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NEUROLOGY 2005;64:224-229
© 2005 American Academy of Neurology

Cerebral atrophy and its relation to cognitive impairment in Parkinson disease

A. Nagano-Saito, MD, PhD, Y. Washimi, MD, PhD, Y. Arahata, MD, PhD, T. Kachi, MD, PhD, J. P. Lerch, BA, A. C. Evans, PhD, A. Dagher, MD and K. Ito, MD, PhD

From Department of Neurology (Drs. Nagano-Saito, Washimi, Arahata, and Kachi), National Hospital for Geriatric Medicine, and Department of Brain Science and Molecular Imaging (Dr. Ito), National Institute for Longevity Sciences, National Center for Geriatrics and Gerontology, Obu, Japan; and McConnell Brain Imaging Centre (Drs. Nagano-Saito, Lerch, Evans, and Dagher), Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.

Address correspondence and reprint requests to Dr. Y. Arahata, Department of Neurology, National Center for Geriatrics and Gerontology, 36-3 Gengo, Morioka, Obu, Aichi, Japan 474-8511; e-mail: arahatay{at}nils.go.jp

Objective: Voxel-based morphometry was used to compare the amounts of gray matter in the brains of patients with Parkinson disease (PD) and normal control subjects (NCs) and to identify the specific regions responsible for cognitive dysfunction in PD.

Methods: Patients were classified into nondemented (ND) and demented (D) groups according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.), and a group comparison was performed. In the ND patients, a correlation was also performed between local gray matter density and the score on Raven Colored Progressive Matrices (RCPM), a test of executive and visuospatial function.

Results: In patients with advanced ND-PD vs NCs, atrophic changes were observed in the limbic/paralimbic areas and the prefrontal cortex. In D vs ND patients, atrophic change was observed widely in the limbic/paralimbic system, including the anterior cingulate gyrus and hippocampus as well as the temporal lobe, dorsolateral prefrontal cortex, thalamus, and caudate nucleus. The RCPM score was positively correlated with the gray matter density in the dorsolateral prefrontal cortex and the parahippocampal gyrus.

Conclusions: In patients with Parkinson disease (PD), atrophic changes occur mainly in the limbic/paralimbic and prefrontal areas. These atrophic changes may be related to the development of dementia in PD.

Supported by funds for Research on Health Science of Mind of Aging and Health from the Ministry and Welfare of Japan.

Received May 20, 2004. Accepted in final form September 29, 2004.




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