title: Cerebral atrophy and its relation to cognitive impairment in Parkinson disease.
abstract: OBJECTIVE
  Voxel-based morphometry was used to compare the amounts of gray matter in the brains of patients with Parkinson disease (PD) and normal control subjects (NCs) and to identify the specific regions responsible for cognitive dysfunction in PD.
  
  
  METHODS
  Patients were classified into nondemented (ND) and demented (D) groups according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.), and a group comparison was performed. In the ND patients, a correlation was also performed between local gray matter density and the score on Raven Colored Progressive Matrices (RCPM), a test of executive and visuospatial function.
  
  
  RESULTS
  In patients with advanced ND-PD vs NCs, atrophic changes were observed in the limbic/paralimbic areas and the prefrontal cortex. In D vs ND patients, atrophic change was observed widely in the limbic/paralimbic system, including the anterior cingulate gyrus and hippocampus as well as the temporal lobe, dorsolateral prefrontal cortex, thalamus, and caudate nucleus. The RCPM score was positively correlated with the gray matter density in the dorsolateral prefrontal cortex and the parahippocampal gyrus.
  
  
  CONCLUSIONS
  In patients with Parkinson disease (PD), atrophic changes occur mainly in the limbic/paralimbic and prefrontal areas. These atrophic changes may be related to the development of dementia in PD.
authors.affiliation: Department of Neurology, National Hospital for Geriatric Medicine, Obu, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Nagano-Saito
authors.forename: Y
authors.initials: Y
authors.lastname: Washimi
authors.forename: Y
authors.initials: Y
authors.lastname: Arahata
authors.forename: T
authors.initials: T
authors.lastname: Kachi
authors.forename: J P
authors.initials: JP
authors.lastname: Lerch
authors.forename: A C
authors.initials: AC
authors.lastname: Evans
authors.forename: A
authors.initials: A
authors.lastname: Dagher
authors.forename: K
authors.initials: K
authors.lastname: Ito
mesh_terms: D000368:Aged; D001284:Atrophy; D001921:Brain / Q000473:pathology*; D002421:Caudate Nucleus / Q000473:pathology; D003704:Dementia / Q000209:etiology / Q000473:pathology* / Q000523:psychology; D005260:Female; D006613:Higher Nervous Activity; D006801:Humans; D008032:Limbic System / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009474:Neurons / Q000473:pathology; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000473:pathology* / Q000523:psychology; D017397:Prefrontal Cortex / Q000473:pathology; D013028:Space Perception; D013702:Temporal Lobe / Q000473:pathology; D013788:Thalamus / Q000473:pathology; D014796:Visual Perception