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Asymmetrical lateral ventricular enlargement in Parkinson's disease
Authors:M. M. Lewis  A. B. Smith  M. Styner  H. Gu  R. Poole  H. Zhu  Y. Li  X. Barbero  S. Gouttard  M. J. McKeown  R. B. Mailman   X. Huang
Affiliation:Department of Neurology, Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA, USA;;Department of Neurology, University of North Carolina, Chapel Hill, NC USA;;Department of Pharmacology, Pennsylvania State University College of Medicine, Hershey, PA;;Department of Computer Science, University of North Carolina, Chapel Hill, NC, USA;;Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA;;Department of Biostatistics, University of North Carolina, Chapel Hill, NC, USA;;and Department of Medicine (Neurology), Pacific Parkinson's Research Centre, University of British Columbia, Vancouver, BC, Canada
Abstract:Background:  A recent case report suggested the presence of asymmetrical lateral ventricular enlargement associated with motor asymmetry in Parkinson's disease (PD). The current study explored these associations further.
Methods:  Magnetic resonance imaging (3T) scans were obtained on 17 PD and 15 healthy control subjects at baseline and 12–43 months later. Baseline and longitudinal lateral ventricular volumetric changes were compared between contralateral and ipsilateral ventricles in PD subjects relative to symptom onset side and in controls relative to their dominant hand. Correlations between changes in ventricular volume and United Parkinson's disease rating scale motor scores (UPDRS-III) whilst on medication were determined.
Results:  The lateral ventricle contralateral to symptom onset side displayed a faster rate of enlargement compared to the ipsilateral ( P  = 0.004) in PD subjects, with no such asymmetry detected ( P  = 0.312) in controls. There was a positive correlation between ventricular enlargement and worsening motor function assessed by UPDRS-III scores ( r  = 0.96, P  < 0.001).
Discussion:  There is asymmetrical lateral ventricular enlargement that is associated with PD motor asymmetry and progression. Further studies are warranted to investigate the underlying mechanism(s), as well as the potential of using volumetric measurements as a marker for PD progression.
Keywords:lateral ventricular volume    motor asymmetry    semi-automatic segmentation    structural magnetic resonance imaging    Parkinson's disease
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