and grey matter concentration.

Results Compared with controls, no grey matter differences were found in PD-N. PD-MCI showed limited grey matter atrophy in the temporal, parietal and frontal cortex as well as the bilateral caudal hippocampus, amygdala and right putamen. PD-D subjects exhibited far more extensive atrophy in regions involved in PD-MCI but also had reduced grey matter volume in other large areas of the temporal lobe (including the parahippocampi), the intracalcarine and lingual gyri, posterior cingulate gyrus, frontal regions and bilateral caudate. Grey matter loss in PD correlated with global cognitive score but not motor impairment in most of these regions.

Interpretation Marked grey matter atrophy occurs in PD with dementia but far less extensive changes are evident in PD-MCI. Some grey matter atrophy precedes the development of dementia but may be accelerated once frank dementia begins.

Footnotes

  • Funding This work was supported by the Neurological Foundation of New Zealand, the Canterbury Medical Research Foundation and the Neurology Trust.

  • Competing interests None.

  • Ethics approval The study was approved by the Upper South Regional Ethics Committee of the New Zealand Ministry of Health.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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