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  • Title: In vivo cholinergic basal forebrain degeneration and cognition in Parkinson's disease: Imaging results from the COPPADIS study.
    Author: Grothe MJ, Labrador-Espinosa MA, Jesús S, Macías-García D, Adarmes-Gómez A, Carrillo F, Camacho EI, Franco-Rosado P, Lora FR, Martín-Rodríguez JF, Barberá MA, Pastor P, Arroyo SE, Vila BS, Foraster AC, Martínez JR, Padilla FC, Morlans MP, Aramburu IG, Ceberio JI, Vara JH, de Fábregues-Boixar O, de Deus Fonticoba T, Pascual-Sedano B, COPPADIS Study Group, Kulisevsky J, Martínez-Martín P, Santos-García D, Mir P.
    Journal: Parkinsonism Relat Disord; 2021 Jul; 88():68-75. PubMed ID: 34144230.
    Abstract:
    INTRODUCTION: We aimed to assess associations between multimodal neuroimaging measures of cholinergic basal forebrain (CBF) integrity and cognition in Parkinson's disease (PD) without dementia. METHODS: The study included a total of 180 non-demented PD patients and 45 healthy controls, who underwent structural MRI acquisitions and standardized neurocognitive assessment through the PD-Cognitive Rating Scale (PD-CRS) within the multicentric COPPADIS-2015 study. A subset of 73 patients also had Diffusion Tensor Imaging (DTI) acquisitions. Volumetric and microstructural (mean diffusivity, MD) indices of CBF degeneration were automatically extracted using a stereotactic CBF atlas. For comparison, we also assessed multimodal indices of hippocampal degeneration. Associations between imaging measures and cognitive performance were assessed using linear models. RESULTS: Compared to controls, CBF volume was not significantly reduced in PD patients as a group. However, across PD patients lower CBF volume was significantly associated with lower global cognition (PD-CRStotal: r = 0.37, p < 0.001), and this association remained significant after controlling for several potential confounding variables (p = 0.004). Analysis of individual item scores showed that this association spanned executive and memory domains. No analogue cognition associations were observed for CBF MD. In covariate-controlled models, hippocampal volume was not associated with cognition in PD, but there was a significant association for hippocampal MD (p = 0.02). CONCLUSIONS: Early cognitive deficits in PD without dementia are more closely related to structural MRI measures of CBF degeneration than hippocampal degeneration. In our multicentric imaging acquisitions, DTI-based diffusion measures in the CBF were inferior to standard volumetric assessments for capturing cognition-relevant changes in non-demented PD.
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