Neuroanatomical structural correlates of nonmotor symptoms in patients with movement disorders

Abstract

In recent years, Impulse control disorders in PD patients have been explored by several studies but reported findings are not easy to summarize. Studies using neuropsychological and psychiatric extensive screening correlated with volume of brain region, are lacking. Thus, our present study aimed to extensively investigate cognitive functioning, psychiatric symptomatology and functional imagin of brain in PD patients presenting ICD, as compared with PD patients without ICD and healthy controls who did not show clinically significant cognitive deficits. A second comparison between ICD patients with Pathological gambling (PG) versus PD patients without ICD and healthy controls was performed, to examine the features in PG population with PD. A group of 47 PD patients with ICD (ICD) and 16 patients with PG were recruited. Moreover, a group of 43PD patients who did not present ICD (PD-No ICD) and 65 healthy controls (HC) were selected, which were matched to the ICD group for age and educational level. All participants were subjected to a neuropsychological, psychopathological evaluation and to a imaging protocol on 3T scanning to assess brain volume. ICD, but not PD without ICD, had a worse performance confronting to HC, in some neuropsychological tasks, which are at least partially sensitive to frontal lobe dysfunction. Moreover, ICD and PG warrant more Major depressive disorder, anxiety and anhedonia diagnosis and manifested more severe depressive and anxiety symptoms, than PD No-ICD. We have found a positive correlation, in only PG group, between GM volumes and SHAPS scores in the left cerebellum, left hippocampus and amygdala, right middle frontal and occipital gyrus. Finally, GM voletric analysis showed reduced GM volume in left inferior frontal gyrus, left insula and middle and anterior cingulum in ICD patients in comparison with PD No-ICD patients and HC. Moreover, our PG patients showed significantly GM volume reduction in left thalamus, left cingulum, cerebellum, left and right fusiform gyrus, left orbitofrontal cortex and right middle occipital gyrus.