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Association Between White Matter Connectivity and Early Dementia in Patients With Parkinson Disease

 Seok Jong Chung  ;  Yae Ji Kim  ;  Jin Ho Jung  ;  Hye Sun Lee  ;  Byoung Seok Ye  ;  Young H Sohn  ;  Yong Jeong  ;  Phil Hyu Lee 
 NEUROLOGY, Vol.98(18) : e1846-e1856, 2022-05 
Journal Title
Issue Date
Cognitive Dysfunction* / complications ; Cognitive Dysfunction* / etiology ; Dementia* / complications ; Executive Function ; Humans ; Neuropsychological Tests ; Parkinson Disease* / complications ; Parkinson Disease* / diagnostic imaging ; White Matter* / diagnostic imaging
Background and objectives: Several clinical and neuroimaging biomarkers have been proposed to identify individuals with Parkinson disease (PD) who are at risk for ongoing cognitive decline. This study aimed to explore whether white matter (WM) connectivity disruption is associated with dementia conversion in patients with newly diagnosed PD with mild cognitive impairment (PD-MCI).

Methods: Seventy-five patients with drug-naive PD-MCI who underwent serial cognitive assessments during the follow-up period (>5 years) were enrolled for the neuroimaging analyses. The patients were classified into either the PD with dementia (PDD) high-risk group (PDD-H, n = 38) or low-risk group (PDD-L, n = 37), depending on whether they converted to dementia within 5 years of PD diagnosis. We conducted degree-based statistic analyses based on a graph-theoretical concept to identify the subnetworks whose WM connectivity was disrupted in the PDD-H group compared with the PDD-L group.

Results: The PDD-H group showed poorer cognitive performance on frontal/executive, visual memory/visuospatial, and attention/working memory/language function than the PDD-L group at baseline assessment. The PDD-H group exhibited more severely disrupted WM connectivity in both frontal and posterior cortical regions with 8 hub nodes in the degree-based statistic analysis. The strength of structural connectivity within the identified subnetworks was correlated with the composite scores of frontal/executive function domain (γ = 0.393) and the risk score of PDD conversion within 5 years (γ = -0.480).

Discussion: This study demonstrated that disrupted WM connectivity in frontal and posterior cortical regions, which correlated with frontal/executive dysfunction, is associated with early dementia conversion in PD-MCI.

Classification of evidence: This study provides Class II evidence that disrupted WM connectivity in frontal and posterior cortical regions is associated with early dementia conversion in PD-MCI.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Sohn, Young Ho(손영호) ORCID logo https://orcid.org/0000-0001-6533-2610
Ye, Byoung Seok(예병석) ORCID logo https://orcid.org/0000-0003-0187-8440
Lee, Phil Hyu(이필휴) ORCID logo https://orcid.org/0000-0001-9931-8462
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Chung, Seok Jong(정석종) ORCID logo https://orcid.org/0000-0001-6086-3199
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