Evaluation of the relationship between MRI findings and atrophy in the basal nuclei and brainstem gray matter with clinical symptoms and severity of idiopathic parkinsonism
Abstract
Post-mortem studies have shown that about one-quarter of patients diagnosed with Parkinson's disease (PD) actually have other disorders, such as essential tremor, multiple system atrophy (MSA), progressive supranuclear palsy (PSP), vascular Parkinsonism (VP), and cortical-basal degeneration (CBD). Research has demonstrated that atrophy in the subcortical gray matter, including the basal ganglia, plays a role in the progression of Parkinson's disease. Nuclear medicine studies also indicate a reduction in dopamine at dopaminergic nerve terminals, correlating with the severity of Parkinson's symptoms. Therefore, it seems possible to establish a correlation between the extent of atrophy in these structures and the severity of symptoms in Parkinson's patients by measuring the volume of the basal ganglia and brainstem gray matter. This method could complement clinical approaches in accurate diagnosis and staging of Parkinson's disease. Thus, the aim of the present study was to investigate the relationship between MRI findings and atrophy in the basal ganglia and brainstem gray matter with clinical symptoms and the severity of idiopathic Parkinsonism.
Materials and Methods: This non-interventional study aimed to examine the relationship between MRI findings and atrophy in the basal ganglia and brainstem gray matter with clinical symptoms and the severity of idiopathic Parkinsonism. Disease severity was categorized into mild, moderate, and severe groups based on the Hoehn and Yahr scale. The volumes of the caudate nucleus, putamen, globus pallidus, and brainstem gray matter were quantified using Freesurfer software, and after normalization, they were compared to age- and sex-matched healthy controls. Finally, the correlation between the atrophy of these structures and the clinical symptoms and severity of the disease was analyzed.
Results: The results of the study revealed that changes in the brain structures of Parkinson’s patients were significantly correlated with the severity of clinical symptoms and Parkinsonism. The volume of the caudate nucleus in patients with mild and severe Parkinson’s disease was significantly smaller compared to healthy individuals, and a decrease in the volume of this region was associated with more severe symptoms. While the volume of the globus pallidus, putamen, and gray matter did not have a significant impact on clinical symptoms, the reduction in caudate volume indicated a direct influence on motor symptoms.