Abstract
Mild cognitive impairment (MCI) in Parkinson’s disease (PD) is a risk factor for dementia and thus, it is of interest to elucidate if specific patterns of atrophy in PD-MCI patients are associated with a higher risk of developing dementia. We aim to define pattern(s) of regional atrophy in PD-MCI patients who developed dementia during 31 months of follow-up using cortical thickness analysis Twenty-three PD-MCI patients and 18 controls underwent brain MRI and completed a neuropsychological examination at baseline, PD-MCI patients were followed after a 31 month follow-up in order to assess their progression to dementia. At follow up, 8 PD-MCI patients had converted to dementia (PD-MCI converters) whereas 15 remained as PD-MCI (PD-MCI non-converters). All patients were at least 60 years old and suffered PD ≥ 10 years. There were no baseline differences between the two groups of patients in clinical and neuropsychological variables. The cortex of PD-MCI converters was thinner than that of PD-MCI non-converters, bilaterally in the frontal, insula and the left middle temporal areas, also displaying a more widespread pattern of cortical thinning relative to the controls. This study shows that aged and long-term PD patients with MCI who convert to dementia in the short-mid term suffer a thinning of the cortex in several areas (frontal cortex, and middle temporal lobe and insula), even when their cognitive impairment was similar to that of PD-MCI non-converters. Thus, MRI analysis of cortical thickness may represent a useful measure to identify PD-MCI patients at a higher risk of developing dementia.
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This study was supported by a grant from the Government of Navarre (32/2007), grants from the FIS (ISCIII: PI08/1539 y PI14/00763) and by CIBERNED (Spain).
Conflict of interest
Author Carmen Gasca-Salas received honoraria from UCB and TEVA for travel and accommodation to attend scientific meetings.
Author Daniel García-Lorenzo declares that he has no conflict of interest.
Author David García-García declares that he has no conflict of interest.
Author Pedro Clavero has received honoraria for lectures, travel and accommodation to attend scientific meetings from AbbVie, UCB and Esteve.
Author Stephan Lehericy has received honoraria for lectures from Pileje, Lundbeck, Roche and Siemens.
Author José A. Obeso has received honorarium for lecturing in meetings organized by GSK, Lundbeck and UCB in Spain; TEVA-Neuroscience (USA); Boehringer Ingelheim Mexico and funding from Spanish Science and Education Ministery and European Union (REPLACES).
Author María C. Rodríguez-Oroz received honoraria for lectures, travel and accommodation to attend scientific meetings from AbbVie, Teva, Zambon and Boston Scientific.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
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Supplementary figure. Reduced regional cortical thickness in PD-MCI patients compared to healthy controls. (A) PD-MCI converters < controls (FDR, p < 0.05: age and sex as covariates). PD-MCI converters showed thinner cortex in the frontal cortex (mainly superior and medial frontal and precentral cortex), right insula and parietal cortex (superior parietal, supramarginal and inferior parietal on the left side and bilateral precuneus), left superior temporal and left isthmus cingulate. (B)PD-MCI non-converters < controls (FDR, p < 0.05: age and sex as covariates). PD-MCI non-converters showed thinner cortex than controls in the left side, in the frontal (mainly superior and precentral cortex), parietal (superior and supramarginal) and to a lesser extent in the temporal cortex. (PDF 4909 kb)
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Gasca-Salas, C., García-Lorenzo, D., Garcia-Garcia, D. et al. Parkinson’s disease with mild cognitive impairment: severe cortical thinning antedates dementia. Brain Imaging and Behavior 13, 180–188 (2019). https://doi.org/10.1007/s11682-017-9751-6
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DOI: https://doi.org/10.1007/s11682-017-9751-6