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Research paper
Exploratory analysis of neuropsychological and neuroanatomical correlates of progressive mild cognitive impairment in Parkinson's disease
  1. Ji E Lee1,
  2. Kyoo H Cho1,
  3. Sook K Song2,
  4. Hee Jin Kim1,
  5. Hye Sun Lee3,
  6. Young H Sohn1,
  7. Phil Hyu Lee1,4
  1. 1Department of Neurology and Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
  2. 2Department of Neurology, Jeju University College of Medicine, Jeju, Korea
  3. 3Department of Biostatistics or Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
  4. 4Severance Biomedical Science Institute, Seoul, Korea
  1. Correspondence to Professor P H Lee, Department of Neurology, Yonsei University Medical College, 250 Seongsanno, Seodaemun-gu, Seoul 120–752, South Korea; phisland{at}


Background Parkinson's disease with mild cognitive impairment (PD-MCI) is a heterogeneous entity in terms of cognitive profiles and conversion to dementia. However, the risk factors for ongoing cognitive decline in patients with PD-MCI are not clearly defined.

Methods 51 patients with PD-MCI were prospectively followed-up for a minimum of 2 years. Subjects were classified as MCI converters (n=15) or MCI non-converters (n=36) based on whether they were subsequently diagnosed with PD dementia. We explored cognitive profiles and neuroanatomical characteristics of PD-MCI converters using voxel based morphometry (VBM) of grey matter (GM) density and region of interest based volumetric analysis of the substantia innominata (SI).

Results PD-MCI converters showed more severe cognitive deficits in frontal executive functions, immediate verbal memory and visual recognition memory compared with PD-MCI non-converters. VBM analysis revealed that PD-MCI converters had significantly lower GM density in the left prefrontal areas, left insular cortex and bilateral caudate nucleus compared with that in PD-MCI non-converters. The mean normalised SI volume was significantly smaller in both PD-MCI converters (1.19±0.35, p<0.001) and PD-MCI non-converters (1.52±0.27, p<0.001) compared with that in controls (1.87±0.19). PD-MCI converters had a significantly smaller normalised SI volume than PD-MCI non-converters (p<0.001).

Conclusions Our data show that atrophy in the frontostriatal areas and cholinergic structures, as well as frontal lobe associated cognitive performance, may act as predictors of dementia in PD-MCI patients, suggesting distinctive patterns of cognitive profiles and a neuroanatomical basis for progressive PD-MCI.

  • Parkinson'S Disease
  • Neuroanatomy
  • Dementia
  • Cognition

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