Regional Brain Atrophy in Idiopathic Parkinson's Disease and Diffuse Lewy Body Disease

Abstract

This study measured brain atrophy in patients with idiopathic Parkinson''s disease and diffuse Lewy body disease, all of whom had equivalent loss of midbrain dopaminergic neurons and absence of Alzheimer''s disease. Characteristic patterns of volume loss were found throughout the brain, depending on the age of onset and clinical signs. An equivalent loss of medial temporal lobe structures occurred in all parkinsonian patients. This atrophy was similar in magnitude to that seen in Alzheimer''s disease and is likely to be the anatomical substrate for the memory deficits found in each of these patient groups. Frontal lobe atrophy was a feature of both late-onset Parkinson''s disease (mild atrophy) and diffuse Lewy body disease (significant atrophy) groups, with all cases analyzed having dementia. Atrophy of frontal lobes correlated with the duration of motor symptoms in these patients and may suggest an association between dopaminergic deafferentation, frontal atrophy and dementia.

Magnetization transfer measurements of the hippocampus in the early diagnosis of Alzheimer's disease

“…However, atrophy has been shown in vascular dementia (13,14), Parkinson's disease (13,17), dementia with Lewy bodies (15,17), and frontotemporal dementia (16). Although volumetric measurement of specific medial temporal lobe structures may provide a more detailed analysis of atrophy, it is impractical because of the time required to analyze each scan.…”

“…Those with other types of dementia, identified on the basis of clinical criteria, included two patients with idiopathic Parkinson's disease, who were demented; two patients with probable dementia with Lewy bodies, according to the Consortium on DLB International Workshop criteria (30); four patients with idiopathic normal pressure hydrocephalus; three patients with probable progressive supranuclear palsy, according to the criteria of the NINDS-SPSP International Workshop (31); one patient with frontotemporal dementia, according to the criteria of the Lund and Manchester Groups (32); and one patient with Korsakoff's syndrome. The mean MMSE score of patients with vascular dementia and other dementias was 17.5 Ϯ 4.7 (range, 6-23) and 18.5 Ϯ 5.1 (range, [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25], respectively.…”

“…Several studies with MR imaging have shown significant atrophy (2-11) and high signal intensity (12) in the medial temporal lobe, including the hippocampal formation, in patients with AD. Although volumetric measurements of medial temporal lobe structures have been proposed to aid in the diagnosis of AD, atrophic changes also occur in other dementing diseases (13)(14)(15)(16)(17) and may not be a specific marker for AD. Kirsch et al (18) reported that hippocampal T2 relaxation time is markedly pro-longed in AD, but other studies have shown it to be only mildly elongated (19,20).…”

Revisiting oxidative stress and mitochondrial dysfunction in the pathogenesis of Parkinson disease—resemblance to the effect of amphetamine drugs of abuse

“…Neuronal loss is very restricted to areas containing LBs, such as the amygdala, the dorsal motor nucleus of the vagus nerve, locus coeruleus and the neocortex [65Ͳ68]. Although the pathology of PD affects a sort of neuronal systems, it does not cause substantial brain tissue loss [69,70], since cell loss is restricted to only certain neuronal populations, including the SN [19].…”

Reprint of: Revisiting oxidative stress and mitochondrial dysfunction in the pathogenesis of Parkinson disease—resemblance to the effect of amphetamine drugs of abuse

“…Neuronal loss is very restricted to areas containing LBs, such as the amygdala, the dorsal motor nucleus of the vagus nerve, the locus coeruleus, and the neocortex [65-"68]. Although the pathology of PD affects several neuronal systems, it does not cause substantial brain tissue loss [69,70], because cell loss is restricted to only certain neuronal populations, including the SN [19].…”