Diffusion and structural MRI as potential biomarkers in people with Parkinson’s disease and cognitive impairment

Chun Chao Huang, Pei Hao Chen, Chih Chien Tsai, Hsin Fan Chiang, Cheng Chih Hsieh, Ting Lin Chen, Wei Hsin Liao, Yao Liang Chen, Jiun Jie Wang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

2 Scopus citations


Objective: To explore the neuroimage change in Parkinson’s disease (PD) patients with cognitive impairments, this study investigated the correlation between plasma biomarkers and morphological brain changes in patients with normal cognition and mild cognitive impairment. The objective was to identify the potential target deposition regions of the plasma biomarkers and to search for the relevant early neuroimaging biomarkers on the basis of different cognitive domains. Methods: Structural brain MRI and diffusion weighted images were analyzed from 49 eligible PD participants (male/female: 27/22; mean age: 73.4 ± 8.5 years) from a retrospective analysis. Plasma levels of α-synuclein, amyloid beta peptide, and total tau were collected. A comprehensive neuropsychological assessment of the general and specific cognitive domains was performed. Difference between PD patients with normal cognition and impairment was examined. Regression analysis was performed to evaluate the correlation between image-derived index and plasma biomarkers or neuropsychological assessments. Results: Significant correlation was found between plasma Aβ-42 level and fractional anisotropy of the middle occipital, angular, and middle temporal gyri of the left brain, as well as plasma T-tau level and the surface area of the isthmus or the average thickness of the posterior part of right cingulate gyrus. Visuospatial and executive function is positively correlated with axial diffusivity in bilateral cingulate gyri. Conclusion: In nondemented PD patients, the target regions for plasma deposition might be located in the cingulate, middle occipital, angular, and middle temporal gyri. Changes from multiple brain regions can be correlated to the performance of different cognitive domains. Clinical relevance statement: Cognitive impairment in Parkinson’s disease is primarily linked to biomarkers associated with Alzheimer’s disease rather than those related to Parkinson’s disease and resembles the frontal variant of Alzheimer’s disease, which may guide management strategies for cognitive impairment in Parkinson’s disease. Key Points: • Fractional anisotropy, surface area, and thickness in the cingulate, middle occipital, angular, and middle temporal gyri can be significantly correlated with plasma Aβ-42 and T-tau level. • Axial diffusivity in the cingulate gyri was correlated with visuospatial and executive function. • The pattern of cognitive impairment in Parkinson’s disease can be similar to the frontal variant than typical Alzheimer’s disease.

Original languageEnglish
Pages (from-to)126-135
Number of pages10
JournalEuropean Radiology
Issue number1
StatePublished - 01 2024

Bibliographical note

© 2023. The Author(s), under exclusive licence to European Society of Radiology.


  • Cognition
  • Cortical volume
  • Diffusion tensor imaging
  • Parkinson’s disease
  • Plasma biomarkers
  • Cognitive Dysfunction/complications
  • Humans
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging/methods
  • Neuropsychological Tests
  • Amyloid beta-Peptides
  • Aged, 80 and over
  • Parkinson Disease/complications
  • Biomarkers
  • Female
  • Aged
  • Retrospective Studies
  • Alzheimer Disease/complications


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