Degenerative changes were common in brain magnetic resonance imaging in patients with newly diagnosed Parkinson’s disease in a population-based cohort

Lindér, Jan; Birgander, Richard; Olssøn, Ingrid; Riklund, Katrine; Larsson, Ann-Katrine; Edström, Mona; Stenlund, Hans; Forsgren, Lars

doi:10.1007/s00415-009-5177-4

Cited by 18 publications

(16 citation statements)

References 30 publications

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“…In the present study we did not use brain MRI for differential diagnostic purposes because the Gilman MSA criteria from 2008 was published after the commencement of our study. We have previously reported on structural MRI findings in some of the PD patients in our incidence cohort [31]. Interestingly, we found that signs considered typical for PSP and MSA, e.g., midbrain atrophy (''Hummingbird sign''), could be seen in some of the PD patients and also in the controls.…”

Section: Discussionmentioning

confidence: 68%

“…To facilitate the comparison with other studies we also used a wider definition of PD: parkinsonism according to UK PDSBB plus one or two supporting criteria and no exclusion criteria (probable PD). The PD patients were subdivided into PIGD, TD and indeterminate (ID), and we also calculated the total UPDRS-III scores for tremor (items 20 and 21), rigidity (item 22), bradykinesia (items [23][24][25][26]31), and axial (items [27][28][29][30]. If none of the criteria for the specific forms of parkinsonism were fulfilled patients were classified as having unclassifiable parkinsonism and they were excluded.…”

Section: Methodsmentioning

confidence: 99%

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Impaired oculomotor function in a community-based patient population with newly diagnosed idiopathic parkinsonism

et al. 2011

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The differential diagnosis of idiopathic parkinsonism can be very challenging, especially early in the course of the disease. Oculomotor function has been reported to differ between the diseases constituting idiopathic parkinsonism. A detailed examination of the oculomotor functions could thus possibly be useful in the early differential diagnostic procedure. Oculomotor function could also differ between subgroups of patients with Parkinson's disease (PD). We examined the oculomotor function in a population-based incidence cohort with newly diagnosed idiopathic parkinsonism and 38 controls. We examined 135 patients with parkinsonism 105 PD, 11 progressive supranuclear palsy (PSP), and 19 multiple system atrophy with predominant parkinsonism (MSA-P)] within 3 months of their first visit to our clinic and before initiation of dopaminergic medication. The oculomotor measurements were repeated after 12 months. The clinical diagnosis was that of the latest clinical follow-up (median follow-up was 3 years). All patients were examined with (123)I-N-(omega)-fluoropropyl-2-β-carbomethoxy-3-β-(4-iodophenyl) nortropane single-photon emission computed tomography (FP-CIT SPECT), and only patients with pathological uptake of the ligand were included. Pathological changes in the oculomotor function were found in all patient groups compared to controls at the baseline examination. In PD, there were correlations between total axial motor scores and vertical saccade velocity and precision, horizontal saccade velocity and precision, and smooth pursuit gain at 20 and 30°/s. Oculomotor test results could not separate the different forms of idiopathic parkinsonism in the early phase from each other. Few changes in the oculomotor functions were observed between the baseline and the 12-month follow-up examinations. No correlations were found between the oculomotor measurements and disease severity or duration.

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Section: Discussionmentioning

confidence: 68%

Section: Methodsmentioning

confidence: 99%

Impaired oculomotor function in a community-based patient population with newly diagnosed idiopathic parkinsonism

et al. 2011

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“…Only only one volumetric MR study to date has investigated subcortical volumes in TD and PIGD patients. Linder et al reported finding no significant subcortical volumetric differences between subtypes [5]. This study, however, was conducted on a 1.5 T MRI magnet and involved visual analysis, which may be less sensitive than quantitative imaging methods for detecting small volumetric differences.…”

Section: Introductionmentioning

confidence: 98%

Morphologic changes in the mesolimbic pathway in Parkinson's disease motor subtypes

Nyberg

Tanabe

Honce

et al. 2015

Parkinsonism & Related Disorders

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Background Parkinson’s disease (PD) is a common neurodegenerative disorder associated with gray matter atrophy. Cortical atrophy patterns may further help distinguish between PD motor subtypes. Comparable differences in subcortical volumes have not been found. Methods Twenty-one cognitively intact and treated PD patients, including 12 tremor dominant (TD) subtype, Nine postural instability gait dominant (PIGD) subtype, and 20 matched healthy control subjects underwent 3.0 Tesla high-resolution structural MRI scanning. Subcortical volumetric analysis was performed using FreeSurfer and shape analysis was performed with FIRST to assess for differences between PD patients and controls and between PD subtypes. Results No significant differences in subcortical volumes were found between motor PD subtypes, but comparing grouped PD patients with controls revealed a significant increase in hippocampal volume in PD patients (p=0.03). A significant shape difference was detected in the right nucleus accumbens (NAcc) between PD and controls and between motor subtypes. Shape differences were driven by positive deviations in the TD subtype. Correlation analysis revealed a trend between hippocampal volume and decreasing MDS-UPDRS (p=0.06). Conclusion While no significant differences in subcortical volumes between PD motor subtypes were found, increased hippocampal volumes were observed in PD patients compared to controls. Right NAcc shape differences in PD patients were driven by changes in the TD subtype. These unexpected findings may be related to the effects of chronic dopaminergic replacement on the mesolimbic pathway. Further studies are needed to replicate and determine the clinical significance of such morphologic changes.

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“…11 GM atrophy was increased in one study of patients with PD. 12 Visual assessment of GM changes did not detect differences between the PD subtypes 13 ; however, this methodologic approach may not have been sufficiently sensitive to detect subtle GM changes.…”

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Gray matter atrophy distinguishes between Parkinson disease motor subtypes

Rosenberg‐Katz

Herman²,

Jacob³

et al. 2013

Neurology

144

110

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Objective: To assess differences in gray matter (GM) atrophy between 2 Parkinson disease (PD) subtypes: the tremor dominant (TD) subtype and the postural instability gait difficulty (PIGD) subtype.Methods: Patients were classified as belonging to the predominately PIGD (n 5 30) or predominately TD (n 5 29) subtype. Voxel-based morphometry was used to compare GM in these 2 subtypes and to evaluate correlations between predefined regions of interest and the degree of symptoms. In the regions where GM atrophy was associated with symptoms, the relationship between GM volumes and functional connectivity was examined.Results: GM was reduced in the predominately PIGD group, compared with the predominately TD group, in areas that involve motor, cognitive, limbic, and associative functions (p , 0.05, false discovery rate corrected). Lower GM volumes in the pre-supplementary motor area (SMA) and in the primary motor area were associated with increased severity of PIGD symptoms (r 5 20.42, p , 0.001; r 5 20.38, p , 0.003, respectively). Higher GM volumes within the pre-SMA were associated with stronger functional connectivity between the pre-SMA and the putamen (r 5 0.415, p , 0.025) in the patients with predominately PIGD. Conclusions:In patients with PD, PIGD symptoms are apparently associated with GM atrophy in motor-related regions and decreased functional connectivity. GM degeneration and a related decrease in spontaneous coactivation between cortical and subcortical motor-planning areas may partially account for the unique clinical characteristics of a subset of patients with PD.

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Degenerative changes were common in brain magnetic resonance imaging in patients with newly diagnosed Parkinson’s disease in a population-based cohort

Cited by 18 publications

References 30 publications

Impaired oculomotor function in a community-based patient population with newly diagnosed idiopathic parkinsonism

Impaired oculomotor function in a community-based patient population with newly diagnosed idiopathic parkinsonism

Morphologic changes in the mesolimbic pathway in Parkinson's disease motor subtypes

Gray matter atrophy distinguishes between Parkinson disease motor subtypes

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