Frontal white matter injuries predestine gait difficulties in Parkinson's disease
| Autor: | Anne Larsson, Richard Birgander, Lars Forsgren, Niklas Lenfeldt, Henny Holmlund |
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| Rok vydání: | 2015 |
| Předmět: |
Male
0301 basic medicine medicine.medical_specialty Parkinson's disease Neurology Aftercare Disease behavioral disciplines and activities 03 medical and health sciences 0302 clinical medicine Gait (human) Tremor Frontal white matter medicine Humans Gait Disorders Neurologic Aged Parkinsonism Parkinson Disease General Medicine Middle Aged medicine.disease White Matter Frontal Lobe Diffusion Tensor Imaging 030104 developmental biology nervous system Disease Progression Female Neurology (clinical) Psychology Neuroscience 030217 neurology & neurosurgery Diffusion MRI |
| Zdroj: | Acta Neurologica Scandinavica. 134:210-218 |
| ISSN: | 0001-6314 |
| Popis: | This study applies diffusion tensor imaging (DTI) to determine differences in neuronal integrity between motor phenotypes in Parkinson's disease.One hundred and twenty-two patients (47 females, mean age = 70.3 years) were included at baseline. Forty patients were tremor dominant (TD), 64 had postural imbalance and gait difficulty (PIGD), and 18 patients were indeterminate. The DTI was repeated after one, three and 5 years, including reassessment of phenotype. DTI was quantified using fractional anisotropy (FA), and mean, radial and axial diffusion. Targeted white matter involved six regions of interests (ROIs) in prefrontal cortex (PFC), the entrance to the external capsule (EEC) and lateral to the horn of the anterior ventricle (LVAH). Grey matter involved the basal ganglia. Data were analysed using mixed linear models with P0.05 (Bonferroni corrected) as significance threshold.PIGD and Indeterminate had reduced FA and axial diffusion in PFC, EEC and LVAH compared to Tremor dominant (P0.05). Basal ganglia showed no differences. Post hoc analysis showed that FA correlated negatively, and mean and radial diffusion positively, to PIGD symptoms in EEC, LVAH and four ROIs in PFC (P0.05). Tremor symptoms showed no correlations. Patients converting to PIGD and Indeterminate had lower FA, and higher mean and radial diffusion, at baseline in EEC, LVAH and four areas in PFC compared to non-converting patients (P0.05).Degeneration in frontal white matter is connected to PIGD symptoms in Parkinson's disease and if present at an early stage, the risk for conversion to the PIGD phenotype increases. |
| Databáze: | OpenAIRE |
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