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Abstract

Objective

The objective of the current study was to compare the microstructural integrity of the white matter (WM) tracts in patients having Parkinson disease (PD) with and without psychosis (PD-P and PD-NP) through diffusion tensor imaging (DTI).

Methods

This cross-sectional study involved 48 PD-NP and 42 PD-P who were matched for age, sex, and education. Tract-based spatial statistics (TBSS) was used to compare several DTI metrics from the diffusion-weighted MRIs obtained through a 3-Tesla scanner. A set of neuropsychological tests was used for the cognitive evaluation of all patients.

Results

The severity and stage of PD were not statistically different between the groups. The PD-P group performed poorly in all the neuropsychological domains compared with the PD-NP group. TBSS analysis revealed widespread patterns of abnormality in the fractional anisotropy (FA) in the PD-P group, which also correlated with some of the cognitive scores. These tracts include inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, right parieto-occipital WM, body of the corpus callosum, and corticospinal tract.

Conclusion

This study provides novel insights into the putative role of WM tract abnormalities in the pathogenesis of PD-P by demonstrating significant alterations in several WM tracts. Additional longitudinal studies are warranted to confirm the findings of our research.

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Information & Authors

Information

Published In

Neurology®
Volume 94Number 18May 5, 2020
Pages: e1876-e1884
PubMed: 32317347

Publication History

Received: June 21, 2019
Accepted: November 15, 2019
Published online: April 21, 2020
Published in print: May 5, 2020

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Disclosure

A. Lenka has no financial disclosure to make. M. Ingalhalikar has received funding for research from the Science and Engineering Research Board (SERB), Government of India, Department of Science & Technology (DST), Department of Biotechnology (DBT), Government of India, and Ministry of Human Resource Development, Government of India. A. Shah has no financial disclosure to make. J. Saini has received funding for research from the Science and Engineering Research Board (SERB), Government of India, Department of Science & Technology (DST), Department of Biotechnology (DBT), Government of India, and Ministry of Human Resource Development, Government of India. S. S. Arumugham has received research grants from the Indian Council of Medical Research (ICMR) and Wellcome Trust–Department of Biotechnology (DBT) India Alliance Intermediate Fellowship. S. Hegde declares to have the following disclosure: Wellcome Trust–DBT India Alliance Intermediate Clinical Fellowship (IA/CPHI/17/1/503348). L. George has no financial disclosure to make. R. Yadav received research grants from the Indian Council of Medical Research (ICMR). P. K. Pal reports personal fees from honoraria for participating as faculty and giving lectures for Movement Disorders Teaching Courses from the International Parkinson and Movement Disorder Society; other from reimbursement of travel expenses and honoraria to participate as faculty and give lectures at scientific meetings from the Taiwan Movement Disorder Society, Asian Oceanian Association of Neurology, and Korean Movement Disorders Society; other from reimbursement of travel expenses to participate as faculty and give lectures at scientific meetings from the International Association of Parkinsonism and Related Disorders, International Parkinson and Movement Disorder Society, and MDS-AOS; and grants from the Indian Council of Medical Research, Department of Science & Technology, Department of Biotechnology, and Science and Engineering Research Board, India paid to the Institute, outside the submitted work. Go to Neurology.org/N for full disclosures.

Study Funding

This study is part of a project funded by the Indian Council of Medical Research (ICMR) (ICMR/003/304/2013/00694). Symbiosis International University has received partial support from DST SERB (ECR/2016/000808) for setting up the computing facility. The authors thank CDAC BRAF for providing its parallel computing facility.

Authors

Affiliations & Disclosures

Abhishek Lenka, MBBS, PhD https://orcid.org/0000-0003-0725-636X
From the Department of Clinical Neurosciences (A.L.); Department of Neurology (A.L., L.G., R.Y., P.K.P.); Department of Neuroimaging and Interventional Radiology (J.S.); Department of Psychiatry (S.S.A.); Department of Clinical Psychology (S.H.), National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India; Symbiosis Center for Medical Image Analysis (M.I., A.S.), Symbiosis Institute of Technology (M.I.), Symbiosis International (Deemed University), Lavale, India; and Department of Neurology (A.L.), MedStar Georgetown University Hospital, Washington, DC.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Madhura Ingalhalikar, PhD
From the Department of Clinical Neurosciences (A.L.); Department of Neurology (A.L., L.G., R.Y., P.K.P.); Department of Neuroimaging and Interventional Radiology (J.S.); Department of Psychiatry (S.S.A.); Department of Clinical Psychology (S.H.), National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India; Symbiosis Center for Medical Image Analysis (M.I., A.S.), Symbiosis Institute of Technology (M.I.), Symbiosis International (Deemed University), Lavale, India; and Department of Neurology (A.L.), MedStar Georgetown University Hospital, Washington, DC.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
1. SERB 2016/0008/08 (PI) 2017-2020. 2. DBT BT/PR27340/MED/122/130/2018 (PI) 2019-2022.
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Apurva Shah, MTech
From the Department of Clinical Neurosciences (A.L.); Department of Neurology (A.L., L.G., R.Y., P.K.P.); Department of Neuroimaging and Interventional Radiology (J.S.); Department of Psychiatry (S.S.A.); Department of Clinical Psychology (S.H.), National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India; Symbiosis Center for Medical Image Analysis (M.I., A.S.), Symbiosis Institute of Technology (M.I.), Symbiosis International (Deemed University), Lavale, India; and Department of Neurology (A.L.), MedStar Georgetown University Hospital, Washington, DC.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Jitender Saini, MBBS, MD, DM
From the Department of Clinical Neurosciences (A.L.); Department of Neurology (A.L., L.G., R.Y., P.K.P.); Department of Neuroimaging and Interventional Radiology (J.S.); Department of Psychiatry (S.S.A.); Department of Clinical Psychology (S.H.), National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India; Symbiosis Center for Medical Image Analysis (M.I., A.S.), Symbiosis Institute of Technology (M.I.), Symbiosis International (Deemed University), Lavale, India; and Department of Neurology (A.L.), MedStar Georgetown University Hospital, Washington, DC.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
Science and engineering research board, Order No: EMR/2017/004523, 2018 Department of science and technology, Govt of India. Role: Primary investigator
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Shyam Sundar Arumugham, MD
From the Department of Clinical Neurosciences (A.L.); Department of Neurology (A.L., L.G., R.Y., P.K.P.); Department of Neuroimaging and Interventional Radiology (J.S.); Department of Psychiatry (S.S.A.); Department of Clinical Psychology (S.H.), National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India; Symbiosis Center for Medical Image Analysis (M.I., A.S.), Symbiosis Institute of Technology (M.I.), Symbiosis International (Deemed University), Lavale, India; and Department of Neurology (A.L.), MedStar Georgetown University Hospital, Washington, DC.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
1. Indian Council of Medical Research - Principal Investigator 2. Canadian Institute of Health Research - Co-investigator
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
Wellcome Trust/Indian Alliance Intermediate Fellowship
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Shantala Hegde, MPhil, PhD
From the Department of Clinical Neurosciences (A.L.); Department of Neurology (A.L., L.G., R.Y., P.K.P.); Department of Neuroimaging and Interventional Radiology (J.S.); Department of Psychiatry (S.S.A.); Department of Clinical Psychology (S.H.), National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India; Symbiosis Center for Medical Image Analysis (M.I., A.S.), Symbiosis Institute of Technology (M.I.), Symbiosis International (Deemed University), Lavale, India; and Department of Neurology (A.L.), MedStar Georgetown University Hospital, Washington, DC.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
Recipient of Wellcome Trust-DBT India Alliance Intermediate Clinical Fellowship (IA/CPHI/17/1/503348)
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Lija George, MTech
From the Department of Clinical Neurosciences (A.L.); Department of Neurology (A.L., L.G., R.Y., P.K.P.); Department of Neuroimaging and Interventional Radiology (J.S.); Department of Psychiatry (S.S.A.); Department of Clinical Psychology (S.H.), National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India; Symbiosis Center for Medical Image Analysis (M.I., A.S.), Symbiosis Institute of Technology (M.I.), Symbiosis International (Deemed University), Lavale, India; and Department of Neurology (A.L.), MedStar Georgetown University Hospital, Washington, DC.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Ravi Yadav, MBBS, MD, DM
From the Department of Clinical Neurosciences (A.L.); Department of Neurology (A.L., L.G., R.Y., P.K.P.); Department of Neuroimaging and Interventional Radiology (J.S.); Department of Psychiatry (S.S.A.); Department of Clinical Psychology (S.H.), National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India; Symbiosis Center for Medical Image Analysis (M.I., A.S.), Symbiosis Institute of Technology (M.I.), Symbiosis International (Deemed University), Lavale, India; and Department of Neurology (A.L.), MedStar Georgetown University Hospital, Washington, DC.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
Associate Editor of Annals of Movement Disorders from 2017
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
Funding from Indian Council of Medical Research
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Pramod Kumar Pal, MBBS, MD, DNB, DM
From the Department of Clinical Neurosciences (A.L.); Department of Neurology (A.L., L.G., R.Y., P.K.P.); Department of Neuroimaging and Interventional Radiology (J.S.); Department of Psychiatry (S.S.A.); Department of Clinical Psychology (S.H.), National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India; Symbiosis Center for Medical Image Analysis (M.I., A.S.), Symbiosis Institute of Technology (M.I.), Symbiosis International (Deemed University), Lavale, India; and Department of Neurology (A.L.), MedStar Georgetown University Hospital, Washington, DC.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
Received reimbursement of travel expenses to participate as faculty at scientific meetings organized by Taiwan Movement Disorder Society, Asian Oceanian Association of Neurology, Korean Movement Disorders Society, International Association of Parkinsonism and Related Disorders, International Parkinson & Movement Disorder Society, MDS-AOS, Hunter Postgraduate Medical Institute (HPMI), University of Newcastle, Australia, Society of Neurologists of Bangladesh, and speaker honoraria from International Parkinson & Movement Disorder Society for participating as faculty in Movement Disorders Teaching Courses.
Editorial Boards:
1.
Editor-in-Chief of Annals of Movement Disorders Since 1 year No compensation
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
Received research grants (funded to the Institiute) from Indian Council of Medical Research (ICMR), Department of Science & Technology (DST), Department of Biotechnology (DBT), Science & Engineering Research Board (SERB), India.
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
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Correspondence Dr. Pal [email protected]
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

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