title: Structural brain changes in Parkinson disease with dementia: a voxel-based morphometry study.
abstract: BACKGROUND
  Parkinson disease with dementia (PDD) results from neuropathological changes in cortical and subcortical brain regions. Voxel-based morphometric analysis of magnetic resonance images can contribute to in vivo identification of the cerebral regions predominantly involved in PDD.
  
  
  OBJECTIVE
  To identify structural cerebral regions most closely related to the presence of PDD.
  
  
  METHODS
  Magnetic resonance images were obtained from 16 patients who had PDD, 13 patients with PD without dementia, and 13 age-matched healthy control subjects. Gray matter volumes were compared using optimized voxel-based morphometric analyses.
  
  
  RESULTS
  Compared with healthy controls, patients with PDD showed gray matter volume decreases in several of the following regions: bilateral putamen, accumbens nuclei, left side of the thalamus, bilateral hippocampus, parahippocampal region, and anterior cingulate gyrus. Patients with PD also showed gray matter reductions compared with healthy controls in the right side of the hippocampus, left anterior cingulate gyrus, and left superior temporal gyrus.
  
  
  CONCLUSIONS
  The hippocampus, thalamus, and anterior cingulate are the regions most affected in PDD. Our results agree with recent neuropathological findings suggesting the involvement of the limbic and cortical areas in PD.
authors.affiliation: Department de Psiquiatria i Psicobiologia, Universitat de Barcelona, Spain.
authors.forename: Christopher
authors.initials: C
authors.lastname: Summerfield
authors.forename: Carme
authors.initials: C
authors.lastname: Junqué
authors.forename: Eduardo
authors.initials: E
authors.lastname: Tolosa
authors.forename: Pilar
authors.initials: P
authors.lastname: Salgado-Pineda
authors.forename: Beatriz
authors.initials: B
authors.lastname: Gómez-Ansón
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Martí
authors.forename: Pau
authors.initials: P
authors.lastname: Pastor
authors.forename: Blanca
authors.initials: B
authors.lastname: Ramírez-Ruíz
authors.forename: José
authors.initials: J
authors.lastname: Mercader
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003704:Dementia / Q000150:complications / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000473:pathology*