Objective: By using a novel disease staging model to investigate the progression and clinical associations of cortical thinning in Parkinson’s disease (PD) patients.

Background: The pathological progression of PD develops to affect cerebral cortical regions and previous studies have reported cortical thinning in PD. However, the relationship between cortical thinning with disease progression and clinical correlates remains unclear.

Methods: We analysed T1-weighted MRI images from 80 age-matched non-demented PD patients using FreeSurfer image analysis suite. We used a novel Disease Burden Score (DBS), which incorporated disease duration and motor dysfunction scores [Hoehn and Yahr (H&Y) OFF and Unified Parkinson’s disease Rating Scale (UPDRS)-III OFF], and we divided Parkinson’s patients into 3 groups: (1) early PD (n=27) low DBS: <200 (reflecting H&Y 1-2, average UPDRS-III of 21, average disease duration 3 years); (2) moderate PD (n=27) medium DBS: 221-900 (reflecting H&Y 2-3, average UPDRS-III of 32, average disease duration 7 years); and (3) advanced PD (n=26) high DBS: >901 (reflecting H&Y 3-4, average UPDRS-III of 49, average disease duration 13 years). We compared whole-brain surfaced-based cortical thickness measures and deep grey matter nuclei volumes between the 3 groups and assessed for associations with clinical measures including Mini Mental State Examination (MMSE).

Results: PD patients in the advanced group showed significant cortical thinning in the superior and inferior parietal, precuneus, superior and inferior temporal gyrus, lingual gyrus, pericalcarine, cuneus, lateral occipital cortex, precentral, postcentral and paracentral cortex; and significant loss of subcortical nuclei volume in the thalamus and caudate compared to the early stage PD group. Increasing DBS was significantly associated with degeneration in the parietal (superior and inferior parietal cortex), temporal (superior and inferior temporal gyrus, precuneus cortex), occipital (lingual gyrus, pericalcarine, cuneus, lateral occipital cortex), central motor regions (postcentral and paracentral), thalamus and caudate. Furthermore, decline in MMSE scores correlated with cortical thinning in the superior temporal gyrus, inferior parietal cortex and precuneus cortex.

Conclusions: Our findings demonstrate that as PD advances patients exhibit cortical thinning that correlates with increased motor dysfunction and could contribute to cognitive dysfunction.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/staging-and-clinical-correlates-of-cortical-thinning-in-parkinsons-disease/