Inner retinal thinning as a biomarker for cognitive impairment in de novo Parkinson's disease

Abstract

We investigated the association between retinal changes measured using optical coherence tomography (OCT) and diverse clinical grading scales in patients with Parkinson's disease (PD). Seventy-four eyes of 74 patients with de novo PD and 53 eyes of age-matched control subjects were included. The thickness of the peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell-inner plexiform layer (mGCIPL) were measured. We analyzed the correlations between the clinical PD grading scales and OCT parameters, and between the OCT parameters and volumetric data in the cerebral cortical and subcortical structures. The area under the receiver operating characteristic curve (AUC) was calculated for diagnosing cognitive impairment in patients with PD. Statistically significant reductions in the thickness of average, temporal, and inferior pRNFL and overall mGCIPL were observed in patients with PD. The Montreal Cognitive Assessment score was significantly associated with mGCIPL thinning. The AUC of the mGCIPL parameters for diagnosing cognitive impairment in patients with PD ranged from 0.651 to 0.760. Moreover, thinning of the mGCIPL was significantly associated with the volumetric parameters of associated brain structures. Our findings highlight the clinical implications of OCT measurements as a potential biomarker for early detection of cognitive impairment in patients with PD.

Figure 1

Comparison of the mGCIPL thickness between the patients with PD who had a normal cognition (PD-NC) and those with a cognitive impairment (PD-CI). PD = Parkinson’s disease; mGCIPL = macular ganglion cell-inner plexiform layer.

Figure 2

ROC curves and AUC values of the mGCIPL thickness parameters for detection of cognitive impairment in patients with PD. ROC = receiver operating characteristic; AUC = area under the ROC curve; mGCIPL = macular ganglion cell-inner plexiform layer; PD = Parkinson’s disease.