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Abstract
Objective The objective of the current study was to compare the microstructural integrity of the white matter (WM) tracts in patients having Parkinson disease (PD) with and without psychosis (PD-P and PD-NP) through diffusion tensor imaging (DTI).
Methods This cross-sectional study involved 48 PD-NP and 42 PD-P who were matched for age, sex, and education. Tract-based spatial statistics (TBSS) was used to compare several DTI metrics from the diffusion-weighted MRIs obtained through a 3-Tesla scanner. A set of neuropsychological tests was used for the cognitive evaluation of all patients.
Results The severity and stage of PD were not statistically different between the groups. The PD-P group performed poorly in all the neuropsychological domains compared with the PD-NP group. TBSS analysis revealed widespread patterns of abnormality in the fractional anisotropy (FA) in the PD-P group, which also correlated with some of the cognitive scores. These tracts include inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, right parieto-occipital WM, body of the corpus callosum, and corticospinal tract.
Conclusion This study provides novel insights into the putative role of WM tract abnormalities in the pathogenesis of PD-P by demonstrating significant alterations in several WM tracts. Additional longitudinal studies are warranted to confirm the findings of our research.
Glossary
- AD=
- axial diffusivity;
- CFT=
- Complex Figure Test;
- CST=
- corticospinal tract;
- DTI=
- diffusion tensor imaging;
- FA=
- fractional anisotropy;
- FAB=
- Frontal Assessment Battery;
- H&Y=
- Hoehn and Yahr;
- HAM-A=
- Hamilton Anxiety Rating Scale;
- IFOF=
- inferior fronto-occipital fasciculus;
- ILF=
- inferior longitudinal fasciculus;
- JHU=
- Johns Hopkins University;
- LEDD=
- levodopa equivalent dose per day;
- MD=
- mean diffusivity;
- MH=
- minor hallucination;
- MNI=
- Montreal Neuroimaging Institute;
- MoCA=
- Montreal Cognitive Assessment;
- NIMHANS=
- National Institute of Mental Health and Neurosciences;
- PD=
- Parkinson disease;
- PD-NP=
- patients having PD without psychosis;
- PD-P=
- patients having PD with psychosis;
- RAVLT=
- Rey Auditory Verbal Learning Test;
- RD=
- radial diffusivity;
- TBSS=
- tract-based spatial statistics;
- TFCE=
- threshold-free cluster enhancement;
- TMT-B=
- Trail Making Test B;
- VH=
- visual hallucination;
- WM=
- white matter
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Editorial, page 767
- Received June 21, 2019.
- Accepted in final form November 15, 2019.
- © 2020 American Academy of Neurology
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