Early limbic microstructural alterations in apathy and depression in de novo Parkinson's disease.

Prange, Stéphane; Metereau, Elise; Maillet, Audrey; Lhommée, Eugénie; Klinger, Hélène; Pelissier, Pierre; Ibarrola, Danielle; Heckemann, Rolf A; Castrioto, Anna; Tremblay, Léon; Sgambato, Véronique; Broussolle, Emmanuel; Krack, Paul; Thobois, Stéphane (2019). Early limbic microstructural alterations in apathy and depression in de novo Parkinson's disease. Movement disorders, 34(11), pp. 1644-1654. Wiley-Blackwell 10.1002/mds.27793

Text Prange, 2019, Early limbic microstructural alterations in apath yand depression in de novo PD.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (1MB)

BACKGROUND

Whether structural alterations underpin apathy and depression in de novo parkinsonian patients is unknown. The objectives of this study were to investigate whether apathy and depression in de novo parkinsonian patients are related to structural alterations and how structural abnormalities relate to serotonergic or dopaminergic dysfunction.

METHODS

We compared the morphological and microstructural architecture in gray matter using voxel-based morphometry and diffusion tensor imaging coupled with white matter tract-based spatial statistics in a multimodal imaging case-control study enrolling 14 apathetic and 13 nonapathetic patients with de novo Parkinson's disease and 15 age-matched healthy controls, paired with PET imaging of the presynaptic dopaminergic and serotonergic systems.

RESULTS

De novo parkinsonian patients with apathy had bilateral microstructural alterations in the medial corticostriatal limbic system, exhibiting decreased fractional anisotropy and increased mean diffusivity in the anterior striatum and pregenual anterior cingulate cortex in conjunction with serotonergic dysfunction. Furthermore, microstructural alterations extended to the medial frontal cortex, the subgenual anterior cingulate cortex and subcallosal gyrus, the medial thalamus, and the caudal midbrain, suggesting disruption of long-range nondopaminergic projections originating in the brainstem, in addition to microstructural alterations in callosal interhemispheric connections and frontostriatal association tracts early in the disease course. In addition, microstructural abnormalities related to depressive symptoms in apathetic and nonapathetic patients revealed a distinct, mainly right-sided limbic subnetwork involving limbic and frontal association tracts.

CONCLUSIONS

Early limbic microstructural alterations specifically related to apathy and depression emphasize the role of early disruption of ascending nondopaminergic projections and related corticocortical and corticosubcortical networks which underpin the variable expression of nonmotor and neuropsychiatric symptoms in Parkinson's disease. © 2019 International Parkinson and Movement Disorder Society.

Interest & Impact

Downloads

1 since deposited on 14 Nov 2019
0 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item