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Gray and white matter imaging: A biomarker for cognitive impairment in early Parkinson's disease?

Lookup NU author(s): Dr Gordon Duncan, Dr Michael FirbankORCiD, Professor Alison Yarnall, Dr Tien Kheng Khoo, Professor David BrooksORCiD, Professor David Burn, Professor John O'Brien



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


BackgroundThe aim of this work was to investigate the cortical and white matter changes that underlie cognitive impairment in patients with incident Parkinson's disease (PD) disease using voxel-based morphometry and diffusion tensor imaging.MethodsNewly diagnosed nondemented PD (n=125) and control subjects (n=50) were recruited from the Incidence of Cognitive Impairment in Cohorts with Longitudinal Evaluation in Parkinson's Disease Study and completed cognitive assessments and 3T structural and diffusion tensor MR imaging. Voxel-based morphometry was performed to investigate the relationship between gray matter volume and cognitive ability. Microstructural white matter changes were assessed with diffusion tensor imaging measures of fractional anisotropy and mean diffusivity using tract-based spatial statistics.ResultsIncreased mean diffusivity was observed bilaterally in subjects with PD, relative to controls (P=0.019). Increased mean diffusivity was associated with performance on the semantic fluency and Tower of London tasks in frontal and parietal white matter tracts, including the cingulum, superior longitudinal fasciculus, inferior longitudinal fasciculus, and inferior fronto-occipital fasciculus. There was no difference in total gray matter volume between groups; however, bilateral reductions in frontal and parietal gray matter volume were associated with reduced performance on measures of executive function in PD subjects.ConclusionsAt the earliest stages of PD, regionally specific increases in central white matter mean diffusivity are present and suggest early axonal damage. Such changes are not accompanied by significant gray matter volume loss and are consistent with proposed models of pathological progression of the disease. Structural MRI, especially diffusion tensor imaging analysis, offers potential as a noninvasive biomarker reflecting cognitive impairment in PD. (c) 2015 International Parkinson and Movement Disorder Society

Publication metadata

Author(s): Duncan GW, Firbank MJ, Yarnall AJ, Khoo TK, Brooks DJ, Barker RA, Burn DJ, O'Brien JT

Publication type: Article

Publication status: Published

Journal: Movement Disorders

Year: 2016

Volume: 31

Issue: 1

Pages: 103-110

Print publication date: 01/01/2016

Online publication date: 22/07/2015

Acceptance date: 19/05/2015

Date deposited: 12/04/2016

ISSN (print): 0885-3185

ISSN (electronic): 1531-8257

Publisher: Wiley-Blackwell Publishing Ltd.


DOI: 10.1002/mds.26312


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Funder referenceFunder name
Newcastle University Lockhart Parkinson's Disease Research Fund
J-0802Parkinson's UK Program grant