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MRI and cognitive impairment in Parkinson's disease

Authors

  • Naroa Ibarretxe-Bilbao PhD,

    1. Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain
    2. Institute of Biomedical Research August Pi i Sunyer, Institut d'Investigacions Biomédiques August Pi i Sunyer, Barcelona, Spain
    3. Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
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  • Eduardo Tolosa MD,

    Corresponding author
    1. Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain
    2. Institute of Biomedical Research August Pi i Sunyer, Institut d'Investigacions Biomédiques August Pi i Sunyer, Barcelona, Spain
    3. Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Barcelona, Spain
    • Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Villarroel 173, Barcelona, 08036, Spain
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  • Carme Junque PhD,

    1. Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain
    2. Institute of Biomedical Research August Pi i Sunyer, Institut d'Investigacions Biomédiques August Pi i Sunyer, Barcelona, Spain
    3. Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
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  • Maria-Jose Marti MD

    1. Centro de Investigación en Red de Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain
    2. Institute of Biomedical Research August Pi i Sunyer, Institut d'Investigacions Biomédiques August Pi i Sunyer, Barcelona, Spain
    3. Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències (ICN), Hospital Clínic de Barcelona, Barcelona, Spain
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  • Potential conflict of interest: None reported.

Abstract

Patients with Parkinson's disease (PD) may present impairment in cognitive functions even at early stages of the disease. When compared with the general population, their risk of dementia is five to six times higher. Recent investigations using structural MRI have shown that dementia in PD is related to cortical structural changes and that specific cognitive dysfunctions can be attributed to atrophy in specific structures. We review the structural MRI studies carried out in PD using either a manual region of interest (ROI) approach or voxel-based morphometry (VBM). ROI studies have shown that hippocampal volume is decreased in patients with PD with and without dementia; in addition, hippocampal atrophy correlated with deficits in verbal memory. VBM studies have demonstrated that dementia in PD involves structural changes in limbic areas and widespread cortical atrophy. Findings in nondemented patients with PD are less conclusive, possibly because cognitively heterogeneous groups of patients have been studied. Patients with PD with cognitive impairment and/or visual hallucinations present greater brain atrophy than patients without these characteristics. These findings suggest that cortical atrophy is related to cognitive dysfunction in PD and precedes the development of dementia. Structural MRI might therefore provide an early marker for dementia in PD. © 2009 Movement Disorder Society

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