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Neuropsychiatric symptoms in Parkinson's disease: fronto-striatal atrophy contributions.

Neuropsychiatric symptoms in Parkinson's disease: fronto-striatal atrophy contributions.
Neuropsychiatric symptoms in Parkinson's disease: fronto-striatal atrophy contributions.
Background
Neuropsychiatric symptoms (NPS) in Parkinson's disease (PD) have been mostly attributed to neurotransmitter imbalances. However, recent findings suggest that gray matter atrophy also contributes to NPS in PD. We contrast PD patients with different levels of NPS, who are well-matched for dopaminergic medication levels and disease stage, to identify the fronto-striatal gray matter atrophy areas associated with NPS in PD.

Methods
Fifty mild, non-demented PD patients were included. We median-split the group via a neuropsychiatric screening tool (Cambridge Behavioural Inventory-Revised), which resulted in higher vs. lower NPS groups (n = 25 in each group). Using T1 brain scans acquired on a 3 Tesla MRI scanner, voxel-based morphometry analysis was applied to characterize the pattern of fronto-striatal gray matter atrophy associated with elevated NPS.

Results
We found that the higher NPS group was characterized by greater atrophy in the prefrontal cortex, but not striatal areas. This was further corroborated by a post-hoc analysis cross-correlating the severity of NPS with gray matter loss across the whole PD group, which revealed that atrophy in the orbitofrontal cortex and frontal pole was specifically associated with elevated NPS.

Conclusions
Prefrontal cortex atrophy in PD has an additional effect to dopamine replacement therapy on the generation of NPS in these patients. These findings are an important step towards the delineation of atrophy vs. neurochemical imbalance in PD, and the results emphasize the importance of considering interactions between prefrontal atrophy and neurochemical dysfunction in the genesis of neuropsychiatric symptoms in PD.
867-872
O'Callaghan, C
f47ed92d-85af-42c8-b6db-3f75437f6147
JM, Shine
39505916-7309-4204-9090-198348b360ef
SJ, Lewis
38003c2b-dd56-4f04-a0b5-ef1f7bb5f27f
Hornberger, M
a48c1c63-422a-4c11-9a51-c7be0aa3026d
O'Callaghan, C
f47ed92d-85af-42c8-b6db-3f75437f6147
JM, Shine
39505916-7309-4204-9090-198348b360ef
SJ, Lewis
38003c2b-dd56-4f04-a0b5-ef1f7bb5f27f
Hornberger, M
a48c1c63-422a-4c11-9a51-c7be0aa3026d

O'Callaghan, C, JM, Shine, SJ, Lewis and Hornberger, M (2014) Neuropsychiatric symptoms in Parkinson's disease: fronto-striatal atrophy contributions. Parkinsonism & Related Disorders, 20 (8), 867-872. (doi:10.1016/j.parkreldis.2014.04.027).

Record type: Article

Abstract

Background
Neuropsychiatric symptoms (NPS) in Parkinson's disease (PD) have been mostly attributed to neurotransmitter imbalances. However, recent findings suggest that gray matter atrophy also contributes to NPS in PD. We contrast PD patients with different levels of NPS, who are well-matched for dopaminergic medication levels and disease stage, to identify the fronto-striatal gray matter atrophy areas associated with NPS in PD.

Methods
Fifty mild, non-demented PD patients were included. We median-split the group via a neuropsychiatric screening tool (Cambridge Behavioural Inventory-Revised), which resulted in higher vs. lower NPS groups (n = 25 in each group). Using T1 brain scans acquired on a 3 Tesla MRI scanner, voxel-based morphometry analysis was applied to characterize the pattern of fronto-striatal gray matter atrophy associated with elevated NPS.

Results
We found that the higher NPS group was characterized by greater atrophy in the prefrontal cortex, but not striatal areas. This was further corroborated by a post-hoc analysis cross-correlating the severity of NPS with gray matter loss across the whole PD group, which revealed that atrophy in the orbitofrontal cortex and frontal pole was specifically associated with elevated NPS.

Conclusions
Prefrontal cortex atrophy in PD has an additional effect to dopamine replacement therapy on the generation of NPS in these patients. These findings are an important step towards the delineation of atrophy vs. neurochemical imbalance in PD, and the results emphasize the importance of considering interactions between prefrontal atrophy and neurochemical dysfunction in the genesis of neuropsychiatric symptoms in PD.

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More information

Published date: 1 May 2014

Identifiers

Local EPrints ID: 504866
URI: http://eprints.soton.ac.uk/id/eprint/504866
PURE UUID: 521e6c3d-ad40-41f9-85d3-06ed796efaca
ORCID for C O'Callaghan: ORCID iD orcid.org/0000-0002-1839-0591
ORCID for M Hornberger: ORCID iD orcid.org/0000-0002-2214-3788

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Date deposited: 19 Sep 2025 16:48
Last modified: 20 Sep 2025 02:31

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Contributors

Author: C O'Callaghan ORCID iD
Author: Shine JM
Author: Lewis SJ
Author: M Hornberger ORCID iD

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