Regional volume analysis of the Parkinson disease brain in early disease stage: gray matter, white matter, striatum, and thalamus

Abstract

Background and purpose: Loss of dopaminergic neurons in the nigrostriatal pathway is well-documented in PD, whereas neuronal changes beyond the nigrostriatal pathway are uncertain. The purpose of our study was to estimate volume changes in the striatum and thalamus, which are areas of the basal ganglia, as well as in GM and WM located beyond the nigrostriatal pathway, in early-stage PD.

Materials and methods: We enrolled 30 participants (15 healthy controls and 15 patients with PDND with H & Y stage I or II). Cognitive function was assessed by using the MMSE. ICV and the volumes of the caudate nucleus, putamen, thalamus, GM, and WM were calculated via 3D volume analysis by using MR imaging.

Results: A comparison of the PD group with the control group revealed an absence of significant differences between them regarding age and MMSE scores. Comparison of the volumes of regional brain structures of patients with PD with those of controls revealed the presence of significant differences in the caudate nucleus, thalamus, and WM (P<.05) between the groups. However, there were no significant differences in the volumes of the putamen and GM or in ICV between patients with PD and controls. The results of ANCOVA by using the covariates of age and ICV showed a significant difference in the caudate nucleus, thalamus, and WM between patients with PD and controls (P<.05).

Conclusions: We suggest that loss of WM volume may occur in early disease stages and that variation of the volumes of the caudate nucleus and thalamus may be an early phenomenon of disease progression.

Fig 1.

A–G, Volumes of interest of the caudate nucleus, putamen, and thalamus. Each substructure was traced manually and labeled separately, according to the predefined boundary criteria. The most anterior caudate nuclei (A), putamina (B), and thalami (D) are displayed. 3D rendering of the volumes of interest of both caudate nuclei, putamina, and thalami (H). Red indicates the right caudate nucleus; green, the left caudate nucleus; blue, the right putamen; yellow, the left putamen; sky blue, the right thalamus; and purple, the left thalamus.