Hippocampal subfield atrophy in relation to cerebrospinal fluid biomarkers and cognition in early Parkinson’s disease: a cross-sectional study

• Published in: NPJ Parkinson's Disease 2016, Vol.2 (1), p.15030-15030, Article 15030
• Main Authors: Stav, Ane Løvli, Johansen, Krisztina Kunszt, Auning, Eirik, Kalheim, Lisa Flem, Selnes, Per, Bjørnerud, Atle, Hessen, Erik, Aarsland, Dag, Fladby, Tormod
• Format: Article
• Language: English
• Subjects: 631/378/2612; 692/308/1892; Biomedical and Life Sciences; Biomedicine; Neurology; Neurosciences
• ISSN: 2373-8057; 2373-8057
• DOI: 10.1038/npjparkd.2015.30

Cognition is often affected early in Parkinson’s disease (PD). Lewy body and amyloid β (Aβ) pathology and cortical atrophy may be involved. The aim of this study was to examine whether medial temporal lobe structural changes may be linked to cerebrospinal fluid (CSF) biomarker levels and cognition in early PD. PD patients had smaller volumes of total hippocampus, presubiculum, subiculum, CA2–3, CA4-DG, and hippocampal tail compared with normal controls (NCs). In the PD group, lower CSF Aβ38 and 42 were significant predictors for thinner perirhinal cortex. Lower Aβ42 and smaller presubiculum and subiculum predicted poorer verbal learning and delayed verbal recall. Smaller total hippocampus, presubiculum and subiculum predicted poorer visuospatial copying. Lower Aβ38 and 40 and thinner perirhinal cortex predicted poorer delayed visual reproduction. In conclusion, smaller volumes of hippocampal subfields and subhippocampal cortex thickness linked to lower CSF Aβ levels may contribute to cognitive impairment in early PD. Thirty-three early PD patients (13 without, 5 with subjective, and 15 with mild cognitive impairment) and NC had 3 T magnetic resonance imaging (MRI) scans. The MRI scans were post processed for volumes of hippocampal subfields and entorhinal and perirhinal cortical thickness. Lumbar puncture for CSF biomarkers Aβ38, 40, 42, total tau, phosphorylated tau (Innogenetics), and total α-synuclein (Meso Scale Diagnostics) were performed. Multiple regression analyses were used for between-group comparisons of the MRI measurements in the NC and PD groups and for assessment of CSF biomarkers and neuropsychological tests in relation to morphometry in the PD group. Cognitive impairment: Degenerative changes linked to memory problems Selective deterioration of key brain regions and biomarkers of neurodegeneration are linked with cognitive decline in Parkinson’s disease. Cognitive impairment is common in patients with this disease but the mechanisms behind it are unclear. Ane Løvli Stav at Akershus University Hospital, Norway, and colleagues used magnetic resonance imaging to study anatomical changes in the brains of early Parkinson’s patients without dementia. They found that the hippocampus, a brain region involved in memory, and discrete subregions within it were smaller in Parkinson’s patients. Next, they investigated certain neurodegeneration-linked biomarker proteins in the cerebrospinal fluid of Parkinson’s patients. The team showed that the anatomi