Reduced Gray Matter Volume and Risk of Falls in Parkinson’s Disease with Dementia Patients: A Voxel-Based Morphometry Study
Abstract
:1. Background
2. Materials and Methods
2.1. Subjects
2.2. Assessment of Clinical Disease Severity
2.3. Neuropsychological Tests (NPT)
2.4. MRI Image Acquisition
2.5. Voxel-Based Morphometry Processing
2.6. Statistical Analysis
2.6.1. Analysis of Demographic Data between Groups
2.6.2. Relationships among Disease Severity, Cognition Function, and Gray Matter Volume
3. Results
3.1. Clinical Characteristics, NPT, and Disease Severity among Groups
3.2. Regional Gray Matter Volume (GMV) Aberrations among Groups
3.2.1. Comparison between all PDD Patients and Normal Controls
3.2.2. Comparison between PDD without Fall and Control Groups, and between PDD with Fall and Control Groups
3.2.3. Comparison between the PDD with Fall and without Fall Groups
3.3. Relationship among Disease Severity Profiles, NPT, and Extracted Regional GMV from PDD Patients
4. Discussion
4.1. Brief Summary and Potential Implications
4.2. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Demographics | Normal Group | PDD | F + | p-Value + | ||
---|---|---|---|---|---|---|
With Fall | Without Fall | All Patients | ||||
Number of cases | 37 | 17 | 18 | 35 | ||
Sex (n = men/women) | 10/27 | 5 / 12 | 3 / 15 | 8/27 | 0.630 | |
Ages (years) | 63.1 ± 5.34 | 65.3 ± 5.99 | 62.8 ± 5.61 | 64.0 ± 5.85 | 1.112 | 0.335 |
Education | 9.95 ± 4.73 # | 5.53 ± 4.14 # | 6.72 ± 4.78 | 6.14 ± 4.45 | 6.416 | 0.003 |
MMSE | 26.7 ± 2.22§# | 19.2 ± 4.10 # | 21.1 ± 4.30 § | 20.1 ± 4.25 | 36.481 | <0.001 |
Neuropsychological domains | ||||||
Attention | 0.46 ± 0.48 § # | −0.70 ±-0.66 # | −0.30 ± 0.72 § | −0.49 ± 0.71 | 5.871 | <0.001 |
Executive function | 0.43 ± 0.76 § # | −0.54 ± 0.62 # | −0.41 ± 0.65 § | −0.48 ± 0.63 | 1.461 | <0.001 |
Memory | 0.41 ± 0.53 § # | −0.54 ± 0.85 # | −0.34 ± 0.65 § | −0.43 ± 0.75 | 2.140 | 0.001 |
Speech and language | 0.46 ± 0.71 § # | −0.52 ± 0.58 # | −0.50 ± 0.69 § | −0.51 ± 0.63 | 0.317 | <0.001 |
Visuospatial function | 0.46 ± 0.62 § # | −0.45 ± 0.77 # | −0.53 ± 0.74 § | −0.49 ± 0.74 | 1.054 | <0.001 |
Disease Severity | PD with Dementia | F + | p-Value + | ||
---|---|---|---|---|---|
With Fall | Without Fall | All Patients | |||
Number of Cases | 17 | 18 | 35 | ||
Unified Parkinson’s Disease Rating Scale (UPDRS) a | 57.0 ± 28.3 | 42.6 ± 22.9 | 49.6 ± 26.3 | 0.559 | 0.106 |
UPDRS I b | 4.88 ± 2.91 | 3.72 ± 2.95 | 4.28 ± 2.95 | 0.040 | 0.250 |
UPDRS-II c | 16.7 ± 9.98 | 10.5 ± 5.54 | 13.5 ± 8.49 | 2.540 | 0.028 * |
UPDRS III d | 35.4 ± 16.8 | 28.3 ± 16.1 | 31.8 ± 16.6 | 0.010 | 0.213 |
Hoehn and Yahr staging | 2.53 ± 0.89 | 2.14 ± 0.98 | 2.33 ± 0.95 | 0.294 | 0.228 |
Activity of daily living | 76.5 ± 15.0 | 80.6 ± 16.3 | 78.6 ± 15.6 | 0.022 | 0.446 |
Morse fall scale | 62.9 ± 27.7 | 49.7 ± 26.8 | 56.1 ± 27.7 | 0.102 | 0.161 |
Gray Matter Volume | Anatomical Regions | x | y | z | Cluster Size | T-Value |
---|---|---|---|---|---|---|
Normal > all PDD | ||||||
R superior temporal gyrus * | 59 | −11 | 0 | 14770 | 5.90 | |
L putamen * | −27 | 15 | 6 | 10899 | 5.68 | |
R cerebellum * | 20 | −74 | −47 | 14753 | 5.54 | |
R middle frontal gyrus * | 29 | 50 | 8 | 591 | 5.40 | |
L middle frontal gyrus * | −29 | 42 | 30 | 304 | 4.94 | |
R fusiform | 41 | −57 | −18 | 289 | 4.55 | |
R precentral gyrus | 53 | -8 | 47 | 711 | 4.51 | |
L precentral gyrus | −44 | 6 | 47 | 646 | 4.42 | |
L superior frontal gyrus | −18 | 60 | 8 | 445 | 4.26 | |
L middle occipital gyrus | −33 | −81 | 14 | 195 | 4.20 | |
L superior medial frontal gyrus | −11 | 4 | −20 | 238 | 4.11 | |
L cerebellum | −30 | −68 | -36 | 648 | 3.52 | |
Normal > PDD with fall | ||||||
L middle temporal gyrus * | −47 | 2 | −35 | 53327 | 7.82 | |
L cuneus * | −5 | −86 | 3 | 28263 | 7.14 | |
L medial frontal gyrus * | −12 | 39 | 18 | 2027 | 5.34 | |
L middle occipital gyrus | −33 | −81 | 14 | 641 | 6.10 | |
R inferior parietal gyrus | 57 | −56 | 44 | 270 | 5.23 | |
L inferior parietal gyrus | −59 | −47 | 45 | 281 | 4.79 | |
R middle occipital gyrus | 42 | −80 | 8 | 532 | 4.67 | |
L middle temporal gyrus | −41 | −65 | 12 | 441 | 4.40 | |
R cingulate gyrus | 14 | 11 | 44 | 165 | 3.92 | |
R anterior cingulate | 14 | 44 | 3 | 234 | 3.87 | |
Normal > PDD without fall | ||||||
R cerebellum | 17 | −74 | −45 | 1860 | 4.00 | |
R superior temporal gyrus | 62 | 2 | −3 | 236 | 3.63 | |
PDD with fall < PDD without fall | ||||||
L calcarine * | −9 | −68 | 20 | 3735 | 5.97 | |
R inferior frontal gyrus *(pars triangularis) | 48 | 20 | 17 | 333 | 6.01 | |
L inferior temporal gyrus | −47 | 3 | −35 | 717 | 4.97 | |
R precentral gyrus | 41 | −15 | 38 | 363 | 4.77 | |
L inferior frontal gyrus (pars opercularis) | −47 | 15 | 15 | 444 | 4.73 | |
R middle temporal gyrus | 50 | -53 | 20 | 390 | 4.52 | |
R inferior frontal gyrus (pars orbitalis) | 30 | 35 | −14 | 385 | 4.32 | |
L Rolandic operculum | −42 | 2 | 15 | 312 | 4.06 | |
L caudate head | −14 | 15 | 3 | 248 | 3.82 | |
R middle occipital gyrus | 41 | −78 | 9 | 205 | 3.72 |
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Cheng, K.-L.; Lin, L.-H.; Chen, P.-C.; Chiang, P.-L.; Chen, Y.-S.; Chen, H.-L.; Chen, M.-H.; Chou, K.-H.; Li, S.-H.; Lu, C.-H.; et al. Reduced Gray Matter Volume and Risk of Falls in Parkinson’s Disease with Dementia Patients: A Voxel-Based Morphometry Study. Int. J. Environ. Res. Public Health 2020, 17, 5374. https://doi.org/10.3390/ijerph17155374
Cheng K-L, Lin L-H, Chen P-C, Chiang P-L, Chen Y-S, Chen H-L, Chen M-H, Chou K-H, Li S-H, Lu C-H, et al. Reduced Gray Matter Volume and Risk of Falls in Parkinson’s Disease with Dementia Patients: A Voxel-Based Morphometry Study. International Journal of Environmental Research and Public Health. 2020; 17(15):5374. https://doi.org/10.3390/ijerph17155374
Chicago/Turabian StyleCheng, Kai-Lun, Li-Han Lin, Po-Cheng Chen, Pi-Ling Chiang, Yueh-Sheng Chen, Hsiu-Ling Chen, Meng-Hsiang Chen, Kun-Hsien Chou, Shau-Hsuan Li, Cheng-Hsien Lu, and et al. 2020. "Reduced Gray Matter Volume and Risk of Falls in Parkinson’s Disease with Dementia Patients: A Voxel-Based Morphometry Study" International Journal of Environmental Research and Public Health 17, no. 15: 5374. https://doi.org/10.3390/ijerph17155374