Clinical, cognitive, and behavioural correlates of white matter damage in progressive supranuclear palsy
2014
White matter (WM) tract alterations were assessed in patients with
progressive supranuclear palsy(PSP) relative to healthy controls and patients with idiopathic Parkinson’s disease (PD) to explore the relationship of WM tract damage with clinical disease severity, performance on
cognitive tests, and
apathy. 37 PSP patients, 41 PD patients, and 34 healthy controls underwent an MRI scan and clinical testing to evaluate
physical disability, cognitive impairment, and
apathy. In PSP, the contribution of WM tract damage to global disease severity and cognitive and behavioural disturbances was assessed using Random Forest analysis. Relative to controls, PSP patients showed diffusion tensor (DT) MRI abnormalities of the
corpus callosum,
superior cerebellar peduncle(SCP), cingulum and
uncinate fasciculusbilaterally, and right
inferior longitudinal fasciculus.
Corpus callosumand SCP DT MRI measures distinguished PSP from PD patients with high accuracy (area under the curve ranging from 0.89 to 0.72). In PSP, DT MRI metrics of the
corpus callosumand
superior cerebellar peduncleswere the best predictors of global disease severity scale scores. DT MRI metrics of the
corpus callosum, right superior longitudinal and
inferior longitudinal fasciculus, and left uncinate were the best predictors of
executive dysfunction. In PSP,
apathyseverity was related to the damage to the
corpus callosum, right superior longitudinal, and uncinate fasciculi. In conclusion, WM tract damage contributes to the
motor,
cognitive, and behavioural deficits in PSP. DT MRI offers markers for PSP diagnosis, assessment, and monitoring.
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