Structural and Functional Changes in Mild Cognitive Impairment in Parkinson’s Disease
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participant Selection
2.2. Neuropsychological Measures
2.3. MRI Acquisition, Preprocessing and Analysis
2.4. Statistical Analysis
3. Results
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Total | HC | PDMCI | p | ||
---|---|---|---|---|---|
(n = 52) | (n = 26) | (n = 26) | |||
Age, mean (SD.) | 67.77 (7.38) | 67.77 (7.48) | 67.77 (7.44) | 0.999 ᵗ | |
Gender (female), n (%) | 20 (38.5) | 12 (46.2) | 8 (30.8) | 0.393 ᶜ | |
Education, median (min/max) | 11 (2/15) | 12 (5/15) | 9 (2/15) | 0.155 ᵘ | |
Hand dominance (right), n (%) | 51 (98.1) | 26 (100) | 25 (96.2) | 0.999 ᶠ | |
PDMCI domain (nonamnestic), n (%) | 2 (7.7) | 0 (0) | 2 (7.7) | - | |
Years, median (min/max) | 3 (1/25) | - | 3 (1/25) | - | |
Hoehn Yahr, median (min/max) | 2 (1.5/5) | - | 2 (1.5/5) | - | |
UPDRS motor, median (min/max) | 24 (3/40) | - | 24 (3/40) | - | |
Levodopa equivalent daily dose (mg), median (min/max) | 500 (100/1257) | - | 500 (100/1257) | - | |
PD meds, n (%) | - | ||||
L-dopa | 10 (38.5) | 0 (0) | 10 (38.5) | ||
Dopamine agonist | 2 (7.7) | 0 (0) | 2 (7.7) | ||
MAO-B | 2 (7.7) | 0 (0) | 2 (7.7) | ||
Combined | 12 (46.2) | 0 (0) | 12 (46.2) |
Total | HC | PD-MCI | p | |
---|---|---|---|---|
(n = 52) | (n = 26) | (n = 26) | ||
Montreal Cognitive Assessment total score, median (min/max) | 23 (9/29) | − | 23 (9/29) | - |
MMSE-pentagon figure, n (%) | 44 (84.6) | 25 (96.2) | 19 (73.1) | 0.049 ᶠ |
Yesavage Geriatric Depression Scale total score, median (min/max) | 5 (0/13) | 5 (0/13) | 6 (0/13) | 0.512 ᵘ |
Mini Mental State Examination total score, median (min/max) | 29 (19/30) | 29 (27/30) | 28 (19/30) | <0.001 ᵘ |
Trail Making Test, Part A (total duration—second—to complete the task), mean (SD.) | 73.73 (34.23) | 51.28 (11.04) | 96.18 (34.93) | 0.001 ᵗ |
Benton Line Orientation Test total score, median (min/max) | 19 (11/30) | 22.26 (13/30) | 16.22 (11/23) | <0.001 ᵘ |
Clock Drawing total score, median (min/max) | 10 (0/10) | 10 (8/10) | 10 (0/10) | 0.016 ᵘ |
Z_Trail Making Test, Part A (total duration— seconds—to complete the task), mean (SD.) | 2.03 (3.1) | 0 (1) | 4.07 (3.16) | 0.001 ᵗ |
Z_Benton Line Orientation Test total score, median (min/max) | −0.74 (−2.55/1.75) | 0 (−2.1/1.75) | −1.37 (−2.55/0.17) | <0.001 ᵘ |
Z_MMSE-pentagon figure, median (min/max) | −0.57 (−4.8/0.2) | 0.01 (−4.8/0.2) | −1 (−4.8/0.2) | 0.048 ᵘ |
Z_Clock Drawing total score, median (min/max) | 0.28 (−22.98/0.28) | 0.01 (−4.37/0.28) | −1.5 (−22.98/0.28) | 0.016 ᵘ |
Visuospatial skills, median (min/max) | 0.09 (−6.23/1.25) | 0.1 (−1.28/0.61) | 0.08 (−6.23/1.25) | 0.768 ᵘ |
Gray matter volume, mean (SD.) | 41.63 (2.72) | 42.08 (2.36) | 41.18 (3.02) | 0.249 ᵗ |
White matter volume, mean (SD.) | 35.82 (2.65) | 36.62 (2.4) | 35.01 (2.69) | 0.030 ᵗ |
Total brain volume, mean (SD.) | 77.45 (4.01) | 78.7 (3.12) | 76.19 (4.45) | 0.028 ᵗ |
Total | HC | PDMCI | p | Total | HC | PD-MCI | p | |
---|---|---|---|---|---|---|---|---|
(n = 52) | (n = 26) | (n = 26) | (n = 52) | (n = 26) | (n = 26) | |||
Left | Right | |||||||
Mean (SD.) or Median (Min/Max) | Mean (SD.) or Median (Min/Max) | |||||||
Superior Frontal Gyrus | 1.9 (0.14) | 1.9 (0.12) | 1.91 (0.16) | 0.985 ᵗ | 1.86(1.53/2.19) | 1.85(1.73/2.16) | 1.88(1.53/2.19) | 0.768 ᵘ |
Middle Frontal Gyrus | 1.41 (0.13) | 1.41 (0.11) | 1.42 (0.15) | 0.797 ᵗ | 1.44 (0.12) | 1.44 (0.11) | 1.43 (0.13) | 0.765 ᵗ |
Inferior Frontal Gyrus | 0.66 (0.06) | 0.66 (0.06) | 0.66 (0.07) | 0.651 ᵗ | 0.72 (0.07) | 0.71 (0.06) | 0.72 (0.08) | 0.974 ᵗ |
Precentral Gyrus | 0.74 (0.08) | 0.75 (0.07) | 0.73 (0.09) | 0.281 ᵗ | 0.73 (0.07) | 0.73 (0.07) | 0.72 (0.08) | 0.714 ᵗ |
Middle Orbitofrontal Gyrus | 0.34 (0.03) | 0.34 (0.03) | 0.34 (0.04) | 0.894 ᵗ | 0.35 (0.03) | 0.35 (0.02) | 0.35 (0.04) | 0.756 ᵗ |
Lateral Orbitofrontal Gyrus | 0.23 (0.02) | 0.23 (0.02) | 0.23 (0.03) | 0.876 ᵗ | 0.2 (0.02) | 0.2 (0.01) | 0.19 (0.03) | 0.272 ᵗ |
Gyrus Rectus | 0.13 (0.01) | 0.13 (0.01) | 0.13 (0.01) | 0.516 ᵗ | 0.13 (0.01) | 0.13 (0.01) | 0.13 (0.01) | 0.908 ᵗ |
Postcentral Gyrus | 0.62 (0.07) | 0.63 (0.07) | 0.61 (0.08) | 0.272 ᵗ | 0.58 (0.07) | 0.59 (0.06) | 0.58 (0.07) | 0.644 ᵗ |
Superior Parietal Gyrus | 0.77 (0.07) | 0.76 (0.07) | 0.78 (0.06) | 0.512 ᵗ | 0.76 (0.08) | 0.76 (0.08) | 0.77 (0.09) | 0.892 ᵗ |
Supramarginal Gyrus | 0.48 (0.05) | 0.49 (0.04) | 0.47 (0.06) | 0.135 ᵗ | 0.47 (0.05) | 0.48 (0.05) | 0.47 (0.06) | 0.450 ᵗ |
Angular Gyrus | 0.63 (0.07) | 0.64 (0.06) | 0.61 (0.07) | 0.122 ᵗ | 0.68 (0.06) | 0.7 (0.06) | 0.67 (0.06) | 0.050 ᵗ |
Precuneus | 0.44 (0.04) | 0.44 (0.04) | 0.44 (0.05) | 0.704 ᵗ | 0.44 (0.05) | 0.44 (0.05) | 0.44 (0.05) | 0.691 ᵗ |
Superior Occipital Gyrus | 0.23 (0.03) | 0.24 (0.02) | 0.23 (0.03) | 0.178 ᵗ | 0.26 (0.03) | 0.27 (0.03) | 0.25 (0.03) | 0.041 ᵗ |
Middle Occipital Gyrus | 0.75 (0.07) | 0.77 (0.07) | 0.72 (0.06) | 0.029 ᵗ | 0.77 (0.08) | 0.79 (0.07) | 0.76 (0.08) | 0.159 ᵗ |
Inferior Occipital Gyrus | 0.41(0.33/0.49) | 0.41(0.34/0.47) | 0.38(0.33/0.49) | 0.091 ᵘ | 0.41 (0.04) | 0.41 (0.03) | 0.41 (0.04) | 0.943 ᵗ |
Cuneus | 0.21 (0.02) | 0.21 (0.02) | 0.21 (0.03) | 0.844 ᵗ | 0.23(0.16/0.26) | 0.23(0.16/0.26) | 0.22(0.17/0.26) | 0.406 ᵘ |
Superior Temporal Gyrus | 1.06 (0.09) | 1.09 (0.09) | 1.04 (0.1) | 0.074 ᵗ | 0.99 (0.1) | 1.02 (0.09) | 0.97 (0.11) | 0.104 ᵗ |
Middle Temporal Gyrus | 0.9 (0.09) | 0.91 (0.09) | 0.89 (0.09) | 0.290 ᵗ | 0.94 (0.1) | 0.96 (0.1) | 0.93 (0.09) | 0.152 ᵗ |
Inferior Temporal Gyrus | 0.84 (0.08) | 0.85 (0.07) | 0.83 (0.08) | 0.285 ᵗ | 0.9 (0.09) | 0.91 (0.08) | 0.89 (0.09) | 0.586 ᵗ |
Parahippocampal Gyrus | 0.25 (0.02) | 0.25 (0.02) | 0.25 (0.02) | 0.986 ᵗ | 0.26 (0.02) | 0.26 (0.02) | 0.26 (0.02) | 0.946 ᵗ |
Lingual Gyrus | 0.48 (0.05) | 0.49 (0.05) | 0.47 (0.05) | 0.145 ᵗ | 0.49 (0.05) | 0.5 (0.04) | 0.48 (0.05) | 0.089 ᵗ |
Fusiform Gyrus | 0.54 (0.05) | 0.54 (0.05) | 0.53 (0.05) | 0.331 ᵗ | 0.53 (0.05) | 0.53 (0.05) | 0.52 (0.05) | 0.493 ᵗ |
Insula | 0.37 (0.03) | 0.37 (0.03) | 0.37 (0.04) | 0.769 ᵗ | 0.37(0.29/0.42) | 0.37(0.29/0.42) | 0.36(0.3/0.41) | 0.704 ᵘ |
Cingulate Gyrus | 0.52 (0.05) | 0.52 (0.04) | 0.51 (0.06) | 0.252 ᵗ | 0.58 (0.05) | 0.59 (0.05) | 0.58 (0.06) | 0.416 ᵗ |
Caudate | 0.16 (0.03) | 0.16 (0.03) | 0.15 (0.02) | 0.194 ᵗ | 0.15 (0.02) | 0.16 (0.02) | 0.15 (0.02) | 0.118 ᵗ |
Putamen | 0.23 (0.03) | 0.23 (0.03) | 0.23 (0.02) | 0.258 ᵗ | 0.23 (0.02) | 0.24 (0.03) | 0.22 (0.02) | 0.088 ᵗ |
Hippocampus | 0.23 (0.03) | 0.23 (0.02) | 0.22 (0.03) | 0.150 ᵗ | 0.24 (0.03) | 0.24 (0.03) | 0.23 (0.03) | 0.217 ᵗ |
Reference: PD-MCI | Cut Off | Sensitivity | Specificity | +PV | −PV | AUC ± SE. | p Value |
---|---|---|---|---|---|---|---|
Mini Mental State Examination total score | ≤26 | 38.46 | 100.00 | 100.0 | 61.9 | 0.763 ± 0.066 | <0.001 |
Trail Making Test, Part A (total duration—seconds—to complete the task) | >65 | 80.77 | 92.31 | 91.3 | 82.8 | 0.922 ± 0.038 | <0.001 |
Benton Line Orientation Test total score | ≤20 | 88.46 | 76.92 | 79.3 | 87.0 | 0.853 ± 0.056 | <0.001 |
Clock Drawing total score | ≤8 | 30.77 | 96.15 | 88.9 | 58.1 | 0.626 ± 0.078 | 0.108 |
Z_Trail Making Test, Part A (total duration—seconds—to complete the task) | >1.24 | 80.77 | 92.31 | 91.3 | 82.8 | 0.922 ± 0.038 | <0.001 |
Z_Benton Line Orientation Test total score | ≤−0.05 | 88.46 | 76.92 | 79.3 | 87.0 | 0.853 ± 0.056 | <0.001 |
Z_MMSE-pentagon Figure | ≤−4.8 | 26.92 | 96.15 | 87.5 | 56.8 | 0.615 ± 0.079 | 0.142 |
Z_Clock Drawing total score | ≤−4.37 | 30.77 | 96.15 | 88.9 | 58.1 | 0.626 ± 0.078 | 0.108 |
White matter volume | ≤36.39 | 80.77 | 57.69 | 65.6 | 75.0 | 0.694 ± 0.074 | 0.009 |
Total brain volume | ≤74.02 | 38.46 | 96.15 | 90.9 | 61.0 | 0.666 ± 0.076 | 0.030 |
Right angular gyrus | ≤0.64 | 46.15 | 84.62 | 75.0 | 61.1 | 0.661 ± 0.076 | 0.034 |
Right superior occipital gyrus | ≤0.25 | 57.69 | 76.92 | 71.4 | 64.5 | 0.651 ± 0.077 | 0.049 |
Left middle occipital gyrus | ≤0.69 | 38.46 | 92.31 | 83.3 | 60.0 | 0.683 ± 0.074 | 0.013 |
Left inferior occipital gyrus | ≤0.38 | 46.15 | 92.31 | 85.7 | 63.2 | 0.639 ± 0.080 | 0.083 |
Left superior temporal gyrus | ≤1 | 46.15 | 84.62 | 75.0 | 61.1 | 0.649 ± 0.077 | 0.053 |
Right lingual gyrus | ≤0.49 | 69.23 | 61.54 | 64.3 | 66.7 | 0.633 ± 0.078 | 0.089 |
Right putamen | ≤0.24 | 84.62 | 42.31 | 59.5 | 73.3 | 0.633 ± 0.078 | 0.088 |
Dependent Reference Group: (PD-MCI) | Trail Making Test, Part A (Total Duration in Seconds to Complete the Task), Adjusted | |||
---|---|---|---|---|
Odds Ratio | 95% C.I. for Odds Ratio | p | ||
Lower | Upper | |||
Mini Mental State Examination total score (≤26) | 5.5 | 0.9 | 35.0 | 0.069 |
Trail Making Test, Part A (total duration—seconds—to complete the task) (>65) | 92.2 | 5.5 | 1535.0 | 0.002 |
Benton Line Orientation Test total score (≤20) | 13.4 | 1.9 | 96.4 | 0.010 |
White matter volume (≤36.39) | 13.5 | 1.1 | 169.5 | 0.044 |
Total brain volume (≤74.02) | 30.2 | 1.8 | 503.3 | 0.018 |
Predicted ratio | Cut point | PDMCI | HC | All |
0.5 | 88.5 | 92.3 | 90.4 |
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Güllüoğlu, H.; Hünerli, D.; Çakmur, R.; Çolakoğlu, B.D.; Ada, E.; Yener, G. Structural and Functional Changes in Mild Cognitive Impairment in Parkinson’s Disease. Medicina 2024, 60, 33. https://0-doi-org.brum.beds.ac.uk/10.3390/medicina60010033
Güllüoğlu H, Hünerli D, Çakmur R, Çolakoğlu BD, Ada E, Yener G. Structural and Functional Changes in Mild Cognitive Impairment in Parkinson’s Disease. Medicina. 2024; 60(1):33. https://0-doi-org.brum.beds.ac.uk/10.3390/medicina60010033
Chicago/Turabian StyleGüllüoğlu, Halil, Duygu Hünerli, Raif Çakmur, Berril Dönmez Çolakoğlu, Emel Ada, and Görsev Yener. 2024. "Structural and Functional Changes in Mild Cognitive Impairment in Parkinson’s Disease" Medicina 60, no. 1: 33. https://0-doi-org.brum.beds.ac.uk/10.3390/medicina60010033