title: Anterior temporal atrophy and posterior progression in patients with Parkinson's disease.
abstract: BACKGROUND
  Parkinson's disease (PD) is characterized by specific motor and nonmotor impairments. This suggests that PD is characterized by disease-specific regional cortical atrophy. Given the change of symptoms over time, a concurrent increase in regional atrophy may further be assumed to reflect the dynamic process of disease progression.
  
  
  METHODS
  In this study we retrospectively collected T1-weighted MRI scans from previous studies performed in our center, enabling the comparison of gray matter atrophy in 77 PD patients with 87 controls using voxel-based morphometry (VBM). This large VBM analysis provided the opportunity to investigate cortical atrophy in relation with disease progression.
  
  
  RESULTS
  We found significant PD-related reductions of gray matter density bilaterally in the anterior temporal cortex, the left inferior frontal and left extrastriate visual cortex, independent from normal aging. The anterior temporal cortex did not show major progression, whereas particularly the posterior parts of the lateral temporal cortex and adjacent extrastriate visual cortex occurred at a later stage of disease.
  
  
  CONCLUSIONS
  Temporal pole atrophy as an early sign of PD is consistent with the PD pathology classification of Braak. The initial anterior temporal atrophy with spread to occipitotemporal and posterior parietal regions may subserve 'emotion-based' sensorimotor transformations and deficits in the visual domain, respectively, which may be regarded as premotor symptoms.
authors.affiliation: Department of Neurology, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Adriaan R E
authors.initials: AR
authors.lastname: Potgieser
authors.forename: Anouk
authors.initials: A
authors.lastname: van der Hoorn
authors.forename: Anne Marthe
authors.initials: AM
authors.lastname: Meppelink
authors.forename: Laura K
authors.initials: LK
authors.lastname: Teune
authors.forename: Janneke
authors.initials: J
authors.lastname: Koerts
authors.forename: Bauke M
authors.initials: BM
authors.lastname: de Jong
mesh_terms: D000368:Aged; D000375:Aging / Q000473:pathology; D001284:Atrophy; D018450:Disease Progression; D005260:Female; D005625:Frontal Lobe / Q000473:pathology; D066128:Gray Matter / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010296:Parietal Lobe / Q000473:pathology; D010300:Parkinson Disease / Q000473:pathology*; D013702:Temporal Lobe / Q000473:pathology*; D014793:Visual Cortex / Q000473:pathology*