Thalamic volume mediates associations between cardiorespiratory fitness (VO2max) and cognition in Parkinson's disease |
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| Institution: | 1. Department of Cardiology, Angiology and Intensive Care, Klinikum Chemnitz gGmbH, Medizincampus Chemnitz der Technischen Universität Dresden, Dresden, Germany;2. Department of Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universität Dresden, Dresden, Germany;3. Medizinische Klinik und Poliklinik I, Klinikum der Universität, LMU Munich, 81377, Munich, Germany;4. German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, 80802, Munich, Germany;5. Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany;6. Movement Disorders Outpatient Clinic, Department of Molecular Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany;7. Center for Rare Movement Disorders, Department of Molecular Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany;8. Department of Neurology, St. Josef Hospital, Ruhr-University, Gudrunstraße 56, 44791, Bochum, Germany;9. Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität München, München, Germany;10. Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany;11. Translational Neurodegeneration Section “Albrecht-Kossel”, Department of Neurology, University Medical Center, University of Rostock, Rostock, Germany;12. DZNE, German Center for Neurodegenerative Diseases, Research Site Rostock/Greifswald, Rostock, Germany;13. Center for Transdisciplinary Neurosciences Rostock (CTNR), University Medical Center Rostock, University of Rostock, Rostock, Germany |
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| Abstract: | IntroductionCognitive deficits occur in Parkinson's disease (PD). Cardiorespiratory fitness (CRF) is associated with better cognitive performance in aging especially in executive function (EF) and memory. The association between CRF and cognitive performance is understudied in people with PD. Brain structures underlying associations also remains unknown. This cross-sectional study examined the associations between CRF and cognitive performance in PD. We also examined associations between CRF and brain structures impacted in PD. Mediation analysis were conducted to examine whether brain structures impacted in PD mediate putative associations between CRF and cognitive performance.MethodsIndividuals with PD (N = 33) underwent magnetic resonance imaging (MRI), CRF evaluation (estimated VO2max), and neuropsychological assessment. Composite cognitive scores of episodic memory, EF, attention, language, and visuospatial functioning were generated. Structural equation models were constructed to examine whether MRI volume estimates (thalamus and pallidum) mediated associations between CRF and cognitive performance (adjusting for age, education, PD disease duration, sex, MDS-UPDRS motor score, and total intracranial volume).ResultsHigher CRF was associated with better episodic memory (Standardized β = 0.391; p = 0.008), EF (Standardized β = 0.324; p = 0.025), and visuospatial performance (Standardized β = 0.570; p = 0.005). Higher CRF was associated with larger thalamic (Standardized β = 0.722; p = 0.004) and pallidum (Standardized β = 0.635; p = 0.004) volumes. Thalamic volume mediated the association between higher CRF and better EF (Indirect effect = 0.309) and episodic memory (Indirect effect = 0.209) performance (p < 0.05). The pallidum did not significantly mediate associations between CRF and cognitive outcomes.ConclusionThe thalamus plays an important role in the association between CRF and both EF and episodic memory in PD. |
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| Keywords: | Thalamus Cardiorespiratory fitness Cognition Structural magnetic resonance imaging MRI Imaging Exercise |
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