Comparing the hippocampal volumetric atrophy between demented and nondemented individuals with Parkinson's disease: A systematic review and meta-analysis

Abstract

Background: Parkinson's disease (PD) is one of the most common neurodegenerative conditions in the world and, when combined with dementia, can lead to immense cerebral volume loss. Of significant importance among all cerebral regions, is the hippocampus. This region plays a pivotal role in memory, and understanding its pathological alterations can answer vital questions regarding dementia. As such, we designed this study to compare the hippocampal volumes of PD patients with dementia (PDD) versus PD without dementia.

Methods: PubMed, Web of Science, Scopus, and Embase were searched for relevant studies. We also searched the references sections of all included studies. The original search began in March 2022 and was extended to the end of July 2022. All related data were extracted from the studies. If the studies were conducted on patients from comparable patient groups, the most recent study with the most extensive data set would be included.

Results: A statistically significant difference was observed comparing the raw hippocampal volumes in participants with PDD and PD (p value = 0.01). In a comparison of normalized hippocampal volume between PDD and PD, there was a statistically significant difference (p value < 0.01), as well.

Conclusion: Although further research is required to illuminate the temporal relation between the onset of dementia and hippocampal atrophy in demented PD individuals, the present study highlights the importance of utilizing volumetric studies on memory-related cerebral regions to diagnose the initiation of dementia in the early stages.

Keywords: Parkinson's disease; dementia; hippocampal atrophy; volumetry.

Figure 1

Flow diagram summarizing the criteria for selecting eligible studies under PRISMA. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta‐Analyses.

Figure 2

The forest plot of comparison of raw hippocampal volume between PDD and PD, illustrating statistical differences in the hippocampal volume. PD, Parkinson's disease; PDD, Parkinson's disease with dementia.

Figure 3

The forest plot of comparison of normalized hippocampal volume between PDD and PD, demonstrating statistical differences in the hippocampal volume. PD, Parkinson's disease; PDD, Parkinson's disease with dementia.

Figure 4

(A) The funnel plot provides no evidence of publication bias, and Egger's regression test confirms this. (B) Sensitivity analysis indicates that omitting four studies significantly alters the effect size.

Figure 5

(A) The funnel plot demonstrates no publication bias, as confirmed by Egger's regression test. (B). Sensitivity analysis found no significant changes.