Hippocampal, caudate, and ventricular changes in Parkinson's disease with and without dementia

Abstract

Parkinson's disease (PD) has been associated with mild cognitive impairment (PDMCI) and with dementia (PDD). Using radial distance mapping, we studied the 3D structural and volumetric differences between the hippocampi, caudates, and lateral ventricles in 20 cognitively normal elderly (NC), 12 cognitively normal PD (PDND), 8 PDMCI, and 15 PDD subjects and examined the associations between these structures and Unified Parkinson's Disease Rating Scale (UPDRS) Part III:motor subscale and Mini-Mental State Examination (MMSE) performance. There were no hippocampal differences between the groups. 3D caudate statistical maps demonstrated significant left medial and lateral and right medial atrophy in the PDD vs. NC, and right medial and lateral caudate atrophy in PDD vs. PDND. PDMCI showed trend-level significant left lateral caudate atrophy vs. NC. Both left and right ventricles were significantly larger in PDD relative to the NC and PDND with posterior (body/occipital horn) predominance. The magnitude of regionally significant between-group differences in radial distance ranged between 20-30% for caudate and 5-20% for ventricles. UPDRS Part III:motor subscale score correlated with ventricular enlargement. MMSE showed significant correlation with expansion of the posterior lateral ventricles and trend-level significant correlation with caudate head atrophy. Cognitive decline in PD is associated with anterior caudate atrophy and ventricular enlargement.

FIG. 1

3D statistical and quantitative between-group caudate maps. The statistical maps (top) show regions where statistically significant between-group differences are seen. The red and white colors denote areas where the P-value is equal to or less than 0.05 and the dark blue colors denote P-values of 0.1 or higher. The quantitative maps (bottom) show the magnitude of between-group differences (in %).

FIG. 2

3D statistical and quantitative between-group ventricular maps. The statistical maps (top) show regions where statistically significant between-group differences are seen. The red and white colors denote areas where the P-value is equal to or less than 0.05 and the dark blue colors denote P-values of 0.1 or higher. The quantitative maps (bottom) show the magnitude of between-group differences (in %).

FIG. 3

3D caudate clinical covariate maps. For the significance maps (top two rows) the red and white colors denote areas where the P-value is equal to or less than 0.05 and the dark blue colors denote P-values of 0.1 or higher. The correlation maps (bottom two rows) show the strength of the correlations between radial distance (or caudate thickness) and MMSE or UPDRS Part III:motor subscale at each surface point of the caudate model.

FIG. 4

3D ventricular clinical covariate maps. For the significance maps (top two rows), the red and white colors denote areas where the P-value is equal to or less than 0.05 and the dark blue colors denote P-values of 0.1 or higher. The correlation maps (bottom two rows) show the strength of the correlations between radial distance (or ventricular expansion) and MMSE or UPDRS Part III:motor subscale scores at each surface point of the caudate model.