Abnormalities in the white matter tracts in patients with Parkinson disease and psychosis

• Published in: Neurology Vol. 94; no. 18; pp. e1876 - e1884
• Main Authors: Lenka, Abhishek, Ingalhalikar, Madhura, Shah, Apurva, Saini, Jitender, Arumugham, Shyam Sundar, Hegde, Shantala, George, Lija, Yadav, Ravi, Pal, Pramod Kumar
• Format: Journal Article
• Language: English
• Published: United States American Academy of Neurology 05-05-2020
• ISSN: 0028-3878; 1526-632X
• DOI: 10.1212/WNL.0000000000009363

OBJECTIVEThe objective of the current study was to compare the microstructural integrity of the white matter (WM) tracts in patients having Parkinson disease (PD) with and without psychosis (PD-P and PD-NP) through diffusion tensor imaging (DTI).
METHODSThis cross-sectional study involved 48 PD-NP and 42 PD-P who were matched for age, sex, and education. Tract-based spatial statistics (TBSS) was used to compare several DTI metrics from the diffusion-weighted MRIs obtained through a 3-Tesla scanner. A set of neuropsychological tests was used for the cognitive evaluation of all patients.
RESULTSThe severity and stage of PD were not statistically different between the groups. The PD-P group performed poorly in all the neuropsychological domains compared with the PD-NP group. TBSS analysis revealed widespread patterns of abnormality in the fractional anisotropy (FA) in the PD-P group, which also correlated with some of the cognitive scores. These tracts include inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, right parieto-occipital WM, body of the corpus callosum, and corticospinal tract.
CONCLUSIONThis study provides novel insights into the putative role of WM tract abnormalities in the pathogenesis of PD-P by demonstrating significant alterations in several WM tracts. Additional longitudinal studies are warranted to confirm the findings of our research.