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18.12.2023 | Original Communication

Neuroimaging correlates of postural instability in Parkinson’s disease

verfasst von: Andrea Quattrone, Camilla Calomino, Alessia Sarica, Maria Eugenia Caligiuri, Maria Giovanna Bianco, Basilio Vescio, Pier Paolo Arcuri, Jolanda Buonocore, Marida De Maria, Maria Grazia Vaccaro, Aldo Quattrone

Erschienen in: Journal of Neurology | Ausgabe 4/2024

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Abstract

Background

Postural instability (PI) is a common disabling symptom in Parkinson’s disease (PD), but little is known on its pathophysiological basis.

Objective

In this study, we aimed to identify the brain structures associated with PI in PD patients, using different MRI approaches.

Methods

We consecutively enrolled 142 PD patients and 45 control subjects. PI was assessed using the MDS-UPDRS-III pull-test item (PT). A whole-brain regression analysis identified brain areas where grey matter (GM) volume correlated with the PT score in PD patients. Voxel-based morphometry (VBM) and Tract-Based Spatial Statistics (TBSS) were also used to compare unsteady (PT ≥ 1) and steady (PT = 0) PD patients. Associations between GM volume in regions of interest (ROI) and several clinical features were then investigated using LASSO regression analysis.

Results

PI was present in 44.4% of PD patients. The whole-brain approach identified the bilateral inferior frontal gyrus (IFG) and superior temporal gyrus (STG) as the only regions associated with the presence of postural instability. VBM analysis showed reduced GM volume in fronto-temporal areas (superior, middle, medial and inferior frontal gyrus, and STG) in unsteady compared with steady PD patients, and the GM volume of these regions was selectively associated with the PT score and not with any other motor or non-motor symptom.

Conclusions

This study demonstrates a significant atrophy of fronto-temporal regions in unsteady PD patients, suggesting that these brain areas may play a role in the pathophysiological mechanisms underlying postural instability in PD. This result paves the way for further studies on postural instability in Parkinsonism.

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Titel: Neuroimaging correlates of postural instability in Parkinson’s disease
verfasst von: Andrea Quattrone
Camilla Calomino
Alessia Sarica
Maria Eugenia Caligiuri
Maria Giovanna Bianco
Basilio Vescio
Pier Paolo Arcuri
Jolanda Buonocore
Marida De Maria
Maria Grazia Vaccaro
Aldo Quattrone
Publikationsdatum: 18.12.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Neurology / Ausgabe 4/2024
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-023-12136-9

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Methods

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Conclusions

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