Whole-Brain Diffusion-Tensor Changes in Parkinsonian Patients with Impulse Control Disorders
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Background and Purpose The aim of this study was to determine the changes in diffusiontensor images associated with medication-related impulse control disorder (ICD) in Parkinson’sdisease (PD) patients undergoing chronic dopamine-replacement therapy. Methods Nineteen PD patients, comprising 10 with ICD (PD-ICD) and 9 without ICD (PDnonICD), and 18 age-matched healthy controls (HCs) with no cognitive or other psychiatricdisorders were analyzed. All subjects underwent 3-T magnetic resonance diffusion-tensor imaging. For all PD patients, clinical data on PD duration, antiparkinsonian medication dosages,Unified Parkinson’s Disease Rating Scale and Mini-Mental State Examination were collected. Whole-brain voxel-based measures of fractional anisotropy (FA) and mean diffusivity (MD)were analyzed. Results In comparison with HCs, the PD-nonICD subjects had low FA at the bilateral orbitofrontal areas. While the PD-ICD subjects exhibited no such difference, their FA was significantly elevated at the anterior corpus callosum. Analysis of FA between the two PD groups revealed that FA in the anterior corpus callosum, right internal capsule posterior limbs, rightposterior cingulum, and right thalamic radiations were significantly higher (corrected p<0.05)in the PD-ICD than in the PD-nonICD patients. MD did not differ between the PD-ICD andPD-nonICD groups in any brain regions. Conclusions The PD-ICD patients appear to have relatively preserved white-matter integrityin the regions involved in reward-related behaviors compared to PD-nonICD patients. Furtherinvestigation is required to determine whether the difference in FA between PD-ICD and PDnonICD patients reflects microstructural differences in the pathological progression of PD or issecondary to ICD.
Abstract
Background and Purpose The aim of this study was to determine the changes in diffusiontensor images associated with medication-related impulse control disorder (ICD) in Parkinson’sdisease (PD) patients undergoing chronic dopamine-replacement therapy. Methods Nineteen PD patients, comprising 10 with ICD (PD-ICD) and 9 without ICD (PDnonICD), and 18 age-matched healthy controls (HCs) with no cognitive or other psychiatricdisorders were analyzed. All subjects underwent 3-T magnetic resonance diffusion-tensor imaging. For all PD patients, clinical data on PD duration, antiparkinsonian medication dosages,Unified Parkinson’s Disease Rating Scale and Mini-Mental State Examination were collected. Whole-brain voxel-based measures of fractional anisotropy (FA) and mean diffusivity (MD)were analyzed. Results In comparison with HCs, the PD-nonICD subjects had low FA at the bilateral orbitofrontal areas. While the PD-ICD subjects exhibited no such difference, their FA was significantly elevated at the anterior corpus callosum. Analysis of FA between the two PD groups revealed that FA in the anterior corpus callosum, right internal capsule posterior limbs, rightposterior cingulum, and right thalamic radiations were significantly higher (corrected p<0.05)in the PD-ICD than in the PD-nonICD patients. MD did not differ between the PD-ICD andPD-nonICD groups in any brain regions. Conclusions The PD-ICD patients appear to have relatively preserved white-matter integrityin the regions involved in reward-related behaviors compared to PD-nonICD patients. Furtherinvestigation is required to determine whether the difference in FA between PD-ICD and PDnonICD patients reflects microstructural differences in the pathological progression of PD or issecondary to ICD.
참고문헌 (14)
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