Distinct functional and macrostructural brain changes in Parkinson's disease and multiple system atrophy

• Published in: Human brain mapping Vol. 36; no. 3; pp. 1165 - 1179
• Main Authors: Planetta, Peggy J., Kurani, Ajay S., Shukla, Priyank, Prodoehl, Janey, Corcos, Daniel M., Comella, Cynthia L., McFarland, Nikolaus R., Okun, Michael S., Vaillancourt, David E.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.03.2015; John Wiley & Sons, Inc; John Wiley and Sons Inc
• Subjects: Aged; Atrophy - pathology; atypical parkinsonism; Basal Ganglia - pathology; Basal Ganglia - physiopathology; Brain - pathology; Brain - physiopathology; brain atrophy; Cerebellum - pathology; Cerebellum - physiopathology; Cerebrum - pathology; Cerebrum - physiopathology; Female; force; functional magnetic resonance imaging; Functional Neuroimaging; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Multiple System Atrophy - pathology; Multiple System Atrophy - physiopathology; Parkinson Disease - pathology; Parkinson Disease - physiopathology; Parkinson's disease; Psychomotor Performance - physiology; voxel-based morphometry; magnetic resonance imaging; Parkinson's disease; atypical parkinsonism; brain atrophy; force; voxel-based morphometry; functional magnetic resonance imaging
• ISSN: 1065-9471; 1097-0193
• DOI: 10.1002/hbm.22694

Parkinson's disease (PD) and the parkinsonian variant of multiple system atrophy (MSAp) are neurodegenerative disorders that can be difficult to differentiate clinically. This study provides the first characterization of the patterns of task‐related functional magnetic resonance imaging (fMRI) changes across the whole brain in MSAp. We used fMRI during a precision grip force task and also performed voxel‐based morphometry (VBM) on T1‐weighted images in MSAp patients, PD patients, and healthy controls. All groups were matched on age, and the patient groups had comparable motor symptom durations and severities. There were three main findings. First, MSAp and PD had reduced fMRI activation in motor control areas, including the basal ganglia, thalamus, insula, primary sensorimotor and prefrontal cortices, and cerebellum compared with controls. Second, there were no activation differences among the disease groups in the basal ganglia, thalamus, insula, or primary sensorimotor cortices, but PD had more extensive activation deficits throughout the cerebrum compared with MSAp and controls. Third, VBM revealed reduced volume in the basal ganglia, middle and inferior cerebellar peduncles, pons, and throughout the cerebrum in MSAp compared with controls and PD, and additionally throughout the cerebellar cortex and vermis in MSAp compared with controls. Collectively, these results provide the first evidence that fMRI activation is abnormal in the basal ganglia, cerebellum, and cerebrum in MSAp, and that a key distinguishing feature between MSAp and PD is the extensive and widespread volume loss throughout the brain in MSAp. Hum Brain Mapp 36:1165–1179, 2015. © 2014 Wiley Periodicals, Inc.