Microstructural Connectivity is More Related to Cognition than Conventional MRI in Parkinson’s Disease

Article type: Research Article

Authors: Lee, Yang Hyun^a | Lee, Wha Jin^b | Chung, Seok Jong^a | Yoo, Han Soo^a | Jung, Jin Ho^a | Baik, Kyoungwon^a | Sohn, Young H.^a | Seong, Joon-Kyung^{b; c; *} | Lee, Phil Hyu^{a; d; *}

Affiliations: [a] Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea | [b] School of Biomedical Engineering, Korea University, Seoul, South Korea | [c] Department of Artificial Intelligence, Korea University, Seoul, South Korea | [d] Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea

Correspondence: [*] Correspondence to: Phil Hyu Lee, MD, PhD, Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 30722, South Korea. Tel.: +82 2 2228 1608; Fax: +82 2 393 0705; E-mail: phlee@yuhs.ac.; Joon-Kyung Seong, PhD, School of Biomedical Engineering, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Korea. Tel.: +82 2 3290 5660; Fax: +82 2 921 6434; E-mail: jkseong@korea.ac.kr.

Abstract: Background:The different effects of white matter hyperintensity (WMH) severity and WMH-associated microstructural connectivity on cognition in the early stages of Parkinson’s disease (PD) have not been investigated. Objective:To investigate the differential effect of WMH severity and WMH-associated microstructural connectivity on cognition in early stages of PD. Methods:A total of 136 de novo PD patients were enrolled and divided into groups based on total WMH visual rating scores as follows: mild, moderate, and severe. Microstructural connectivity was measured using graph theoretical analysis according to WMH severity. Additionally, correlation coefficients between WMH-associated microstructural connectivity or WMH scores and cognitive performance were assessed. Results:Patients with severe WMHs demonstrated poorer performance in language function than those with moderate WMHs, and in frontal/executive and visual memory function than those with mild WMHs. Areas of microstructural connectivity were more extensive in patients with severe WMHs compared to those with mild and moderate WMHs, involving frontal and parieto-temporal regions. WMH-associated right fronto-temporo-parietal microstructural disintegration was correlated with cognitive dysfunction in attention, frontal/executive, and memory domains, whereas there was no correlation between WMH scores and any cognitive domains. Conclusion:These data suggest that disruption of microstructural networks by WMHs, rather than WMH burden itself, contributed more to cognitive impairment in PD.

Keywords: Cognition, diffusion tensor imaging, microstructural connectivity, Parkinson’s disease, white matter hyperintensities

DOI: 10.3233/JPD-202312

Journal: Journal of Parkinson's Disease, vol. 11, no. 1, pp. 239-249, 2021