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Advanced MRI studies provide new insight on
early Parkinson's Disease
BUFFALO, N.Y. -- Parkinson's disease is a degenerative
disorder of the brain affecting movement,
speech, mood, behavior, thinking and
sensation for which there is no known cause
or cure.
Two studies from the University at Buffalo being presented at
the 2008 American Academy of Neurology
meeting in Chicago shed new light on very
early development of the disease.
The work is the result of a joint project by neurology and
imaging specialists from UB, Stavanger
University Hospital and University of
Bergen, both in Norway.
Turi O. Dalaker, M.D., a doctoral fellow from Stavanger
University Hospital who conducted the
research in the Buffalo Neuroimaging
Analysis Center (BNAC), is first author on
both studies.
The BNAC, housed in Kaleida Health's Buffalo General
Hospital, is part of the Jacobs Neurological
Institute, the Department of Neurology in
the UB School of Medicine and Biomedical
Sciences.
The symptoms of Parkinson's disease (PD) result from
disintegration of the brain's white matter,
the network of nerves that transport
messages to the various brain regions, and
grey matter, the brain regions where those
messages are received, interpreted and acted
upon.
Using advanced magnetic resonance imaging (MRI) technologies
available at the Buffalo Neuroimaging
Analysis Center (BNAC), the researchers can
identify brain regions linked to Parkinson's
disease based on images showing the status
of both white and grey matter.
One study, a case-control investigation, compared brain MRI
scans and scores on the Mini-Mental State
Examination (MMSE), a standard mental
screening test, of 155 patients diagnosed
with early Parkinson's disease with those of
101 normal subjects. Results will be
presented today (April 17, 2008).
This study describes one of the first large-scale analyses of
the extent of global (overall),
tissue-specific and regional brain atrophy,
and white matter hyperintensities (WMH). WMH
are diseased areas of the white matter seen
commonly in brain MRI scans in the elderly.
Results showed that in Parkinson's patients, white matter
hyperintensities were associated
significantly with lower scores on the
mental test: The more areas of
hyperintensity, the lower the MMSE score.
"The relationship between higher white matter
hyperintensities and lower MMSE scores in PD
provide a possible explanation for cognitive
impairment in PD," said Dalaker.
The second study examined whether mild cognitive impairment
in early PD is associated with atrophy of a
specific brain region. The researchers were
interested also in investigating the
possible link between mild cognitive
impairment in PD and a higher risk of
developing dementia. Results were presented
April 16.
Applying an MRI analytical process called voxel-based
morphology, Dalaker and colleagues analyzed
high-resolution MRI scans of 43 newly
diagnosed PD patients and those of 31
sex-matched normal controls.
They found that the PD patients with mild cognitive
impairment showed a trend toward reduced
grey matter in the cingulate area, a brain
region associated with cognitive
performance.
"This study shows that cingulate atrophy is associated with
early cognitive deficit in PD," said Dalaker,
"and might serve as a possible biomarker for
increased risk of developing dementia in
PD."
The subjects in both studies were part of The Norwegian
ParkWest project, a four-center prospective
longitudinal cohort study of patients with
PD from southwestern Norway. The project
involves 265 patients with early stage
incident PD, their caregivers and a control
group of 205 subjects with similar age- and
sex- distribution. The researchers plan to
follow this sample for 10 years.
Additional contributors to the cingulate study from the BNAC
were Robert Zivadinov, M.D., Ph.D., UB
associate professor of neurology and
director of the BNAC, Jennifer Cox, Ph.D.,
and Ronald Antulov, M.D.
Jan P. Larsen, M.D., Ph.D.; Mona Beyer, M.D., Ph.D.; Guido
Alves, M.D., Ph.D.; Kolbjorn Bronnick, and
Dag Aarsland, M.D., Ph.D., all researchers
from Stavanger, Norway, and Ole-Bjorn Tysnes,
M.D., Ph.D., from Bergen, Norway, also
contributed to this study.
All of the above were involved in the WMH study, plus Niels
Bergsland and Michael Dwyer from the BNAC,
and Arpad Kelemen, Ph.D., and Ralph
Benedict, Ph.D., UB associate professors of
neurology.
Dalaker's BNAC research was supported by a Dr. Larry D.
Jacobs Fellowship, The Leiv Eiriksson
mobility programme through the Research
Council of Norway, and a grant from the
Norwegian Society of Radiology. The
Norwegian ParkWest study was funded in part
by the Western Norway Regional Health
Authority and the Research Council of
Norway.
The University at Buffalo is a premier research-intensive
public university, the largest and most
comprehensive campus in the State University
of New York. UB's more than 28,000 students
pursue their academic interests through more
than 300 undergraduate, graduate and
professional degree programs.
Founded in 1846, the University at Buffalo is a member of the
Association of American Universities. The
School of Medicine and Biomedical Sciences,
School of Dental Medicine, School of
Nursing, School of Pharmacy and
Pharmaceutical Sciences and School of Public
Health and Health Professions are the five
schools that constitute UB's Academic Health
Center.
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