JNNP: Longitudinal changes in thalamic white matter and gray matter related to visual hallucinations in patients with Parkinson's disease

Visual hallucinations (VH) are common in Parkinson’s disease (PD) and can cause severe suffering to affected individuals and their families, leading to worse results: patients with Parkinson’s disease and visual hallucinations have poor quality of life and death The rate increases, and the subsequent incidence of dementia is higher

The thalamus is a key diencephalon center for sensory processing in the cerebral cortex, and has recently been recognized as a potential key driver of unbalanced network activation

White matter changes detected using diffusion-weighted MRI may be more sensitive to the early degenerative process of PD than gray matter loss, because they reflect changes in axons rather than loss of neurons

This article was published in " Journal of Neurology, Neurosurgery & Psychiatry " ( Journal of Neurology, Neurosurgery & Psychiatry )

Patients underwent clinical evaluation and brain imaging at baseline and 18 months later

They are classified as PD patients with VH

All participants used Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) for general cognitive assessment

Whole brain, gray matter and white matter changes in patients with Parkinson's disease

Patients with PD with visual hallucinations showed white matter changes in the corpus callosum during baseline examination, and extensively involved the hindbrain over time

(A) In patients with Parkinson's disease, the right middle olfactory thalamus is affected by visual hallucinations, and the white matter tracts connected to the right middle olfactory thalamus showed macroscopic structural changes (decreased FC) at baseline examination, and volume loss in the nucleus appeared after 18 months , (B) Over time, extensive white matter macrostructure changes, involving most of the white matter tracts of the thalamic cortex, (c) White matter changes associated with PD hallucinations precede the loss of cortical thickness, and changes in the whole brain white matter are at baseline It has appeared at the time of examination, but the difference in cortical thickness will only appear after follow-up

During the 8-month follow-up, the specific changes in the thalamic subnucleus of PD with visual hallucinations compared with PD without visual hallucinations

In short, people with PD with visual hallucinations have white matter loss, especially in the thalamic nucleus, and the cortical thickness is relatively preserved over time

ZarkaliA ,McColganP ,LeylandLA ZarkaliAZarkali McColganPMcColgan LeylandLALeyland, et alLongitudinal thalamic white and grey matter changes associated with visual hallucinations in Parkinson's diseaseJournal of Neurology, Neurosurgery & PsychiatryPublished First:28 September 2021.

 

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