Anxiety in Parkinson's Disease Is Associated with Changes in Brain Structural Connectivity

J Parkinsons Dis. 2023;13(6):989-998. doi: 10.3233/JPD-230035.

Abstract

Background: Anxiety in Parkinson's disease (PD) has been associated with grey matter changes and functional changes in anxiety-related neuronal circuits. So far, no study has analyzed white matter (WM) changes in patients with PD and anxiety.

Objective: The aim of this study was to identify WM changes by comparing PD patients with and without anxiety, using diffusion-tensor imaging (DTI).

Methods: 108 non-demented PD patients with (n = 31) and without (n = 77) anxiety as defined by their score on the Parkinson Anxiety Scale participated. DTI was used to determine the fractional anisotropy (FA) and mean diffusivity (MD) in specific tracts within anxiety-related neuronal circuits. Mean FA and MD were compared between groups and correlated with the severity of anxiety adjusted by sex, center, Hoehn & Yahr stage, levodopa equivalent daily dosage, and Hamilton depression rating scale.

Results: Compared to patients without anxiety, PD patients with anxiety showed lower FA within the striato-orbitofrontal, striato-cingulate, cingulate-limbic, and caudate-thalamic tracts; higher FA within the striato-limbic and accumbens-thalamic tracts; higher MD within the striato-thalamic tract and lower MD within the striato-limbic tract.

Conclusions: Anxiety in PD is associated with microstructural alterations in anxiety-related neuronal circuits within the WM. This result reinforces the view that PD-related anxiety is linked to structural alteration within the anxiety-related brain circuits.

Keywords: ClinicalTrials.gov Identifier: NCT01792843..

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anxiety / diagnostic imaging
  • Anxiety / etiology
  • Brain / diagnostic imaging
  • Gray Matter
  • Humans
  • Levodopa
  • Parkinson Disease* / complications
  • Parkinson Disease* / diagnostic imaging

Substances

  • Levodopa