Structural Changes on the Brain MRI and Cognitive Function in Parkinson Disease
DOI:
https://doi.org/10.12970/2310-8231.2014.02.01.5Keywords:
Parkinson disease, dementia, cognitive function, brain magnetic resonance imaging, atrophy.Abstract
Purpose: Cognitive impairment in Parkinson disease (PD) related with the fronto-striatal dysfunction as one cause of subcortical dementia. However, cognitive impairment in PD might be associated with medial temporal lobe atrophy in recent studies. We carried out this study to know whether structural changes on brain MRI are responsible for cognitive dysfunction in PD.
Materials and Methods: We recruited 183 patients who were newly diagnosed with PD from January, 2007 to February, 2012. All patients were undertaken brain MRI and neuropsychological assessment. Structural changes of the brain images were evaluated with visual rating scales. We analyzed clinical and neuro-imaging data to assess a relation between cognitive function and brain structural changes in the total patients and did subanalysis with PD-cognitively declined (PD-CD) and PD-cognitively preserved (PD-CP) subgroup.
Results: Total scores of the MMSE and 3MS was worsened as havingsevere white matter change (WMC), ventricular enlargement (VE), medial temporal lobe atrophy (MTA), and cortical atrophy in PD patients. PD-CD showed more severe WMC, VE and MTA than those in PD-CP patients even after adjustment of age and durations of education. Degree of the MTA among the brain structural changes was the most relevant factor for cognitive dysfunction in PD patients.
Conclusions: Although cognitive dysfunction in PD is suggestive of subcortical origin, medial temporal structure also may have an important role for cognition in PD. Therefore, clinicians need thorough evaluation of the structural changes in the brain MRI as well as neuropsychological assessment to define cognitive function in PD.
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