Objective: To investigate whether non-motor symptoms burden is associated with cortical and subcortical morphological changes in PD patients.

Background: Non-motor symptoms are common aspects of Parkinson’s disease (PD) occurring in prodromal PD and greatly affecting the quality of life. The global impact of non-motor symptoms can be graded using the non-motor symptoms burden classification system and can be used to address the neural correlates of non-motor symptoms burden, which is an unmet need.

Methods: We studied 41 non-demented PD patients (24M, mean age: 64.0±9.3 years). Non-motor symptoms burden was assessed using the Non-Motor Symptoms Scale gradings (NMSS). Cortical thickness and subcortical nuclei volume analyses were carried out using the automated surface-based analysis package Free-Surfer (version 5.3.0). PD patients were divided into two groups according to the NMSS grading: mild to moderate (NMSS: 0-40) and severe (NMSS: ≥41) non-motor symptom burden.

Results: Thalamic atrophy was associated with worse NMSQ (r=−0.42, P=0.042) and NMSS (r=−0.47, P=0.014) total scores. The non-motor symptoms that drove this correlation were sleep/fatigue (r=−0.36, P=0.042) and gastrointestinal tract dysfunction (r=−0.36, P=0.042). When the PD patients were divided into two groups, we found that PD patients with severe non-motor symptom burden had significant thalamic atrophy compared to the group with mild to moderate non-motor symptom burden (P=0.048).

Conclusions: Our findings show that greater non-motor symptom burden is associated with thalamic atrophy in PD. Thalamus plays an important role in processing sensory information including visceral afferent from the gastrointestinal tract and in regulating states of sleep and wakefulness.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/non-motor-symptom-burden-is-associated-with-thalamic-atrophy-in-parkinsons-disease/