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Multicenter Study
. 2021 Jul:88:68-75.
doi: 10.1016/j.parkreldis.2021.05.027. Epub 2021 May 31.

In vivo cholinergic basal forebrain degeneration and cognition in Parkinson's disease: Imaging results from the COPPADIS study

Michel J Grothe  1 , Miguel A Labrador-Espinosa  2 , Silvia Jesús  2 , Daniel Macías-García  2 , Astrid Adarmes-Gómez  2 , Fátima Carrillo  3 , Elena Iglesias Camacho  3 , Pablo Franco-Rosado  3 , Florinda Roldán Lora  4 , Juan Francisco Martín-Rodríguez  2 , Miquel Aguilar Barberá  5 , Pau Pastor  5 , Sonia Escalante Arroyo  6 , Berta Solano Vila  7 , Anna Cots Foraster  7 , Javier Ruiz Martínez  8 , Francisco Carrillo Padilla  9 , Mercedes Pueyo Morlans  9 , Isabel González Aramburu  10 , Jon Infante Ceberio  10 , Jorge Hernández Vara  11 , Oriol de Fábregues-Boixar  11 , Teresa de Deus Fonticoba  12 , Berta Pascual-Sedano  13 ; COPPADIS Study Group; Jaime Kulisevsky  14 , Pablo Martínez-Martín  15 , Diego Santos-García  16 , Pablo Mir  17
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Free article
Multicenter Study

In vivo cholinergic basal forebrain degeneration and cognition in Parkinson's disease: Imaging results from the COPPADIS study

Michel J Grothe et al. Parkinsonism Relat Disord. 2021 Jul.
Free article

Abstract

Introduction: We aimed to assess associations between multimodal neuroimaging measures of cholinergic basal forebrain (CBF) integrity and cognition in Parkinson's disease (PD) without dementia.

Methods: The study included a total of 180 non-demented PD patients and 45 healthy controls, who underwent structural MRI acquisitions and standardized neurocognitive assessment through the PD-Cognitive Rating Scale (PD-CRS) within the multicentric COPPADIS-2015 study. A subset of 73 patients also had Diffusion Tensor Imaging (DTI) acquisitions. Volumetric and microstructural (mean diffusivity, MD) indices of CBF degeneration were automatically extracted using a stereotactic CBF atlas. For comparison, we also assessed multimodal indices of hippocampal degeneration. Associations between imaging measures and cognitive performance were assessed using linear models.

Results: Compared to controls, CBF volume was not significantly reduced in PD patients as a group. However, across PD patients lower CBF volume was significantly associated with lower global cognition (PD-CRStotal: r = 0.37, p < 0.001), and this association remained significant after controlling for several potential confounding variables (p = 0.004). Analysis of individual item scores showed that this association spanned executive and memory domains. No analogue cognition associations were observed for CBF MD. In covariate-controlled models, hippocampal volume was not associated with cognition in PD, but there was a significant association for hippocampal MD (p = 0.02).

Conclusions: Early cognitive deficits in PD without dementia are more closely related to structural MRI measures of CBF degeneration than hippocampal degeneration. In our multicentric imaging acquisitions, DTI-based diffusion measures in the CBF were inferior to standard volumetric assessments for capturing cognition-relevant changes in non-demented PD.

Keywords: DTI; Diffusion; MRI; Nucleus basalis Meynert; Parkinson's disease; Substantia innominata.

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