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A Voxel-Based Morphometry Study

Christopher Summerfield, MSc; Carme Junqué, PhD; Eduardo Tolosa, MD; Pilar Salgado-Pineda, PhD; Beatriz Gómez-Ansón, MD, PhD, FRCR; Maria José Martí, MD; Pau Pastor, MD; Blanca Ramírez-Ruíz, MSc; José Mercader, MD

Arch Neurol. 2005;62:281-285.

Background  Parkinson disease with dementia (PDD) results from neuropathological changes in cortical and subcortical brain regions. Voxel-based morphometric analysis of magnetic resonance images can contribute to in vivo identification of the cerebral regions predominantly involved in PDD.

Objective  To identify structural cerebral regions most closely related to the presence of PDD.

Design  Magnetic resonance images were obtained from 16 patients who had PDD, 13 patients with PD without dementia, and 13 age-matched healthy control subjects. Gray matter volumes were compared using optimized voxel-based morphometric analyses.

Results  Compared with healthy controls, patients with PDD showed gray matter volume decreases in several of the following regions: bilateral putamen, accumbens nuclei, left side of the thalamus, bilateral hippocampus, parahippocampal region, and anterior cingulate gyrus. Patients with PD also showed gray matter reductions compared with healthy controls in the right side of the hippocampus, left anterior cingulate gyrus, and left superior temporal gyrus.

Conclusions  The hippocampus, thalamus, and anterior cingulate are the regions most affected in PDD. Our results agree with recent neuropathological findings suggesting the involvement of the limbic and cortical areas in PD.

Author Affiliations: Department de Psiquiatria i Psicobiologia, Universitat de Barcelona (Mr Summerfield, Drs Junqué and Salgado-Pineda, and Ms Ramírez-Ruíz), Institut d’Investigacions Biomèdiques August Pi i Sunyer (Drs Junqué, Tolosa, Gómez-Ansón, Martí, and Mercader); Parkinson’s Disease and Movement Disorders Unit, Neurology Service, Institut Clínic de Malalties del Sistema Nerviós, Hospital Clínic de Barcelona (Drs Tolosa, Martí, and Pastor); and the Centre de Diagnòstic per la Imatge, Hospital Clínic de Barcelona (Drs Gómez-Ansón and Mercader), Barcelona, Spain.

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