RT Journal Article
T1 Longitudinal degeneration of the basal forebrain predicts subsequent dementia in Parkinson's disease.
A1 Pereira, Joana B
A1 Hall, Sara
A1 Jalakas, Mattis
A1 Grothe, Michel J
A1 Strandberg, Olof
A1 Stomrud, Erik
A1 Westman, Eric
A1 van-Westen, Danielle
A1 Hansson, Oskar
K1 Basal forebrain
K1 Cognitive decline
K1 Dementia
K1 Longitudinal MRI
K1 Parkinson's disease
AB ObjectivesCholinergic dysfunction plays a prominent role in  cognitive impairment  in  Parkinson's disease  (PD). The aim of this study was to assess the relationship of baseline and longitudinal  basal forebrain   atrophy with cognitive decline and dementia in PD.MethodsWe included 106 non-demented PD patients , 19 PD dementia (PDD) patients and 42 controls with longitudinal structural MRI and cognitive testing . After 4.2 ± 1.8 years, 20 non-demented PD patients were diagnosed with dementia (PD- dementia converters), whereas the rest of PD patients remained non-demented (stable-PD). We compared MRI volumes of the medial septum/diagonal band (Ch1/Ch2) and  nucleus basalis of Meynert  (Ch4) between groups. Cox regression analyses were applied to test whether Ch1/Ch2 or Ch4 atrophy could predict future dementia and linear mixed models assessed their association with cognitive decline .ResultsCompared to controls, we found reduced Ch4 baseline volumes in PD- dementia converters (p = .003) and those who already had PDD (p < .001) but not in stable-PD. Over time , there was a greater loss in Ch1/Ch2 volumes in PD- dementia converters and PDD compared to the other groups (p = .004). Baseline and longitudinal Ch4 volumes were associated with cognition (p < .002) and longitudinal Ch4 atrophy predicted future dementia (p = .009).ConclusionsAtrophy of Ch4 precedes and predicts future dementia in PD and is followed by changes in Ch1/Ch2, reflecting a posterior-anterior pattern of basal forebrain atrophy . This pattern could be used to track the spread of cholinergic degeneration and identify patients at risk of developing dementia .
PB Academic Press
YR 2020
FD 2020-03-05
LK http://hdl.handle.net/10668/15212
UL http://hdl.handle.net/10668/15212
LA en
NO Pereira JB, Hall S, Jalakas M, Grothe MJ, Strandberg O, Stomrud E, et al. Longitudinal degeneration of the basal forebrain predicts subsequent dementia in Parkinson's disease. Neurobiol Dis. 2020 Jun;139:104831.
DS RISalud
RD Jul 6, 2025