Early Detection of White Matter Changes with Cognitive Decline in Parkinson's Patients
Shimaa Ahmed Ibrahim Elgamal
Department of Neurology, Kafrelshiekh University, Mansoura, Egypt.
Maha Hazem Khalil
Department of Neurology, Mansoura University, Mansoura, Egypt.
Omar Abd-Elsalam Ahmed *
Department of Neurology, Mansoura University, Mansoura, Egypt.
Adel Galal El-Badrawy
Department of Radiology, Mansoura University, Mansoura, Egypt.
Ahmed Esmael
Department of Neurology, Mansoura University, Mansoura, Egypt.
Shady Khalil El-Rashedy
Department of Neurology, Mansoura University, Mansoura, Egypt.
Tamer Mohamed Ebrahim Belal
Department of Neurology, Mansoura University, Mansoura, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Objective: The aim of this study was to detect changes in white matter in patients with Parkinson's disease applied by diffusion tensor imaging to predict cognitive impairment.
Methods: Montreal cognitive assessment was applied to 50 Parkinson's disease patients to confirm cognitive decline (M: F = 41:9; age: 62.72±9.07 years) and to 20 Parkinson's disease patients with no cognitive impairment as a control (M: F =13:7; age 58.95±11.22). All patients underwent disease severity testing by using Modified Hoehn and Yahr Scale, Unified Parkinson disease rating scale and Diffusion tensor imaging (DTI) for the corpus callosum and cingulum including their involved parts to define affected tracts.
Results: In PD with cognitive impairment subjects, the cognitive affection correlated with abnormal DTI parameters of the corpus callosum and cingulum. There were FA or MD differences in both the corpus callosum and cingulum pathways. These findings were independent of age, sex and total white matter volume.
Conclusion: Patients with Parkinson's disease associated with cognition decline are detected by tractography changes of the corpus callosum and cingulum.
Keywords: Parkinson’s, dementia, tractography, degenerative, white-matter