J Neurol Neurosurg Psychiatry doi:10.1136/jnnp-2012-304126
  • Movement disorders
  • Research paper

Cortical thinning is associated with disease stages and dementia in Parkinson's disease

  1. Maria Jose Martí6
  1. 1Department of Neurology, University of Nottingham, Nottingham, UK
  2. 2Institute for Cognitive Science Studies, Tehran, Iran
  3. 3Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Catalonia, Spain
  4. 4Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Catalonia, Spain
  5. 5Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country, Spain
  6. 6Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències (ICN), Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Barcelona, Catalonia, Spain
  7. 7Centre for Functional MRI of the Brain, University of Oxford, Oxford, UK
  8. 8Centre de Diagnòstic per la Imatge Hospital Clínic de Barcelona (CDIC), Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
  1. Correspondence to Dr Maria Jose Martí, Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències (ICN), Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, c./Villarroel 170, Barcelona, Catalonia 08036, Spain; mjmarti{at}
  • Received 13 September 2012
  • Revised 21 January 2013
  • Accepted 11 February 2013
  • Published Online First 5 March 2013


Objective To investigate the pattern of cortical thinning in Parkinson's disease (PD) across different disease stages and to elucidate to what extent cortical thinning is related to cognitive impairment.

Design Ninety-six subjects including 39 controls and 57 PD patients participated in this study. PD subjects were divided into three groups (early, n=24; moderate, n=18; with dementia, n=15). High field structural brain MRI images were acquired in a 3T scanner and analyses of cortical thickness and surface were carried out. Vertex-wise group comparisons were performed and cortical thickness was correlated with motor and cognitive measures.

Results We found a positive correlation between Mini-Mental State Examination scores and cortical thickness in the anterior temporal, dorsolateral prefrontal, posterior cingulate, temporal fusiform and occipitotemporal cortex. Unified Parkinson's Disease Rating Scale-III (motor subsection) scores showed a robust negative correlation with caudate volumes. We found that disease stage in PD was associated with thinning of the medial frontal (premotor and supplementary motor cortex), posterior cingulate, precuneus, lateral occipital, temporal and dorsolateral prefrontal cortex. Discriminant analysis and a receiver operating characteristics approach showed that mean cortical thickness and hippocampus volume have 80% accuracy in identifying PD patients with dementia. PD stage and PD dementia can be characterised by a specific pattern of cortical thinning.

Conclusions We conclude that measuring cortical thickness can be useful in assessing disease stage and cognitive impairment in patients with PD. In addition, cortical thickness may be useful in identifying dementia in PD.

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