White and gray matter alterations in de novo PD patients: which matter most?

Objectives This paper aimed to identify white matter (WM) and gray matter (GM) abnormalities in a sample of early PD patients, and their correlations with motor and non-motor symptom severity. Methods We enrolled 62 de novo PD patients and 31 healthy subjects. Disease severity and non-motor symptom...

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Bibliographic Details
Published in:Journal of neurology 2023-05, Vol.270 (5), p.2734-2742
Main Authors: Pietracupa, Sara, Belvisi, Daniele, Piervincenzi, Claudia, Tommasin, Silvia, Pasqua, Gabriele, Petsas, Nikolaos, De Bartolo, Maria Ilenia, Fabbrini, Andrea, Costanzo, Matteo, Manzo, Nicoletta, Berardelli, Alfredo, Pantano, Patrizia
Format: Article
Language:English
Subjects:
Anisotropy
Brain - diagnostic imaging
Cerebellum
Cognitive ability
Corpus Callosum
Diffusion Magnetic Resonance Imaging
Gray Matter - diagnostic imaging
Humans
Magnetic Resonance Imaging
Medicine
Medicine & Public Health
Movement disorders
Neurodegenerative diseases
Neurology
Neuroradiology
Neurosciences
Original Communication
Parkinson's disease
Pyramidal tracts
Substantia alba
Substantia grisea
Thalamus
White Matter - diagnostic imaging
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Summary:Objectives This paper aimed to identify white matter (WM) and gray matter (GM) abnormalities in a sample of early PD patients, and their correlations with motor and non-motor symptom severity. Methods We enrolled 62 de novo PD patients and 31 healthy subjects. Disease severity and non-motor symptom burden were assessed by the Unified Parkinson’s Disease Rating Scale part III and the Non-Motor Symptoms Scale, respectively. Cognitive performance was assessed using Montreal Cognitive Assessment and Frontal Assessment Battery. All subjects underwent a 3-Tesla MRI protocol. MRI analyses included tract-based spatial statistics, cortical thickness, and subcortical and cerebellar volumetry. Results In comparison to control subjects, PD patients exhibited lower fractional anisotropy and higher mean, axial, and radial diffusivity in most WM bundles, including corticospinal tracts, the internal and external capsule, the anterior and posterior thalamic radiations, the genu and body of the corpus callosum, cerebellar peduncles, and superior and inferior longitudinal and fronto-occipital fasciculi. Correlations between Montreal Cognitive Assessment scores and fractional anisotropy values in the right posterior thalamic radiation, left superior corona radiata, right inferior-fronto-occipital fasciculus, left inferior longitudinal fasciculus, bilateral anterior thalamic radiations, and bilateral superior longitudinal fasciculi were found. Smaller cerebellar volumes in early PD patients in the left and right crus I were also found. No GM changes were present in subcortical or cortical regions. Conclusion The combined evaluation of WM and GM in the same patient sample demonstrates that WM microstructural abnormalities precede GM structural changes in early PD patients.
ISSN:0340-5354
1432-1459
DOI:10.1007/s00415-023-11607-3