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An MRI study of patients with Parkinson's disease with mild cognitive impairment and dementia using voxel based morphometry.

Beyer MK, Janvin CC, Larsen JP, Aarsland D

Stavanger University Hopital, Norway.

BACKGROUND: Dementia is common in Parkinson's disease (PD), but the underlying brain pathology is not yet fully understood. The purpose of this study is to examine the brain changes in PD patients with mild cognitive impairment (MCI) and dementia, using structural magnetic resonance imaging (MRI). METHODS: Using Voxel Based Morphometry (VBM) we studied grey matter atrophy on brain MRIs of patients with PD and dementia (PDD) (n=16) and PD without dementia (PDND) (n=20), and healthy elderly subjects (n=20). In the PDND group, 12 subjects had normal cognitive status, and 8 had MCI. Standardized rating scales for motor, cognitive and psychiatric symptoms were used. RESULTS: We found widespread areas of cortical atrophy in PDD compared with normal controls ( both temporal and frontal lobes and in the left parietal lobe). Grey matter reductions were found in both frontal, parietal, limbic and temporal lobes in patients with PDD compared with PDND patients. In PDND with MCI we found areas of reduced grey matter in the left frontal and both temporal lobes. CONCLUSION: These findings demonstrate that dementia in PD is associated with structural neocortical brain changes, and that cognitive impairment in non-demented PD patients may be associated with structural brain changes. Further studies with larger groups of patients are needed to confirm these findings.

Published 9 October 2006 in J Neurol Neurosurg Psychiatry.
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