Cortical asymmetry in Parkinson's disease: early susceptibility of the left hemisphere

Brain and Behavior - Tập 6 Số 12 - 2016
Daniel O. Claassen1, Katherine E. McDonell1, Manus J. Donahue2, Shiv Rawal3, Scott A. Wylie1, Joseph S. Neimat4, Hakmook Kang5, Peter Hedera1, David H. Zald6, Bennett A. Landman7, Benoît M. Dawant7, Swati Rane2
1Department of Neurology, Vanderbilt University, Nashville TN, USA
2Vanderbilt University Institute of Imaging Science, Nashville, TN, USA
3Meharry Medical College, Nashville, TN, USA
4Department of Neurosurgery, University of Louisville, Louisville, KY, USA
5Department of Biostatistics, Vanderbilt University, Nashville, TN, USA
6Department of Psychology, Vanderbilt University, Nashville, TN, USA
7Department of Electrical Engineering, Vanderbilt University, Nashville, TN, USA

Tóm tắt

AbstractBackground and PurposeClinically, Parkinson's disease (PD) presents with asymmetric motor symptoms. The left nigrostriatal system appears more susceptible to early degeneration than the right, and a left‐lateralized pattern of early neuropathological changes is also described in several neurodegenerative conditions, including Alzheimer's disease, frontotemporal dementia, and Huntington's disease. In this study, we evaluated hemispheric differences in estimated rates of atrophy in a large, well‐characterized cohort of PD patients.MethodsOur cohort included 205 PD patients who underwent clinical assessments and T1‐weighted brain MRI's. Patients were classified into Early (n = 109) and Late stage (n = 96) based on disease duration, defined as greater than or less than 10 years of motor symptoms. Cortical thickness was determined using FreeSurfer, and a bootstrapped linear regression model was used to estimate differences in rates of atrophy between Early and Late patients.ResultsOur results show that patients classified as Early stage exhibit a greater estimated rate of cortical atrophy in left frontal regions, especially the left insula and olfactory sulcus. This pattern was replicated in left‐handed patients, and was not influenced by the degree of motor symptom asymmetry (i.e., left‐sided predominant motor symptoms). Patients classified as Late stage exhibited greater atrophy in the bilateral occipital, and right hemisphere‐predominant cortical areas.ConclusionsWe show that cortical degeneration in PD differs between cerebral hemispheres, and findings suggest a pattern of early left, and late right hemisphere with posterior cortical atrophy. Further investigation is warranted to elucidate the underlying mechanisms of this asymmetry and pathologic implications.

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Brain and Behavior

Tập 6 Số 12

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