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The topography of brain damage at different stages of Parkinson's disease
Authors:Federica Agosta  Elisa Canu  Tanja Stojković  Michela Pievani  Aleksandra Tomić  Lidia Sarro  Nataša Dragašević  Massimiliano Copetti  Giancarlo Comi  Vladimir S. Kostić  Massimo Filippi
Affiliation:1. Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita‐Salute San Raffaele University, , Milan, Italy;2. Clinic of Neurology, Faculty of Medicine, University of Belgrade, , Belgrade, Serbia;3. Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita‐Salute San Raffaele University, , Milan, Italy;4. Biostatistics Unit, IRCCS‐Ospedale Casa Sollievo della Sofferenza, , San Giovanni Rotondo, Foggia, Italy
Abstract:This study investigated gray matter (GM) and white matter (WM) damage in 89 patients at different clinical stages of Parkinson's disease (PD) (17 early, 46 mild, 14 moderate, and 12 severe) to differentiate the trajectories of tissue injury in this condition. PD patients had a very little GM atrophy even at the more advanced stages of the disease. Microstructural damage to the WM occurs with increasing PD severity and involves the brainstem, thalamocortical pathways, olfactory tracts, as well as the major interhemispheric, limbic, and extramotor association tracts. The most marked WM damage was found in moderate vs. mild cases. WM damage correlated with the degree of global cognitive deficits. WM abnormalities beyond the nigrostriatal system accumulate with increasing PD severity. WM damage is likely to contribute to the more severe motor and nonmotor dysfunctions occurring in patients at the later stages. Hum Brain Mapp 34:2798–2807, 2013. © 2012 Wiley Periodicals, Inc.
Keywords:Parkinson's disease  white matter damage  DT MRI  brain atrophy  VBM
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