Dopaminergic Therapy Modulates Cortical Perfusion in Parkinson Disease With and Without Dementia According to Arterial Spin Labeled Perfusion Magnetic Resonance Imaging

Lin, Wei Che; Chen, Pei Chin; Huang, Yung Cheng; Tsai, Nai‐Wen; Chen, Hsiu-Ling; Wang, Hung-Chen; Lin, Tay-Jyi; Chou, Kun Hsien; Chen, Meng Hsiang; Chen, Yi Wen; Lu, Cheng Hsien

doi:10.1097/md.0000000000002206

Cited by 24 publications

(29 citation statements)

References 38 publications

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“…Gray matter atrophy and cortical thinning in the thalamus have been reported in PD‐MCI (Chen et al, ; Danti et al, ). Previous ASL studies found decreased thalamic CBF in PD patients including PD‐D with relatively advanced disease (Lin et al, ; Melzer et al, ). The present study shows that a thalamic hemodynamic abnormality also occurs in PD‐MCI with early stage disease.…”

Section: Discussionmentioning

confidence: 87%

“…Arterial spin labeling (ASL) is a magnetic resonance imaging (MRI) method for quantifying cerebral blood flow (CBF) and arterial transit time (ATT) by using magnetically labeled arterial blood water as an endogenous tracer. Because it is entirely noninvasive, and needs no radioactive tracer or other contrast agent (Detre, Leigh, Williams, & Koretsky, ), ASL has been increasingly used to investigate perfusion in healthy controls (HCs) and several neurological and psychiatric disorders (Hales, Kawadler, Aylett, Kirkham, & Clark, ; Lin et al, ; Lui et al, ), including PD (Al‐Bachari et al, ; Al‐Bachari, Vidyasagar, Emsley, & Parkes, ; Fernandez‐Seara et al, ; Lin et al, ; Melzer et al, ; Wei et al, ).…”

Section: Introductionmentioning

confidence: 99%

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Multidelay multiparametric arterial spin labeling perfusion MRI and mild cognitive impairment in early stage Parkinson's disease

Suo

Lei

Cheng

et al. 2018

Human Brain Mapping

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Mild cognitive impairment (MCI), a well‐defined nonmotor manifestation of Parkinson's disease (PD), greatly impairs functioning and quality of life. However, the contribution of cerebral perfusion, quantified by arterial spin labeling (ASL), to MCI in PD remains poorly understood. The selection of an optimal delay time is difficult for single‐delay ASL, a problem which is avoided by multidelay ASL. This study uses a multidelay multiparametric ASL to investigate cerebral perfusion including cerebral blood flow (CBF) and arterial transit time (ATT) in early stage PD patients exhibiting MCI using a voxel‐based brain analysis. Magnetic resonance imaging data were acquired on a 3.0 T system at rest in 39 early stage PD patients either with MCI (PD‐MCI, N = 22) or with normal cognition (PD‐N, N = 17), and 36 age‐ and gender‐matched healthy controls (HCs). CBF and ATT were compared among the three groups with SPM using analysis of variance followed by post hoc analyses to define regional differences and examine their relationship to clinical data. PD‐MCI showed prolonged ATT in right thalamus compared to both PD‐N and HC, and in right supramarginal gyrus compared to HC. PD‐N showed shorter ATT in left superior frontal cortex compared to HC. Prolonged ATT in right thalamus was negatively correlated with the category fluency test (p = .027, r = −0.495) in the PD‐MCI group. This study shows that ATT may be a more sensitive marker than CBF for the MCI, and highlights the potential role of thalamus and inferior parietal region for MCI in early stage PD.

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Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Multidelay multiparametric arterial spin labeling perfusion MRI and mild cognitive impairment in early stage Parkinson's disease

Suo

Lei

Cheng

et al. 2018

Human Brain Mapping

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“…Cognitive function is associated with cortical atrophy in PD patients, such that PD patients with cognitive impairments may show more extensive cortical atrophy and decreased cortical perfusion compared with PD patients without cognitive impairments (Ibarretxe-Bilbao et al, 2009; Chen et al, 2016; Lin et al, 2016) Relatedly, in PD patients with dementia, a previous study reported extensive frontal and subcortical atrophy compared with PD patients with no cognitive impairment (Borroni et al, 2015). The results of this study, meanwhile, show extensive WM changes even in the early stages of the disease.…”

Section: Discussionmentioning

confidence: 99%

Associations among Cognitive Functions, Plasma DNA, and White Matter Integrity in Patients with Early-Onset Parkinson's Disease

Chen

et al. 2017

Front. Neurosci.

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Early-onset Parkinson's disease (EOPD) patients are symptomatic at a relatively young age, and the impacts of the disease on both the patients and their caregivers are dramatic. Few studies have reported on the cognitive impairments seen in EOPD, and the results of these studies have been diverse. Furthermore, it is still unclear what microstructural white matter (WM) changes are present in EOPD patients. As such, we conducted this study to investigate the microstructural WM changes experienced by EOPD patients and their association with cognitive function and plasma DNA levels. We enrolled 24 EOPD patients and 33 sex- and age-matched healthy volunteers who underwent complete neuro-psychological testing (NPT) to evaluate their cognitive function and diffusion tensor imaging (DTI) scanning to determine their fiber integrity. The plasma DNA measurements included measurements of nuclear and mitochondrial DNA levels. Fractional anisotropy (FA) maps were compared using voxel-based statistics to determine differences between the two groups. The differences in DTI indices and NPT scores were correlated after adjusting for age, sex, and education. Our results demonstrate that patients with EOPD have elevated nuclear DNA levels and wide spectrums of impairments in NPT, especially in the executive function and visuospatial function domains. Exploratory group-wise comparisons of the DTI indices revealed that the patients with EOPD exhibited lower DTI parameters in several brain locations. These poorer DTI parameters were associated with worse cognitive performances and elevated plasma nuclear DNA levels, especially in the anterior thalamic radiation region. Our findings suggest that the thalamus and its adjacent anterior thalamic radiation may be important in the pathogenesis of EOPD, as they appear to become involved in the disease process at an early stage.

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“…All the image processing procedure, including tissue segmentation, study specific template construction, spatial normalization, and CBF partial volume effect (PVE) correction were conducted according to previous study (13) and was summarized in Supplementary Material.…”

Section: Methodsmentioning

confidence: 99%

Autonomic Function Impairment and Brain Perfusion Deficit in Parkinson’s Disease

et al. 2017

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IntroductionAutonomic disorders have been recognized as important Parkinson’s disease (PD) components. Some vulnerable structures are related to the central autonomic network and have also been linked to autonomic function alterations. The aims of the study are to evaluate the severity of the autonomic dysfunction and the cortical hypoperfusion using arterial spin labeling (ASL) MRI. And then, possible relationships of significant between-group differences in perfusion pattern to clinical variables and autonomic functions were examined to determine the pharmaceutical effects of dopaminergic treatment on cerebral blood flow (CBF) in patients with PD.MethodsBrain ASL MRI was carried out in 20 patients with PD (6 men and 14 women, mean age: 63.3 ± 6.4 years) and 22 sex- and age-matched healthy volunteers to assess whole-brain CBF and the effects of dopaminergic therapy on perfusion. All subjects underwent a standardized evaluation of cardiovagal and adrenergic function including a deep breathing, Valsalva maneuver, and 5-min head-up tilt test. Perfusion MRI data were acquired on a 3.0 T scanner with a pulsed continuous ASL technique. The CBF, autonomic parameters, and clinical data were analyzed after adjusting for age and sex.ResultsPatients exhibited a decline in autonomic function (rapid heart rate in response to deep breathing, low baroreflex sensitivity, high systolic and diastolic pressure, and altered tilting test response), widespread low CBF, and robust response to dopaminergic therapy. Lower perfusion in the middle frontal gyrus was associated with increased clinical disease severity (Unified Parkinson’s Disease Rating Scale I score, P < 0.001). Lower perfusion in autonomic control areas, such as the frontal lobe and insula, were significantly associated with autonomic impairment (P < 0.001).ConclusionsOur study indicates that PD is a progressive neurodegenerative disorder that changes the perfusion of central nervous system and is associated with variable autonomic dysfunctions. Neuronal loss and sympathetic activation may explain the interaction between cortical autonomic region perfusion and cardiovascular autonomic function.

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Dopaminergic Therapy Modulates Cortical Perfusion in Parkinson Disease With and Without Dementia According to Arterial Spin Labeled Perfusion Magnetic Resonance Imaging

Abstract: Supplemental Digital Content is available in the text

Cited by 24 publications

References 38 publications

Multidelay multiparametric arterial spin labeling perfusion MRI and mild cognitive impairment in early stage Parkinson's disease

Multidelay multiparametric arterial spin labeling perfusion MRI and mild cognitive impairment in early stage Parkinson's disease

Associations among Cognitive Functions, Plasma DNA, and White Matter Integrity in Patients with Early-Onset Parkinson's Disease

Autonomic Function Impairment and Brain Perfusion Deficit in Parkinson’s Disease

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