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<meta name="DC.Title" content="Different Functional and Microstructural Changes Depending on Duration of Mild Cognitive Impairment in Parkinson Disease" />
<meta name="DC.Identifier" content="10.3174/ajnr.A4626" />
<meta name="DC.Date" content="2016-05-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2016 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: The higher cortical burden of Lewy body and Alzheimer disease–type pathology has been reported to be associated with a faster onset of cognitive impairment of Parkinson disease. So far, there has been a few studies only about the changes of gray matter volume depending on duration of cognitive impairment in Parkinson disease. Therefore, our aim was to evaluate the different patterns of structural and functional changes in Parkinson disease with mild cognitive impairment according to the duration of parkinsonism before mild cognitive impairment.

MATERIALS AND METHODS: Fifty-nine patients with Parkinson disease with mild cognitive impairment were classified into 2 groups on the basis of shorter (&lt;1 year, n = 16) and longer (≥1 year, n = 43) durations of parkinsonism before mild cognitive impairment. Fifteen drug-naïve patients with de novo Parkinson disease with intact cognition were included for comparison. Cortical thickness, Tract-Based Spatial Statistics, and seed-based resting-state functional connectivity analyses were performed. Age, sex, years of education, age at onset of parkinsonism, and levodopa-equivalent dose were included as covariates.

RESULTS: The group with shorter duration of parkinsonism before mild cognitive impairment showed decreased fractional anisotropy and increased mean and radial diffusivity values in the frontal areas compared with the group with longer duration of parkinsonism before mild cognitive impairment (corrected P &lt; .05). The group with shorter duration of parkinsonism before mild cognitive impairment showed decreased resting-state functional connectivity in the default mode network area when the left or right posterior cingulate was used as a seed, and in the dorsolateral prefrontal areas when the left or right caudate was used as a seed (corrected P &lt; .05). The group with longer duration of parkinsonism before mild cognitive impairment showed decreased resting-state functional connectivity mainly in the medial prefrontal cortex when the left or right posterior cingulate was used as a seed, and in the parieto-occipital areas when the left or right caudate was used as a seed (corrected P &lt; .05). No differences in cortical thickness were found in all group contrasts.

CONCLUSIONS: Resting-state functional connectivity and WM alterations might be useful imaging biomarkers for identifying changes in patients with Parkinson disease with mild cognitive impairment according to the duration of parkinsonism before mild cognitive impairment. The functional and microstructural substrates may topographically differ depending on the rate of cognitive decline in these patients.

AD
:   Alzheimer disease
DMN
:   default mode network
MCI
:   mild cognitive impairment
PCC
:   posterior cingulate cortex
PD
:   Parkinson disease
PD-IC
:   PD with intact cognition
PD-MCI
:   PD with mild cognitive impairment
PD-MCI-LD
:   PD-MCI with ≥1 year of parkinsonism prior to MCI
PD-MCI-SD
:   PD-MCI with &lt;1 year of parkinsonism prior to MCI
RSFC
:   resting-state functional connectivity" />
<meta name="DC.Contributor" content="N.-Y. Shin" />
<meta name="DC.Contributor" content="Y.S. Shin" />
<meta name="DC.Contributor" content="P.H. Lee" />
<meta name="DC.Contributor" content="U. Yoon" />
<meta name="DC.Contributor" content="S. Han" />
<meta name="DC.Contributor" content="D.J. Kim" />
<meta name="DC.Contributor" content="S.-K. Lee" />
<meta name="article:published_time" content="2016-05-01" />
<meta name="article:section" content="FUNCTIONAL" />
<meta name="citation_title" content="Different Functional and Microstructural Changes Depending on Duration of Mild Cognitive Impairment in Parkinson Disease" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;The higher cortical burden of Lewy body and Alzheimer disease–type pathology has been reported to be associated with a faster onset of cognitive impairment of Parkinson disease. So far, there has been a few studies only about the changes of gray matter volume depending on duration of cognitive impairment in Parkinson disease. Therefore, our aim was to evaluate the different patterns of structural and functional changes in Parkinson disease with mild cognitive impairment according to the duration of parkinsonism before mild cognitive impairment.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Fifty-nine patients with Parkinson disease with mild cognitive impairment were classified into 2 groups on the basis of shorter (&amp;lt;1 year, &lt;i&gt;n&lt;/i&gt; = 16) and longer (≥1 year, &lt;i&gt;n&lt;/i&gt; = 43) durations of parkinsonism before mild cognitive impairment. Fifteen drug-naïve patients with de novo Parkinson disease with intact cognition were included for comparison. Cortical thickness, Tract-Based Spatial Statistics, and seed-based resting-state functional connectivity analyses were performed. Age, sex, years of education, age at onset of parkinsonism, and levodopa-equivalent dose were included as covariates.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;The group with shorter duration of parkinsonism before mild cognitive impairment showed decreased fractional anisotropy and increased mean and radial diffusivity values in the frontal areas compared with the group with longer duration of parkinsonism before mild cognitive impairment (corrected &lt;i&gt;P&lt;/i&gt; &amp;lt; .05). The group with shorter duration of parkinsonism before mild cognitive impairment showed decreased resting-state functional connectivity in the default mode network area when the left or right posterior cingulate was used as a seed, and in the dorsolateral prefrontal areas when the left or right caudate was used as a seed (corrected &lt;i&gt;P&lt;/i&gt; &amp;lt; .05). The group with longer duration of parkinsonism before mild cognitive impairment showed decreased resting-state functional connectivity mainly in the medial prefrontal cortex when the left or right posterior cingulate was used as a seed, and in the parieto-occipital areas when the left or right caudate was used as a seed (corrected &lt;i&gt;P&lt;/i&gt; &amp;lt; .05). No differences in cortical thickness were found in all group contrasts.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Resting-state functional connectivity and WM alterations might be useful imaging biomarkers for identifying changes in patients with Parkinson disease with mild cognitive impairment according to the duration of parkinsonism before mild cognitive impairment. The functional and microstructural substrates may topographically differ depending on the rate of cognitive decline in these patients.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_publication_date" content="2016/05/01" />
<meta name="citation_mjid" content="ajnr;37/5/897" />
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<meta name="citation_issn" content="0195-6108" />
<meta name="citation_issn" content="1936-959X" />
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<meta name="citation_firstpage" content="897" />
<meta name="citation_lastpage" content="903" />
<meta name="citation_author" content="N.-Y. Shin" />
<meta name="citation_author_institution" content="aFrom the Department of Radiology (N.-Y.S.), Ewha Womans University School of Medicine, Seoul, Korea" />
<meta name="citation_author_institution" content="dRadiology (N.-Y.S., D.J.K., S.-K.L.), Yonsei University College of Medicine, Seoul, Korea" />
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<meta name="citation_author" content="Y.S. Shin" />
<meta name="citation_author_institution" content="bDepartment of Psychology (Y.S.S., S.H.), Yonsei University, Seoul, Korea" />
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<meta name="citation_author_institution" content="eDepartment of Biomedical Engineering (U.Y.), College of Health and Medical Science, Catholic University of Daegu, Gyeongsan-si, South Korea." />
<meta name="citation_author_orcid" content="http://orcid.org/0000-0002-9308-0040" />
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<meta name="citation_author_institution" content="bDepartment of Psychology (Y.S.S., S.H.), Yonsei University, Seoul, Korea" />
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<meta name="twitter:title" content="Different Functional and Microstructural Changes Depending on Duration of Mild Cognitive Impairment in Parkinson Disease" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: The higher cortical burden of Lewy body and Alzheimer disease–type pathology has been reported to be associated with a faster onset of cognitive impairment of Parkinson disease. So far, there has been a few studies only about the changes of gray matter volume depending on duration of cognitive impairment in Parkinson disease. Therefore, our aim was to evaluate the different patterns of structural and functional changes in Parkinson disease with mild cognitive impairment according to the duration of parkinsonism before mild cognitive impairment.

MATERIALS AND METHODS: Fifty-nine patients with Parkinson disease with mild cognitive impairment were classified into 2 groups on the basis of shorter (&lt;1 year, n = 16) and longer (≥1 year, n = 43) durations of parkinsonism before mild cognitive impairment. Fifteen drug-naïve patients with de novo Parkinson disease with intact cognition were included for comparison. Cortical thickness, Tract-Based Spatial Statistics, and seed-based resting-state functional connectivity analyses were performed. Age, sex, years of education, age at onset of parkinsonism, and levodopa-equivalent dose were included as covariates.

RESULTS: The group with shorter duration of parkinsonism before mild cognitive impairment showed decreased fractional anisotropy and increased mean and radial diffusivity values in the frontal areas compared with the group with longer duration of parkinsonism before mild cognitive impairment (corrected P &lt; .05). The group with shorter duration of parkinsonism before mild cognitive impairment showed decreased resting-state functional connectivity in the default mode network area when the left or right posterior cingulate was used as a seed, and in the dorsolateral prefrontal areas when the left or right caudate was used as a seed (corrected P &lt; .05). The group with longer duration of parkinsonism before mild cognitive impairment showed decreased resting-state functional connectivity mainly in the medial prefrontal cortex when the left or right posterior cingulate was used as a seed, and in the parieto-occipital areas when the left or right caudate was used as a seed (corrected P &lt; .05). No differences in cortical thickness were found in all group contrasts.

CONCLUSIONS: Resting-state functional connectivity and WM alterations might be useful imaging biomarkers for identifying changes in patients with Parkinson disease with mild cognitive impairment according to the duration of parkinsonism before mild cognitive impairment. The functional and microstructural substrates may topographically differ depending on the rate of cognitive decline in these patients.

AD
:   Alzheimer disease
DMN
:   default mode network
MCI
:   mild cognitive impairment
PCC
:   posterior cingulate cortex
PD
:   Parkinson disease
PD-IC
:   PD with intact cognition
PD-MCI
:   PD with mild cognitive impairment
PD-MCI-LD
:   PD-MCI with ≥1 year of parkinsonism prior to MCI
PD-MCI-SD
:   PD-MCI with &lt;1 year of parkinsonism prior to MCI
RSFC
:   resting-state functional connectivity" />
<meta name="og-title" property="og:title" content="Different Functional and Microstructural Changes Depending on Duration of Mild Cognitive Impairment in Parkinson Disease" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/37/5/897" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: The higher cortical burden of Lewy body and Alzheimer disease–type pathology has been reported to be associated with a faster onset of cognitive impairment of Parkinson disease. So far, there has been a few studies only about the changes of gray matter volume depending on duration of cognitive impairment in Parkinson disease. Therefore, our aim was to evaluate the different patterns of structural and functional changes in Parkinson disease with mild cognitive impairment according to the duration of parkinsonism before mild cognitive impairment.

MATERIALS AND METHODS: Fifty-nine patients with Parkinson disease with mild cognitive impairment were classified into 2 groups on the basis of shorter (&lt;1 year, n = 16) and longer (≥1 year, n = 43) durations of parkinsonism before mild cognitive impairment. Fifteen drug-naïve patients with de novo Parkinson disease with intact cognition were included for comparison. Cortical thickness, Tract-Based Spatial Statistics, and seed-based resting-state functional connectivity analyses were performed. Age, sex, years of education, age at onset of parkinsonism, and levodopa-equivalent dose were included as covariates.

RESULTS: The group with shorter duration of parkinsonism before mild cognitive impairment showed decreased fractional anisotropy and increased mean and radial diffusivity values in the frontal areas compared with the group with longer duration of parkinsonism before mild cognitive impairment (corrected P &lt; .05). The group with shorter duration of parkinsonism before mild cognitive impairment showed decreased resting-state functional connectivity in the default mode network area when the left or right posterior cingulate was used as a seed, and in the dorsolateral prefrontal areas when the left or right caudate was used as a seed (corrected P &lt; .05). The group with longer duration of parkinsonism before mild cognitive impairment showed decreased resting-state functional connectivity mainly in the medial prefrontal cortex when the left or right posterior cingulate was used as a seed, and in the parieto-occipital areas when the left or right caudate was used as a seed (corrected P &lt; .05). No differences in cortical thickness were found in all group contrasts.

CONCLUSIONS: Resting-state functional connectivity and WM alterations might be useful imaging biomarkers for identifying changes in patients with Parkinson disease with mild cognitive impairment according to the duration of parkinsonism before mild cognitive impairment. The functional and microstructural substrates may topographically differ depending on the rate of cognitive decline in these patients.

AD
:   Alzheimer disease
DMN
:   default mode network
MCI
:   mild cognitive impairment
PCC
:   posterior cingulate cortex
PD
:   Parkinson disease
PD-IC
:   PD with intact cognition
PD-MCI
:   PD with mild cognitive impairment
PD-MCI-LD
:   PD-MCI with ≥1 year of parkinsonism prior to MCI
PD-MCI-SD
:   PD-MCI with &lt;1 year of parkinsonism prior to MCI
RSFC
:   resting-state functional connectivity" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node14502--5" data-node-nid="14502" id="top-node-14502--61478209153" data-pisa="ajnr;37/5/897" data-pisa-master="ajnr;ajnr.A4626" data-apath="/ajnr/37/5/897.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">FUNCTIONAL</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Different Functional and Microstructural Changes Depending on Duration of Mild Cognitive Impairment in Parkinson Disease</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">N.-Y. Shin</span>, <span class="highwire-citation-author" data-delta="1">Y.S. Shin</span>, <span class="highwire-citation-author" data-delta="2">P.H. Lee</span>, <span class="highwire-citation-author" data-delta="3">U. Yoon</span>, <span class="highwire-citation-author" data-delta="4">S. Han</span>, <span class="highwire-citation-author" data-delta="5">D.J. Kim</span> and <span class="highwire-citation-author" data-delta="6">S.-K. Lee</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2016,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">897-903; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4626 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-14502--61478209153" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">N.-Y. Shin </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (N.-Y.S.), Ewha Womans University School of Medicine, Seoul, Korea</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Radiology (N.-Y.S., D.J.K., S.-K.L.), Yonsei University College of Medicine, Seoul, Korea</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=N.-Y.%2BShin%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Shin%20N&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AN.-Y.%2BShin%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0003-1157-6366" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for N.-Y. Shin</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Y.S. Shin </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Psychology (Y.S.S., S.H.), Yonsei University, Seoul, Korea</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Y.S.%2BShin%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Shin%20Y&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AY.S.%2BShin%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-7456-9254" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Y.S. Shin</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">P.H. Lee </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Departments of Neurology (P.H.L.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.H.%2BLee%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lee%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AP.H.%2BLee%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-9931-8462" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P.H. Lee</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">U. Yoon </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Department of Biomedical Engineering (U.Y.), College of Health and Medical Science, Catholic University of Daegu, Gyeongsan-si, South Korea.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=U.%2BYoon%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Yoon%20U&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AU.%2BYoon%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-9308-0040" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for U. Yoon</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">S. Han </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Psychology (Y.S.S., S.H.), Yonsei University, Seoul, Korea</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.%2BHan%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Han%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.%2BHan%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-3086-6142" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S. Han</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">D.J. Kim </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Radiology (N.-Y.S., D.J.K., S.-K.L.), Yonsei University College of Medicine, Seoul, Korea</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.J.%2BKim%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kim%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AD.J.%2BKim%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0002-7035-087X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D.J. Kim</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">S.-K. Lee </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Radiology (N.-Y.S., D.J.K., S.-K.L.), Yonsei University College of Medicine, Seoul, Korea</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.-K.%2BLee%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lee%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.-K.%2BLee%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="http://orcid.org/0000-0001-5646-4072" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S.-K. Lee</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2>Abstract</h2><div id="sec-1" class="subsection"><p id="p-1"><strong>BACKGROUND AND PURPOSE:</strong> The higher cortical burden of Lewy body and Alzheimer disease–type pathology has been reported to be associated with a faster onset of cognitive impairment of Parkinson disease. So far, there has been a few studies only about the changes of gray matter volume depending on duration of cognitive impairment in Parkinson disease. Therefore, our aim was to evaluate the different patterns of structural and functional changes in Parkinson disease with mild cognitive impairment according to the duration of parkinsonism before mild cognitive impairment.</p></div><div id="sec-2" class="subsection"><p id="p-2"><strong>MATERIALS AND METHODS:</strong> Fifty-nine patients with Parkinson disease with mild cognitive impairment were classified into 2 groups on the basis of shorter (&lt;1 year, <em>n</em> = 16) and longer (≥1 year, <em>n</em> = 43) durations of parkinsonism before mild cognitive impairment. Fifteen drug-naïve patients with de novo Parkinson disease with intact cognition were included for comparison. Cortical thickness, Tract-Based Spatial Statistics, and seed-based resting-state functional connectivity analyses were performed. Age, sex, years of education, age at onset of parkinsonism, and levodopa-equivalent dose were included as covariates.</p></div><div id="sec-3" class="subsection"><p id="p-3"><strong>RESULTS:</strong> The group with shorter duration of parkinsonism before mild cognitive impairment showed decreased fractional anisotropy and increased mean and radial diffusivity values in the frontal areas compared with the group with longer duration of parkinsonism before mild cognitive impairment (corrected <em>P</em> &lt; .05). The group with shorter duration of parkinsonism before mild cognitive impairment showed decreased resting-state functional connectivity in the default mode network area when the left or right posterior cingulate was used as a seed, and in the dorsolateral prefrontal areas when the left or right caudate was used as a seed (corrected <em>P</em> &lt; .05). The group with longer duration of parkinsonism before mild cognitive impairment showed decreased resting-state functional connectivity mainly in the medial prefrontal cortex when the left or right posterior cingulate was used as a seed, and in the parieto-occipital areas when the left or right caudate was used as a seed (corrected <em>P</em> &lt; .05). No differences in cortical thickness were found in all group contrasts.</p></div><div id="sec-4" class="subsection"><p id="p-4"><strong>CONCLUSIONS:</strong> Resting-state functional connectivity and WM alterations might be useful imaging biomarkers for identifying changes in patients with Parkinson disease with mild cognitive impairment according to the duration of parkinsonism before mild cognitive impairment. The functional and microstructural substrates may topographically differ depending on the rate of cognitive decline in these patients.</p></div></div><div class="section glossary" id="glossary-1"><h2 class="">ABBREVIATIONS:</h2><dl id="def-list-1"><dt id="def-item-1">AD<span class="def-item-dt-sep"></span></dt><dd>Alzheimer disease<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">DMN<span class="def-item-dt-sep"></span></dt><dd>default mode network<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">MCI<span class="def-item-dt-sep"></span></dt><dd>mild cognitive impairment<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">PCC<span class="def-item-dt-sep"></span></dt><dd>posterior cingulate cortex<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">PD<span class="def-item-dt-sep"></span></dt><dd>Parkinson disease<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">PD-IC<span class="def-item-dt-sep"></span></dt><dd>PD with intact cognition<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">PD-MCI<span class="def-item-dt-sep"></span></dt><dd>PD with mild cognitive impairment<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">PD-MCI-LD<span class="def-item-dt-sep"></span></dt><dd>PD-MCI with ≥1 year of parkinsonism prior to MCI<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">PD-MCI-SD<span class="def-item-dt-sep"></span></dt><dd>PD-MCI with &lt;1 year of parkinsonism prior to MCI<span class="def-item-dd-sep"></span></dd><dt id="def-item-10">RSFC<span class="def-item-dt-sep"></span></dt><dd>resting-state functional connectivity</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2016 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/37/5/897.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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      <div class="highwire-cite-title">Different Functional and Microstructural Changes Depending on Duration of Mild Cognitive Impairment in Parkinson Disease</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2016, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">897-903; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4626 </span></div>
  
  
  
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      <div class="highwire-cite-title">Different Functional and Microstructural Changes Depending on Duration of Mild Cognitive Impairment in Parkinson Disease</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">N.-Y.</span> <span class="nlm-surname">Shin</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Y.S.</span> <span class="nlm-surname">Shin</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">P.H.</span> <span class="nlm-surname">Lee</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">U.</span> <span class="nlm-surname">Yoon</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Han</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">D.J.</span> <span class="nlm-surname">Kim</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">S.-K.</span> <span class="nlm-surname">Lee</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2016, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">37 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">897-903; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4626 </span></div>
  
  
  
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