Multifocal alterations of white matter accompany the transition from normal cognition to dementia in Parkinson’s disease patients

  • Maria Chondrogiorgi
  • Loukas G. Astrakas
  • Anastasia K. Zikou
  • Luca Weis
  • Vassilios G. Xydis
  • Angelo Antonini
  • Maria I. Argyropoulou
  • Spiridon Konitsiotis


The purpose of the present study was to investigate the pattern of white matter (WM) changes associated with Parkinson’s disease (PD)-related cognitive impairment by using fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) measures. Diffusion Tensor Imaging (DTI) was performed in 21 PD-patients with dementia (PDD) and in an age-matched control group including 40 PD-patients without dementia (PD-CTRL). The Parkinson’s disease-Cognitive Rating Scale (PD-CRS) was used for patients’ neuropsychological assessment. Local microstructural WM differences associated with the presence of cognitive impairment were tested using tract-based spatial statistics analysis. Multiple regression models investigated the association of DTI indices with total PD-CRS score, PD-CRS raw items and other clinical measures across the whole study sample. Significant FA decreases were found in PDD compared to PD-CTRL patients mainly in the body of corpus callosum, corona radiata and cingulum. Lower PD-CRS score was significantly associated with decreased FA, MD and AD values in multiple WM tracts primarily located in prefrontal and limbic areas as well as across the corpus callosum. Lower performance in specific PD-CRS raw items was also associated with FA decreases in major WM tracts. The results suggest that multifocal microstructural changes of WM accompany the transition from normal to demented cognitive state in PD-patients. The corpus callosum, the corona radiata and the cingulum are among the regions mostly affected during this course. A progressive axonal degeneration is proposed as a key underlying mechanism.


Parkinson’s disease dementia MRI Diffusion tensor imaging Tract-based spatial statistics Axial diffusivity 



This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Conflicts of interest

Nothing to report

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Maria Chondrogiorgi
    • 1
  • Loukas G. Astrakas
    • 2
  • Anastasia K. Zikou
    • 3
  • Luca Weis
    • 4
  • Vassilios G. Xydis
    • 3
  • Angelo Antonini
    • 4
  • Maria I. Argyropoulou
    • 3
  • Spiridon Konitsiotis
    • 1
  1. 1.Department of Neurology, Medical SchoolUniversity of IoanninaIoanninaGreece
  2. 2.Department of Medical Physics, Medical SchoolUniversity of IoanninaIoanninaGreece
  3. 3.Department of Radiology, Medical SchoolUniversity of IoanninaIoanninaGreece
  4. 4.Parkinson Disease and Movement Disorders UnitIRCCS San Camillo Hospital FoundationVenice-LidoItaly

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