Laura Pelizzari1, Sonia Di Tella1, Maria M Laganà1, Niels Bergsland1,2, Federica Rossetto1, Raffaello Nemni1,3, Francesca Baglio4. 1. IRCCS, Fondazione Don Carlo Gnocchi, Milan, Italy. 2. Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA. 3. Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy. 4. IRCCS, Fondazione Don Carlo Gnocchi, Milan, Italy. fbaglio@dongnocchi.it.
Abstract
INTRODUCTION: Parkinson's disease (PD) is a motor disorder that initially presents with unilateral symptoms. Widespread white matter (WM) alterations have been reported since the early stages of the disease. The aim of this study was to investigate WM alterations in right-dominant and left-dominant symptom PD patients (RPD and LPD, respectively) with respect to healthy controls (HC) by diffusion-weighted magnetic resonance imaging (MRI). METHODS: Thirty-eight subjects participated in this study: 12 RPD (median H&Y [IQR] = 1.5 [1.1-2], median UPDRS III [IQR] = 23 [7.8-25]), 9 LPD (median H&Y [IQR] = 1.5 [1-2.5], median UPDRS III [IQR] = 17 [12-22]), and 17 HC. All the participants were scanned on a 1.5-T MRI scanner. Maps of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were computed for all the subjects. Tract-based spatial statistics (TBSS) was performed for each diffusion parameter, to test WM differences between RPD, LPD, and HC (ANCOVA design). Family-wise error (FWE) correction was performed and p values lower than 0.05 were considered significant. RESULTS: No significant FA and RD differences were observed between RPD, LPD, and HC. Significantly increased MD and AD were observed in RPD with respect to HC within widespread WM regions, bilaterally. Conversely, no significant WM alterations were detected in LPD. CONCLUSION: WM integrity was found to be significantly altered in RPD but not in LPD, suggesting that LPD profile may be associated to more favorable prognosis. Since clinical laterality onset may affect the extent of WM integrity changes, it should be taken into account in neuroimaging studies investigating PD.
INTRODUCTION:Parkinson's disease (PD) is a motor disorder that initially presents with unilateral symptoms. Widespread white matter (WM) alterations have been reported since the early stages of the disease. The aim of this study was to investigate WM alterations in right-dominant and left-dominant symptom PDpatients (RPD and LPD, respectively) with respect to healthy controls (HC) by diffusion-weighted magnetic resonance imaging (MRI). METHODS: Thirty-eight subjects participated in this study: 12 RPD (median H&Y [IQR] = 1.5 [1.1-2], median UPDRS III [IQR] = 23 [7.8-25]), 9 LPD (median H&Y [IQR] = 1.5 [1-2.5], median UPDRS III [IQR] = 17 [12-22]), and 17 HC. All the participants were scanned on a 1.5-T MRI scanner. Maps of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were computed for all the subjects. Tract-based spatial statistics (TBSS) was performed for each diffusion parameter, to test WM differences between RPD, LPD, and HC (ANCOVA design). Family-wise error (FWE) correction was performed and p values lower than 0.05 were considered significant. RESULTS: No significant FA and RD differences were observed between RPD, LPD, and HC. Significantly increased MD and AD were observed in RPD with respect to HC within widespread WM regions, bilaterally. Conversely, no significant WM alterations were detected in LPD. CONCLUSION: WM integrity was found to be significantly altered in RPD but not in LPD, suggesting that LPD profile may be associated to more favorable prognosis. Since clinical laterality onset may affect the extent of WM integrity changes, it should be taken into account in neuroimaging studies investigating PD.
Entities:
Keywords:
Clinical laterality onset; Diffusion tensor MRI; Parkinson’s disease; TBSS; White matter; White matter alterations
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