Original Article

European Journal of Nuclear Medicine and Molecular Imaging

, Volume 38, Issue 12, pp 2209-2218

Brain perfusion correlates of cognitive and nigrostriatal functions in de novo Parkinson’s disease

  • Flavio NobiliAffiliated withClinical Neurophysiology, Department of Neurosciences, Ophthalmology and Genetics, University of Genoa Email author 
  • , Dario ArnaldiAffiliated withClinical Neurophysiology, Department of Neurosciences, Ophthalmology and Genetics, University of Genoa
  • , Claudio CampusAffiliated withClinical Neurophysiology, Department of Neurosciences, Ophthalmology and Genetics, University of Genoa
  • , Michela FerraraAffiliated withClinical Neurophysiology, Department of Neurosciences, Ophthalmology and Genetics, University of Genoa
  • , Fabrizio De CarliAffiliated withInstitute of Molecular Bioimaging and Physiology, National Research Council
  • , Andrea BrugnoloAffiliated withClinical Neurophysiology, Department of Neurosciences, Ophthalmology and Genetics, University of Genoa
  • , Barbara DessiAffiliated withClinical Neurophysiology, Department of Neurosciences, Ophthalmology and Genetics, University of Genoa
  • , Nicola GirtlerAffiliated withClinical Neurophysiology, Department of Neurosciences, Ophthalmology and Genetics, University of Genoa
  • , Silvia MorbelliAffiliated withNuclear Medicine, Department of Internal Medicine, University of Genoa
    • , Giovanni AbruzzeseAffiliated withClinical Neurology, Department of Neurosciences, Ophthalmology and Genetics, University Hospital San. Martino
    • , Gianmario SambucetiAffiliated withNuclear Medicine, Department of Internal Medicine, University of Genoa
    • , Guido RodriguezAffiliated withClinical Neurophysiology, Department of Neurosciences, Ophthalmology and Genetics, University of Genoa

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Purpose

Subtle cognitive impairment is recognized in the first stages of Parkinson’s disease (PD), including executive, memory and visuospatial dysfunction, but its pathophysiological basis is still debated.

Methods

Twenty-six consecutive, drug-naïve, de novo PD patients underwent an extended neuropsychological battery, dopamine transporter (DAT) and brain perfusion single photon emission computed tomography (SPECT). We previously reported that nigrocaudate impairment correlates with executive functions, and nigroputaminal impairment with visuospatial abilities. Here perfusion SPECT was first compared between the PD group and age-matched controls (CTR). Then, perfusion SPECT was correlated with both DAT SPECT and four neuropsychological factors by means of voxel-based analysis (SPM8) with a height threshold of p < 0.005 at peak level and p < 0.05 false discovery rate-corrected at cluster level. Both perfusion and DAT SPECT images were flipped in order to have the more affected hemisphere (MAH), defined clinically, on the same side.

Results

Significant hypoperfusion was found in an occipital area of the MAH in PD patients as compared to CTR. Executive functions directly correlated with brain perfusion in bilateral posterior cingulate cortex and precuneus in the less affected hemisphere (LAH), while verbal memory directly correlated with perfusion in the precuneus, inferior parietal lobule and superior temporal gyrus in the LAH. Furthermore, positive correlation was highlighted between nigrocaudate and nigroputaminal impairment and brain perfusion in the precuneus, posterior cingulate and parahippocampal gyri of the LAH.

Conclusion

These data support the evidence showing an early involvement of the cholinergic system in the early cognitive dysfunction and point to a more relevant role of parietal lobes and posterior cingulate in executive functions in PD.

Keywords

Parkinson’s disease DAT SPECT Perfusion SPECT Neuropsychological assessment Cognition