Subcortical microstructural diffusion changes correlate with gait impairment in Parkinson's disease. (June 2021)

• Record Type: Journal Article
• Authors: Surkont, Jakub; Joza, Stephen; Camicioli, Richard; Martin, W.R. Wayne; Wieler, Marguerite; Ba, Fang
• Is Part Of: Parkinsonism & related disorders. Volume 87(2021)
• Page Start: 111
• Page End: 118
• Publication Date: 2021-06
• Subjects: Parkinson's disease -- Gait impairments -- MRI -- Diffusion tensor imaging; Parkinson's disease -- Periodicals; Movement disorders -- Periodicals; Movement Disorders -- Periodicals; Nerve Degeneration -- Periodicals; Nervous System Diseases -- Periodicals; Parkinson Disease -- Periodicals; Tremor -- Periodicals; Parkinson, Maladie de -- Périodiques; Parkinson's disease; 616.833
• DOI: 10.1016/j.parkreldis.2021.05.005
• Languages: English
• ISSNs: 1353-8020

Abstract

Abstract: Background: Gait impairments are common in Parkinson's Disease (PD) and are likely caused by degeneration in multiple brain circuits, including the basal ganglia, thalamus and mesencephalic locomotion centers (MLC). Diffusion tensor imaging (DTI) assesses fractional anisotropy (FA) and mean diffusivity (MD) that reflect the integrity of neuronal microstructure. We hypothesized that DTI changes in motor circuits correlate with gait changes in PD. Objective: We aimed to identify microstructural changes of brain locomotion control centers in PD via DTI and their correlations with clinical and quantitative measures of gait. Methods: Twenty-one PD patients reporting gait impairment and 15 controls were recruited. Quantitative gait and clinical tests were recorded in PD subjects' medication ON and OFF states. Region of Interest (ROI) analysis of the thalamus, basal ganglia and MLC was performed using ExploreDTI. Correlations between FA/MD with clinical gait parameters were examined. Results: Microstructural changes were seen in the thalamus, caudate and MLC in the PD compared to the control group. Thalamic microstructural changes significantly correlated with gait parameters in the pace domain including the Timed Up and Go in the ON state. Caudate changes correlated with cadence and stride time in the OFF state. Conclusions: Our pilot study suggests that PD is associated with a characteristic regional pattern of microstructural degradation in the thalamus, caudate and MLC. The DTI changes may represent subcortical locomotion network failure. Overall, DTI ROI analyses might provide a useful tool for assessing PD for functional status and specific motor domains, such as gait, and potentially could serve as an imaging marker. Highlights: Diffusion tensor imaging analysis using a region of interest approach may provide an imaging marker to assess Parkinson gait. Microstructural changes occur in thalamus, caudate and mesencephalic locomotion centers in Parkinson's disease. Quantitative gait in the pace domain in the ON state correlated with microstructural changes in the thalamus. Rhythm measures in the OFF state correlated with microstructural changes in the caudate.