title: The topography of brain damage at different stages of Parkinson's disease.
abstract: This study investigated gray matter (GM) and white matter (WM) damage in 89 patients at different clinical stages of Parkinson's disease (PD) (17 early, 46 mild, 14 moderate, and 12 severe) to differentiate the trajectories of tissue injury in this condition. PD patients had a very little GM atrophy even at the more advanced stages of the disease. Microstructural damage to the WM occurs with increasing PD severity and involves the brainstem, thalamocortical pathways, olfactory tracts, as well as the major interhemispheric, limbic, and extramotor association tracts. The most marked WM damage was found in moderate vs. mild cases. WM damage correlated with the degree of global cognitive deficits. WM abnormalities beyond the nigrostriatal system accumulate with increasing PD severity. WM damage is likely to contribute to the more severe motor and nonmotor dysfunctions occurring in patients at the later stages.
authors.affiliation: Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Agosta
authors.forename: Elisa
authors.initials: E
authors.lastname: Canu
authors.forename: Tanja
authors.initials: T
authors.lastname: Stojković
authors.forename: Michela
authors.initials: M
authors.lastname: Pievani
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Tomić
authors.forename: Lidia
authors.initials: L
authors.lastname: Sarro
authors.forename: Nataša
authors.initials: N
authors.lastname: Dragašević
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Copetti
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Comi
authors.forename: Vladimir S
authors.initials: VS
authors.lastname: Kostić
authors.forename: Massimo
authors.initials: M
authors.lastname: Filippi
mesh_terms: D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D015415:Biomarkers; D001921:Brain / Q000473:pathology*; D001925:Brain Damage, Chronic / Q000209:etiology / Q000473:pathology* / Q000523:psychology; D001931:Brain Mapping / Q000379:methods*; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology; D018450:Disease Progression; D017352:Echo-Planar Imaging; D004522:Educational Status; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000473:pathology; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications / Q000473:pathology* / Q000523:psychology
chemical_list: D015415:Biomarkers