Brain Morphological Alterations Are Detected in Early‐Stage Parkinson's Disease with MRI Morphometry

Abstract

BACKGROUND AND PURPOSE: To detect brain morphological alterations in patients with early Parkinson's disease (PD) by using magnetic resonance imaging (MRI) morphometry under radiological diagnostic conditions. METHODS: T1-weighted brain images of 18 early PD patients and 18 age-sex-matched healthy controls (HCs) were analyzed with free software Computational Anatomy Toolbox (CAT12). Regional cortical thickness (rCTh) in 68 atlas-defined regionsof-interest (ROIs) and subcortical gray matter volume (SGMV) in 14 atlas-defined ROIs were determined and compared between patients and HCs by paired comparison using both ROI-wise and voxel-wise analyses. False-discovery rate (FDR) was used multiple comparison correction. Possible correlations between brain morphological changes in patients and clinical observations were also analyzed. RESULTS: Comparing to the HCs, the ROI-wise analysis revealed rCTh thinning significantly in left medial orbitofrontal (P = .001), by trend (P < .05 but not significant after FDR correction) in four other ROIs located in frontal and temporal lobes, and a volume decreasing trend in left pallidum of the PD patients, while the voxel-wise analysis revealed one cluster with rCTh thinning trend located between left insula and superior temporal region of the patients. In addition, the patients showed more distinct rCTh thinning in ipsilateral hemisphere and SGMV deceasing trends in contralateral hemisphere in respect of the symptom-onset body side. CONCLUSION: Brain morphological alterations in early PD patients are evident despite of their inconspicuous findings in standard MRI. Quantitative morphological measurements with CAT12 may be an applicable add-on tool for clinical diagnosis of early PD. These results have to be verified in future studies with larger patient samples.

Cerebral Microstructural Alterations in Patients With Early Parkinson’s Disease Detected With Quantitative Magnetic Resonance Measurements

“…Only early-stage PD patients, who were scaled clinically with Hoehn and Yahr stages (H&Y) of 1 or 2 in the best medical “on” state and aged 75 or below, were included in the study. Definition of early-stage PD by the H&Y stages is in accordance with earlier studies of our group ( Klietz et al, 2019a ; Fu et al, 2020 ), additionally, none of our patients complained of a significant amount of motor complications qualifying for advanced PD ( Titova et al, 2017 ). Patients with atypical Parkinsonism and other known brain pathologies, e.g., stroke, small vessel disease, or tumor, were not included in this study.…”

“…The derived values of these tissue parameters were compared between patients and controls with respect to the common asymmetric onset of PD. This allowed for the reorganization of ROIs in ipsilateral and contralateral brain hemispheres with regard to the clinical manifestation, as reported previously ( Klietz et al, 2019a ; Fu et al, 2020 ), depending on the body side with most pronounced symptoms and lateralized brain degeneration ( Riederer and Sian-Hülsmann, 2012 ).…”

“…Part of this early PD patient cohort was studied previously with other MRI methods ( Klietz et al, 2019a ; Fu et al, 2020 ). Patient characteristics showed some differences as one patient was replaced due to incomplete MRI scans.…”

“…However, PD patients typically present a normal routine MRI scan and only patients with atypical Parkinsonism may show specific imaging features ( Yekhlef et al, 2003 ). Since standard MRI measures do not discriminate healthy controls from PD patients, advanced imaging methods are needed for detection of PD related brain changes with higher sensitivity ( Huppertz et al, 2016 ; Fu et al, 2020 ). Therefore, patients at different PD stages were studied with combined multiple parametric MRI and MR spectroscopic imaging methods ( Klietz et al, 2019a ; Fu et al, 2020 ).…”

“…Since standard MRI measures do not discriminate healthy controls from PD patients, advanced imaging methods are needed for detection of PD related brain changes with higher sensitivity ( Huppertz et al, 2016 ; Fu et al, 2020 ). Therefore, patients at different PD stages were studied with combined multiple parametric MRI and MR spectroscopic imaging methods ( Klietz et al, 2019a ; Fu et al, 2020 ). In this study, quantitative MRI measurements were used to study PD patients at an early stage.…”