title: Regional volumetric change in Parkinson's disease with cognitive decline.
abstract: BACKGROUND
  Parkinson's disease (PD), characterized by motor dysfunction and cognitive decline, may demonstrate specific patterns of brain atrophy. Although cross-sectional magnetic resonance imaging (MRI) studies show correlation between regional brain volume loss and cognitive impairment, there is only scarce evidence from longitudinal studies validating the link between cognition and brain anatomy in PD.
  
  
  OBJECTIVE
  To test the relationship between magnitude and spatial extent of atrophy in PD patients with progressive, significant cognitive decline and dementia (PDD).
  
  
  METHODS
  We followed thirty-three initially non-demented patients with prevalent PD for three years while monitoring cognitive function and brain atrophy. Longitudinally acquired T1-weighted magnetic resonance images were analyzed in the voxel-based morphometry framework of SPM.
  
  
  RESULTS
  Groups did not differ significantly with respect to age or gender. More males developed PDD (7 males, 3 females) compared to those remaining intact (12 males, 11 females). Clusters of lower grey matter volume were found in PDD compared to PD in left uncus at baseline and an expanded region that included the left hippocampus and parahippocampal gyrus at 36months. The cognitive status by scan interaction showed differential changes between groups in the right insula. At a more liberal statistical threshold we observed changes in the right insula and bilateral hippocampi as well as the right cuneus additional to the lower brain stem.
  
  
  CONCLUSIONS
  Region specific atrophy, consistent with the pattern of cortical Lewy body deposition seen in autopsy studies, can be detected with MRI in PD patients with significant cognitive decline. MRI may be useful for tracking cognitive decline in PD.
authors.affiliation: Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Myrlene
authors.initials: M
authors.lastname: Gee
authors.affiliation: F. Hoffmann-LaRoche, Roche Innovation Centre, Basel, Switzerland; Laboratoire de Recherche en Neuroimagerie (LREN), Departement des Neurosciences Cliniques, Centre Hopitalier Universitaire Vaudois (CHUV), Universite de Lausanne, 1011 Lausanne, Switzerland.
authors.forename: Juergen
authors.initials: J
authors.lastname: Dukart
authors.affiliation: Laboratoire de Recherche en Neuroimagerie (LREN), Departement des Neurosciences Cliniques, Centre Hopitalier Universitaire Vaudois (CHUV), Universite de Lausanne, 1011 Lausanne, Switzerland.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Draganski
authors.affiliation: Department of Medicine (Neurology), University of Alberta, Edmonton, Alberta, Canada.
authors.forename: W R
authors.initials: WR
authors.lastname: Wayne Martin
authors.affiliation: Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada; Department of Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Derek
authors.initials: D
authors.lastname: Emery
authors.affiliation: Department of Medicine (Neurology), University of Alberta, Edmonton, Alberta, Canada. Electronic address: rcamicio@ualberta.ca.
authors.forename: Richard
authors.initials: R
authors.lastname: Camicioli
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D001284:Atrophy; D001921:Brain / Q000000981:diagnostic imaging*; D060825:Cognitive Dysfunction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D009929:Organ Size; D010300:Parkinson Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology*
chemical_list: D000978:Antiparkinson Agents
keywords: Cognitive decline; Dementia; Magnetic resonance imaging; Parkinson's disease; Statistical parametric mapping