Reduced Gray Matter Volume and Risk of Falls in Parkinson’s Disease with Dementia Patients: A Voxel-Based Morphometry Study
<i>Purpose</i>: Risk of falls is a common sequela affecting patients with Parkinson’s disease (PD). Although motor impairment and dementia are correlated with falls, associations of brain structure and cognition deficits with falls remain unclear. <i>Material and Methods</i>:...
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doaj-c6a0da9df43f45a5ba3ab2720968607f2020-11-25T02:48:05ZengMDPI AGInternational Journal of Environmental Research and Public Health1661-78271660-46012020-07-01175374537410.3390/ijerph17155374Reduced Gray Matter Volume and Risk of Falls in Parkinson’s Disease with Dementia Patients: A Voxel-Based Morphometry StudyKai-Lun Cheng0Li-Han Lin1Po-Cheng Chen2Pi-Ling Chiang3Yueh-Sheng Chen4Hsiu-Ling Chen5Meng-Hsiang Chen6Kun-Hsien Chou7Shau-Hsuan Li8Cheng-Hsien Lu9Wei-Che Lin10Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung 402, TaiwanDepartment of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanBrain Research Center, National Yang-Ming University, Taipei 112, TaiwanDepartment of Oncology and Hematology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Neurology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan<i>Purpose</i>: Risk of falls is a common sequela affecting patients with Parkinson’s disease (PD). Although motor impairment and dementia are correlated with falls, associations of brain structure and cognition deficits with falls remain unclear. <i>Material and Methods</i>: Thirty-five PD patients with dementia (PDD), and 37 age- and sex-matched healthy subjects were recruited for this study. All participants received structural magnetic resonance imaging (MRI) scans, and disease severity and cognitive evaluations. Additionally, patient fall history was recorded. Regional structural differences between PDD with and without fall groups were performed using voxel-based morphometry processing. Stepwise logistic regression analysis was used to predict the fall risk in PDD patients. <i>Results:</i> The results revealed that 48% of PDD patients experienced falls. Significantly lower gray matter volume (GMV) in the left calcarine and right inferior frontal gyrus in PDD patients with fall compared to PDD patients without fall were noted. The PDD patients with fall exhibited worse UPDRS-II scores compared to PDD patients without fall and were negatively correlated with lower GMV in the left calcarine (<i>p</i>/<i>r</i> = 0.004/−0.492). Furthermore, lower GMV in the left calcarine and right inferior frontal gyrus correlated with poor attention and executive functional test scores. Multiple logistic regression analysis showed that the left calcarine was the only variable (<i>p</i> = 0.004, 95% CI = 0.00–0.00) negatively associated with the fall event. <i>Conclusions:</i> PDD patients exhibiting impaired motor function, lower GMV in the left calcarine and right inferior frontal gyrus, and notable cognitive deficits may have increased risk of falls.https://www.mdpi.com/1660-4601/17/15/5374Parkinson’s diseasedementiafallbrain structureexecutive function |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kai-Lun Cheng Li-Han Lin Po-Cheng Chen Pi-Ling Chiang Yueh-Sheng Chen Hsiu-Ling Chen Meng-Hsiang Chen Kun-Hsien Chou Shau-Hsuan Li Cheng-Hsien Lu Wei-Che Lin |
spellingShingle |
Kai-Lun Cheng Li-Han Lin Po-Cheng Chen Pi-Ling Chiang Yueh-Sheng Chen Hsiu-Ling Chen Meng-Hsiang Chen Kun-Hsien Chou Shau-Hsuan Li Cheng-Hsien Lu Wei-Che Lin Reduced Gray Matter Volume and Risk of Falls in Parkinson’s Disease with Dementia Patients: A Voxel-Based Morphometry Study International Journal of Environmental Research and Public Health Parkinson’s disease dementia fall brain structure executive function |
author_facet |
Kai-Lun Cheng Li-Han Lin Po-Cheng Chen Pi-Ling Chiang Yueh-Sheng Chen Hsiu-Ling Chen Meng-Hsiang Chen Kun-Hsien Chou Shau-Hsuan Li Cheng-Hsien Lu Wei-Che Lin |
author_sort |
Kai-Lun Cheng |
title |
Reduced Gray Matter Volume and Risk of Falls in Parkinson’s Disease with Dementia Patients: A Voxel-Based Morphometry Study |
title_short |
Reduced Gray Matter Volume and Risk of Falls in Parkinson’s Disease with Dementia Patients: A Voxel-Based Morphometry Study |
title_full |
Reduced Gray Matter Volume and Risk of Falls in Parkinson’s Disease with Dementia Patients: A Voxel-Based Morphometry Study |
title_fullStr |
Reduced Gray Matter Volume and Risk of Falls in Parkinson’s Disease with Dementia Patients: A Voxel-Based Morphometry Study |
title_full_unstemmed |
Reduced Gray Matter Volume and Risk of Falls in Parkinson’s Disease with Dementia Patients: A Voxel-Based Morphometry Study |
title_sort |
reduced gray matter volume and risk of falls in parkinson’s disease with dementia patients: a voxel-based morphometry study |
publisher |
MDPI AG |
series |
International Journal of Environmental Research and Public Health |
issn |
1661-7827 1660-4601 |
publishDate |
2020-07-01 |
description |
<i>Purpose</i>: Risk of falls is a common sequela affecting patients with Parkinson’s disease (PD). Although motor impairment and dementia are correlated with falls, associations of brain structure and cognition deficits with falls remain unclear. <i>Material and Methods</i>: Thirty-five PD patients with dementia (PDD), and 37 age- and sex-matched healthy subjects were recruited for this study. All participants received structural magnetic resonance imaging (MRI) scans, and disease severity and cognitive evaluations. Additionally, patient fall history was recorded. Regional structural differences between PDD with and without fall groups were performed using voxel-based morphometry processing. Stepwise logistic regression analysis was used to predict the fall risk in PDD patients. <i>Results:</i> The results revealed that 48% of PDD patients experienced falls. Significantly lower gray matter volume (GMV) in the left calcarine and right inferior frontal gyrus in PDD patients with fall compared to PDD patients without fall were noted. The PDD patients with fall exhibited worse UPDRS-II scores compared to PDD patients without fall and were negatively correlated with lower GMV in the left calcarine (<i>p</i>/<i>r</i> = 0.004/−0.492). Furthermore, lower GMV in the left calcarine and right inferior frontal gyrus correlated with poor attention and executive functional test scores. Multiple logistic regression analysis showed that the left calcarine was the only variable (<i>p</i> = 0.004, 95% CI = 0.00–0.00) negatively associated with the fall event. <i>Conclusions:</i> PDD patients exhibiting impaired motor function, lower GMV in the left calcarine and right inferior frontal gyrus, and notable cognitive deficits may have increased risk of falls. |
topic |
Parkinson’s disease dementia fall brain structure executive function |
url |
https://www.mdpi.com/1660-4601/17/15/5374 |
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