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Psychosis is a common and disturbing symptom complicating the course of Parkinson disease (PD). Past investigations of the cerebral structural changes associated with psychosis have focused on the gray matter1–3 and demonstrated that atrophic changes are associated with psychosis. Although white matter tracts clearly play a critical role in connecting cortical and ganglionic neural networks that are involved in the pathogenesis of psychosis,4 there has been little investigation into the white matter involvement in PD psychosis. The literature is constrained not only by limited sample sizes of fewer than a dozen patients with PD with psychosis but also by the study of only a restricted number of structures of interest.5,6
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