title: Whole-brain diffusion-tensor changes in parkinsonian patients with impulse control disorders.
abstract: OBJECTIVE
  The aim of this study was to determine the changes in diffusion-tensor images associated with medication-related impulse control disorder (ICD) in Parkinson's disease (PD) patients undergoing chronic dopamine-replacement therapy.
  
  
  METHODS
  Nineteen PD patients, comprising 10 with ICD (PD-ICD) and 9 without ICD (PD-nonICD), and 18 age-matched healthy controls (HCs) with no cognitive or other psychiatric disorders were analyzed. All subjects underwent 3-T magnetic resonance diffusion-tensor imaging. For all PD patients, clinical data on PD duration, antiparkinsonian medication dosages, Unified Parkinson's Disease Rating Scale and Mini-Mental State Examination were collected. Whole-brain voxel-based measures of fractional anisotropy (FA) and mean diffusivity (MD) were analyzed.
  
  
  RESULTS
  In comparison with HCs, the PD-nonICD subjects had low FA at the bilateral orbitofrontal areas. While the PD-ICD subjects exhibited no such difference, their FA was significantly elevated at the anterior corpus callosum. Analysis of FA between the two PD groups revealed that FA in the anterior corpus callosum, right internal capsule posterior limbs, right posterior cingulum, and right thalamic radiations were significantly higher (corrected p<0.05) in the PD-ICD than in the PD-nonICD patients. MD did not differ between the PD-ICD and PD-nonICD groups in any brain regions.
  
  
  CONCLUSIONS
  The PD-ICD patients appear to have relatively preserved white-matter integrity in the regions involved in reward-related behaviors compared to PD-nonICD patients. Further investigation is required to determine whether the difference in FA between PD-ICD and PD-nonICD patients reflects microstructural differences in the pathological progression of PD or is secondary to ICD.
authors: Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Korea.
authors: Hye Bin
authors: HB
authors: Yoo
authors: Department of Neurology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, College of Medicine, Seoul National University, Seoul, Korea.
authors: Jee-Young
authors: JY
authors: Lee
authors: Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Korea. ; Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors: Jae Sung
authors: JS
authors: Lee
authors: Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors: Hyejin
authors: H
authors: Kang
authors: Department of Nuclear Medicine, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, College of Medicine, Seoul National University, Seoul, Korea.
authors: Yu Kyeong
authors: YK
authors: Kim
authors: Department of Diagnostic Radiology, Seoul National University Hospital, Seoul, Korea.
authors: In Chan
authors: IC
authors: Song
authors: Department of Nuclear Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors: Dong Soo
authors: DS
authors: Lee
authors: Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors: Beom Seok
authors: BS
authors: Jeon
keywords: Parkinson's disease; diffusion-tensor imaging; impulse control disorders
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