Longitudinal Analysis Of The Changes Of White Matter Microstructural In High-risk Individuals Of Mild Cognitive Impairment In Parkinson’s Disease

Objective: To investigate the white matter microstructural longitudinal changes high-risk individuals of mild cognitive impairment in early-stage Parkinson’s disease.Methods: Diffusion tensor images and cognitive scores were performed in 83 PD patients with normal cognition with 4-year follow-up from PPMI database.At the end of the follow-up,26 developed mild cognitive impairment(progression group)and 57 retained normal cognition(stable group).Then,the differences of fractional anisotropy(FA)between the progressive group and the stable group were studied by using the method of tract-based spatial statistics,and the FA changes between the baseline and follow-up and the correlation with cognitive scores were compared in the progressive group.Finally,the FA values of fiber bundles with positive correlation analysis were analyzed by forward stepwise logistic regression to test their predictive value.Results: The results of cross-sectional analysis showed that compared with the stable group,the progression group had decreased FA in the right anterior corona radiata(ACR)at baseline(P < 0.05);at the 4-year follow-up,the progression group showed decreased FA in the ACR,body of corpus callosum(CC),right external capsule(EC)and bilateral posterior thalamic radiation relative to the stable group(P < 0.05).The progression group demonstrated a longitudinal decreased FA in the ACR,CC,EC and left superior longitudinal fasciculus(P < 0.05).In addition,the longitudinal decrease of FA values of the ACR and CC fibers in progression group was positively correlated with the decline of cognitive function such as attention and working memory(P < 0.05).Logistic regression analysis showed that decreased FA in the ACR could be a predictor of conversion from a high-risk MCI to PD-MCI.Conclusion: For high-risk PD-MCI individuals,the white matter microstructural integrity deteriorates may represent the potential imaging biomarkers of cognitive decline in early-stage PD patient.