Longitudinal degeneration of the basal forebrain predicts subsequent dementia in Parkinson's disease.
Adult
Aged
Aged, 80 and over
Atrophy
Basal Forebrain
/ pathology
Case-Control Studies
Cognition
Cognitive Dysfunction
/ pathology
Dementia
/ pathology
Disease Progression
Female
Humans
Longitudinal Studies
Magnetic Resonance Imaging
Male
Middle Aged
Neuropsychological Tests
Parkinson Disease
/ pathology
Prospective Studies
Sweden
Young Adult
Basal forebrain
Cognitive decline
Dementia
Longitudinal MRI
Parkinson's disease
Journal
Neurobiology of disease
ISSN: 1095-953X
Titre abrégé: Neurobiol Dis
Pays: United States
ID NLM: 9500169
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
27
12
2019
revised:
05
02
2020
accepted:
03
03
2020
pubmed:
8
3
2020
medline:
13
4
2021
entrez:
8
3
2020
Statut:
ppublish
Résumé
Cholinergic dysfunction plays a prominent role in cognitive impairment in Parkinson's disease (PD). The aim of this study was to assess the relationship of baseline and longitudinal basal forebrain atrophy with cognitive decline and dementia in PD. We included 106 non-demented PD patients, 19 PD dementia (PDD) patients and 42 controls with longitudinal structural MRI and cognitive testing. After 4.2 ± 1.8 years, 20 non-demented PD patients were diagnosed with dementia (PD-dementia converters), whereas the rest of PD patients remained non-demented (stable-PD). We compared MRI volumes of the medial septum/diagonal band (Ch1/Ch2) and nucleus basalis of Meynert (Ch4) between groups. Cox regression analyses were applied to test whether Ch1/Ch2 or Ch4 atrophy could predict future dementia and linear mixed models assessed their association with cognitive decline. Compared to controls, we found reduced Ch4 baseline volumes in PD-dementia converters (p = .003) and those who already had PDD (p < .001) but not in stable-PD. Over time, there was a greater loss in Ch1/Ch2 volumes in PD-dementia converters and PDD compared to the other groups (p = .004). Baseline and longitudinal Ch4 volumes were associated with cognition (p < .002) and longitudinal Ch4 atrophy predicted future dementia (p = .009). Atrophy of Ch4 precedes and predicts future dementia in PD and is followed by changes in Ch1/Ch2, reflecting a posterior-anterior pattern of basal forebrain atrophy. This pattern could be used to track the spread of cholinergic degeneration and identify patients at risk of developing dementia.
Identifiants
pubmed: 32145376
pii: S0969-9961(20)30106-6
doi: 10.1016/j.nbd.2020.104831
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
104831Informations de copyright
Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest OH has acquired research support (for the institution) from Roche, GE Healthcare, Biogen, AVID Radiopharmaceuticals, Fujirebio, and Euroimmun. In the past 2 years, he has received consultancy/speaker fees (paid to the institution) from Biogen and Roche. The rest of authors have no conflicts of interest.