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White matter alterations in early Parkinson’s disease: role of motor symptom lateralization

Abstract

Introduction

Parkinson’s disease (PD) is a motor disorder that initially presents with unilateral symptoms. Widespread white matter (WM) alterations have been reported since the early stages of the disease. The aim of this study was to investigate WM alterations in right-dominant and left-dominant symptom PD patients (RPD and LPD, respectively) with respect to healthy controls (HC) by diffusion-weighted magnetic resonance imaging (MRI).

Methods

Thirty-eight subjects participated in this study: 12 RPD (median H&Y [IQR] = 1.5 [1.1–2], median UPDRS III [IQR] = 23 [7.8–25]), 9 LPD (median H&Y [IQR] = 1.5 [1–2.5], median UPDRS III [IQR] = 17 [12–22]), and 17 HC. All the participants were scanned on a 1.5-T MRI scanner. Maps of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were computed for all the subjects. Tract-based spatial statistics (TBSS) was performed for each diffusion parameter, to test WM differences between RPD, LPD, and HC (ANCOVA design). Family-wise error (FWE) correction was performed and p values lower than 0.05 were considered significant.

Results

No significant FA and RD differences were observed between RPD, LPD, and HC. Significantly increased MD and AD were observed in RPD with respect to HC within widespread WM regions, bilaterally. Conversely, no significant WM alterations were detected in LPD.

Conclusion

WM integrity was found to be significantly altered in RPD but not in LPD, suggesting that LPD profile may be associated to more favorable prognosis. Since clinical laterality onset may affect the extent of WM integrity changes, it should be taken into account in neuroimaging studies investigating PD.

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Acknowledgments

Sonia Di Tella received a scholarship from Crespi Spano Foundation.

Funding

This study was in part funded by the Italian Ministry of Health (Ricerca Corrente 2016–2018).

Author information

Correspondence to Francesca Baglio.

Ethics declarations

The study was approved by the IRCSS Fondazione Don Carlo Gnocchi Ethics Committee and it was performed in accordance with the principles of the Helsinki Declaration. All the participants provided their written and informed consent.

Conflict of interest

The authors declare that they have no conflict of interest.

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Cite this article

Pelizzari, L., Di Tella, S., Laganà, M.M. et al. White matter alterations in early Parkinson’s disease: role of motor symptom lateralization. Neurol Sci 41, 357–364 (2020). https://doi.org/10.1007/s10072-019-04084-y

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Keywords

  • Parkinson’s disease
  • White matter
  • White matter alterations
  • Diffusion tensor MRI
  • TBSS
  • Clinical laterality onset