DTI correlates of distinct cognitive impairments in Parkinson's disease

Authors

  • Zhong Zheng,

    1. Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California
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  • Shirag Shemmassian,

    1. Department of Psychology, David Geffen School of Medicine at UCLA, Los Angeles, California
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  • Christopher Wijekoon,

    1. Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California
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  • Won Kim,

    1. Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California
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  • Susan Y. Bookheimer,

    1. Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California
    2. Department of Psychology, David Geffen School of Medicine at UCLA, Los Angeles, California
    3. Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California
    4. Interdepartmental Program in Neuroscience, David Geffen School of Medicine at UCLA, Los Angeles, California
    5. Brain Research institute, David Geffen School of Medicine at UCLA, Los Angeles, California
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  • Nader Pouratian

    Corresponding author
    1. Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California
    2. Interdepartmental Program in Neuroscience, David Geffen School of Medicine at UCLA, Los Angeles, California
    3. Brain Research institute, David Geffen School of Medicine at UCLA, Los Angeles, California
    4. Department of Bioengineering, David Geffen School of Medicine at UCLA, Los Angeles, California
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Abstract

The spectrum of cognitive symptoms in Parkinson's disease (PD) can span various domains, including executive function, language, attention, memory, and visuospatial skills. These symptoms may be attributable to the degradation of projection fibers associated with the underlying neurodegenerative process. The primary purpose of this study is to find microstructural correlates of impairments across these cognitive domains in PD using diffusion tensor imaging (DTI). Sixteen patients with PD with comprehensive neuropsychological evaluation and DTI data were retrospectively studied. Fractional anisotropy (FA) and mean diffusivity (MD) were assessed using regions-of-interest (ROI) analysis and confirmed with a voxel-based approach. Executive function directly correlated with FA and inversely correlated with MD in mostly frontal white matter tracts, especially the anterior limb of the internal capsule and genu of the corpus callosum. Likewise, language and attentional performance demonstrated correlations with DTI parameters in the frontal regions, but the attention domain additionally recruited regions widespread throughout the brain, with the most significant correlation identified in cingulate gyrus (cingulum). Lastly, memory impairment mainly involved MD alterations within the fornix. No significant correlations were found between visuospatial skills and DTI measures. Despite some overlap, unique patterns of white matter diffusivity underlie impairments in distinct cognitive domains in patients with PD. DTI combined with neurocognitive tests may be a valuable biomarker for identifying cognitive impairments in PD. Hum Brain Mapp 35:1325–1333, 2014. © 2013 Wiley Periodicals, Inc.

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