White matter tract alterations in Parkinson's disease patients with punding

Parkinsonism Relat Disord. 2017 Oct:43:85-91. doi: 10.1016/j.parkreldis.2017.07.025. Epub 2017 Jul 27.


Objective: To assess brain white matter tract alterations in patients with Parkinson's disease and punding (PD-punding) compared with controls and PD cases without any impulsive-compulsive behaviour.

Methods: Forty-nine PD patients (21 PD-punding and 28 PD with no impulsive-compulsive behaviours) and 28 controls were consecutively recruited. Clinical, cognitive and psychopathological evaluations were performed. Diffusion tensor MRI metrics of the main white matter tracts were assessed using a tractography approach.

Results: Compared with controls, both PD groups showed white matter microstructural alterations of the left pedunculopontine tract and splenium of the corpus callosum. PD-punding patients showed a further damage to the right pedunculopontine tract and uncinate fasciculus, genu of the corpus callosum, and left parahippocampal tract relative to controls. When adjusting for depression and/or apathy severity, a greater damage of the genu of the corpus callosum and the left pedunculopontine tract was found in PD-punding compared with patients with no impulsive-compulsive behaviours.

Conclusions: PD-punding is associated with a disconnection between midbrain, limbic and white matter tracts projecting to the frontal cortices. These alterations are at least partially independent of their psychopathological changes. Diffusion tensor MRI is a powerful tool for understanding the neural substrates underlying punding in PD.

Keywords: Diffusion tensor MRI; Impulsive-compulsive behaviours; Parkinson's disease; Punding; White matter.

MeSH terms

  • Aged
  • Analysis of Variance
  • Compulsive Behavior / etiology*
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Imaging
  • Male
  • Mental Status Schedule
  • Middle Aged
  • Neuropsychological Tests
  • Parkinsonian Disorders / complications*
  • Parkinsonian Disorders / diagnostic imaging
  • Parkinsonian Disorders / pathology
  • White Matter / diagnostic imaging*