Prefrontal and hippocampal atrophy using 7-tesla magnetic resonance imaging in patients with Parkinson's disease

Altered functional-structural coupling may predict Parkinson's patient's depression

We aimed to elucidate the neurobiological basis of depression in Parkinson's disease and identify potential imaging markers for depression in patients with Parkinson's disease. We recruited 43 normal controls (NC), 46 depressed Parkinson's disease patients (DPD) and 56 non-depressed Parkinson's disease (NDPD). All participants underwent routine T2-weighted, T2Flair, and resting-state scans on the same 3.0 T magnetic resonance imaging (MRI) scanner at our hospital. Pre-processing includes calculating surface-based Regional Homogeneity (2DReHo) and cortical thickness. Then we defined the correlation coefficient between 2DReHo and cortical thickness as the functional-structural coupling index. Between-group comparisons were conducted on the Fisher's Z-transformed correlation coefficients. To identify specific regions of decoupling, the 2DReHo for each participant were divided by cortical thickness at each vertex, followed by threshold-free cluster enhancement (TFCE) multiple comparison correction. Binary logistic regression analysis was performed with DPD as the dependent variable, and significantly altered indicators as the independent variables. Receiver operating characteristic curves were constructed to compare the diagnostic performance of individual predictors and combinations using R and MedCalc software. DPD patients exhibited a significantly lower whole-brain functional-structural coupling index than NDPD patients and NC. Abnormal functional-structural coupling was primarily observed in the left inferior parietal lobule and right primary and early visual cortices in DPD patients. Receiver operating characteristic analysis revealed that the combination of cortical functional-structural coupling, surface-based ReHo, and thickness had the best diagnostic performance, achieving a sensitivity of 65% and specificity of 77.7%. This is the first study to explore the relationship between functional and structural changes in DPD patients and evaluate the diagnostic performance of these altered correlations to predict depression in Parkinson's disease patients. We posit that these changes in functional-structural relationships may serve as imaging biomarkers for depression in Parkinson's disease patients, potentially aiding in the classification and diagnosis of Parkinson's disease. Additionally, our findings provide functional and structural imaging evidence for exploring the neurobiological basis of depression in Parkinson's disease.

Volumetric changes and clinical trajectories in Parkinson's disease: a prospective multicentric study

BACKGROUND

Longitudinal measures of structural brain changes using MRI in relation to clinical features and progression patterns in PD have been assessed in previous studies, but few were conducted in well-defined and large cohorts, including prospective clinical assessments of both motor and non-motor symptoms.

OBJECTIVE

We aimed to identify brain volumetric changes characterizing PD patients, and determine whether regional brain volumetric characteristics at baseline can predict motor, psycho-behavioral and cognitive evolution at one year in a prospective cohort of PD patients.

METHODS

In this multicentric 1 year longitudinal study, PD patients and healthy controls from the MPI-R2* cohort were assessed for demographical, clinical and brain volumetric characteristics. Distinct subgroups of PD patients according to motor, cognitive and psycho-behavioral evolution were identified at the end of follow-up.

RESULTS

One hundred and fifty PD patients and 73 control subjects were included in our analysis. Over one year, there was no significant difference in volume variations between PD and control subjects, regardless of the brain region considered. However, we observed a reduction in posterior cingulate cortex volume at baseline in PD patients with motor deterioration at one year (p = 0.017). We also observed a bilateral reduction of the volume of the amygdala (p = 0.015 and p = 0.041) and hippocampus (p = 0.015 and p = 0.053) at baseline in patients with psycho-behavioral deterioration, regardless of age, dopaminergic treatment and center.

CONCLUSION

Brain volumetric characteristics at baseline may predict clinical trajectories at 1 year in PD as posterior cingulate cortex atrophy was associated with motor decline, while amygdala and hippocampus atrophy were associated with psycho-behavioral decline.

Ultra-high-field 7T MRI in Parkinson's disease: ready for clinical use?-a narrative review

Background and Objective

The maturation of ultra-high-field magnetic resonance imaging (MRI) [≥7 Tesla (7T)] has improved our capability to depict and characterise brain structures efficiently, with better signal-to-noise ratio (SNR) and spatial resolution. We evaluated whether these improvements benefit the clinical detection and management of Parkinson's disease (PD).

Methods

We performed a literature search in March 2023 in PubMed (MEDLINE), EMBASE and Google Scholar for articles on "7T MRI" AND "Parkinson*", written in English, published between inception and 1st March, 2023, which we synthesised in narrative form.

Key Content and Findings

In deep-brain stimulation (DBS) surgical planning, early studies show that 7T MRI can distinguish anatomical substructures, and that this results in reduced adverse effects. In other areas, while there is strong evidence for improved accuracy and precision of 7T MRI-based measurements for PD, there is limited evidence for meaningful clinical translation. In particular, neuromelanin-iron complex quantification and visualisation in midbrain nuclei is enhanced, enabling depiction of nigrosomes 1-5, improved morphometry and vastly improved radiological assessments; however, studies on the related clinical outcomes, diagnosis, subtyping, differentiation of atypical parkinsonisms, and monitoring of treatment response using 7T MRI are lacking. Moreover, improvements in clinical utility must be great enough to justify the additional costs.

Conclusions

Together, current evidence supports feasible future clinical implementation of 7T MRI for PD. Future impacts to clinical decision making for diagnosis, differentiation, and monitoring of progression or treatment response are likely; however, to achieve this, further longitudinal studies using 7T MRI are needed in prodromal, early-stage PD and parkinsonism cohorts focusing on clinical translational potential.

Hippocampal-prefrontal long-term potentiation-like plasticity with transcranial direct current stimulation in rats

Transcranial direct current stimulation (tDCS) has been explored as a new treatment method for improving cognitive and motor functions. However, the neuronal mechanisms of tDCS in modulating brain functions, especially cognitive and memory functions, are not well understood. In the present study, we assessed whether tDCS could promote neuronal plasticity between the hippocampus and prefrontal cortex in rats. This is important because the hippocampus-prefrontal pathway is a key pathway in cognitive and memory functions and is involved in various psychiatric and neurodegenerative disorders. Specifically, the effect of anodal or cathodal tDCS on the medial prefrontal cortex was investigated in rats by measuring the medial prefrontal cortex response to electrical stimulation applied to the CA1 region of the hippocampus. Following anodal tDCS, the evoked prefrontal response was potentiated compared to that in the pre-tDCS condition. However, the evoked prefrontal response did not show any significant changes following cathodal tDCS. Furthermore, the plastic change of the prefrontal response following anodal tDCS was only induced when hippocampal stimulation was continuously applied during tDCS. Anodal tDCS without hippocampal activation showed little or no changes. These results indicate that combining anodal tDCS of the prefrontal cortex with hippocampal activation induces long-term potentiation (LTP)-like plasticity in the hippocampus-prefrontal pathway. This LTP-like plasticity can facilitate smooth information transmission between the hippocampus and the prefrontal cortex and may lead to improvements in cognitive and memory function.

Morphological changes in Parkinson's disease based on magnetic resonance imaging: A mini-review of subcortical structures segmentation and shape analysis

Parkinson's disease (PD) is a neurodegenerative disorder caused by the loss of dopaminergic neurons in the substantia nigra, resulting in clinical symptoms, including bradykinesia, resting tremor, rigidity, and postural instability. The pathophysiological changes in PD are inextricably linked to the subcortical structures. Shape analysis is a method for quantifying the volume or surface morphology of structures using magnetic resonance imaging. In this review, we discuss the recent advances in morphological analysis techniques for studying the subcortical structures in PD in vivo. This approach includes available pipelines for volume and shape analysis, focusing on the morphological features of volume and surface area.

Multi-Focus Image Fusion Based on Convolution Neural Network for Parkinson's Disease Image Classification

Parkinson's disease (PD) is a common neurodegenerative disease that has a significant impact on people's lives. Early diagnosis is imperative since proper treatment stops the disease's progression. With the rapid development of CAD techniques, there have been numerous applications of computer-aided diagnostic (CAD) techniques in the diagnosis of PD. In recent years, image fusion has been applied in various fields and is valuable in medical diagnosis. This paper mainly adopts a multi-focus image fusion method primarily based on deep convolutional neural networks to fuse magnetic resonance images (MRI) and positron emission tomography (PET) neural photographs into multi-modal images. Additionally, the study selected Alexnet, Densenet, ResNeSt, and Efficientnet neural networks to classify the single-modal MRI dataset and the multi-modal dataset. The test accuracy rates of the single-modal MRI dataset are 83.31%, 87.76%, 86.37%, and 86.44% on the Alexnet, Densenet, ResNeSt, and Efficientnet, respectively. Moreover, the test accuracy rates of the multi-modal fusion dataset on the Alexnet, Densenet, ResNeSt, and Efficientnet are 90.52%, 97.19%, 94.15%, and 93.39%. As per all four networks discussed above, it can be concluded that the test results for the multi-modal dataset are better than those for the single-modal MRI dataset. The experimental results showed that the multi-focus image fusion method according to deep learning can enhance the accuracy of PD image classification.