Functional and structural alterations as diagnostic imaging markers for depression in de novo Parkinson's disease

Hui Wang; Jianxia Xu; Miao Yu; Gaiyan Zhou; Jingru Ren; Yajie Wang; Huifen Zheng; Yu Sun; Jun Wu; Weiguo Liu

doi:10.3389/fnins.2023.1101623

Functional and structural alterations as diagnostic imaging markers for depression in de novo Parkinson's disease

Front Neurosci. 2023 Feb 22:17:1101623. doi: 10.3389/fnins.2023.1101623. eCollection 2023.

Authors

Hui Wang¹, Jianxia Xu², Miao Yu³, Gaiyan Zhou³, Jingru Ren³, Yajie Wang³, Huifen Zheng⁴, Yu Sun⁵, Jun Wu⁶, Weiguo Liu³

Affiliations

¹ Department of Neurology, Lianyungang Hospital of Traditional Chinese Medicine, Lianyungang Affiliated Hospital of Nanjing University of Chinese Medicine, Lianyungang, China.
² Department of Neurology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China.
³ Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
⁴ Department of Neurology, Geriatric Hospital of Nanjing Medical University, Nanjing, China.
⁵ International Laboratory of Children Medical Imaging Research, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China.
⁶ Department of Clinical Laboratory, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.

Abstract

Background: Depression in Parkinson's disease (PD) is identified and diagnosed with behavioral observations and neuropsychological measurements. Due to the large overlaps of depression and PD symptoms in clinical manifestations, it is challenging for neurologists to distinguish and diagnose depression in PD (DPD) in the early clinical stage of PD. The advancement in magnetic resonance imaging (MRI) technology provides potential clinical utility in the diagnosis of DPD. This study aimed to explore the alterations of functional and structural MRI in DPD to produce neuroimaging markers in discriminating DPD from non-depressed PD (NDPD) and healthy controls (HC).

Methods: We recruited 20 DPD, 37 NDPD, and 41 HC matched in age, gender, and education years. The patients' diagnosis with PD was de novo. The differences in regional homogeneity (ReHo), voxel-wise degree centrality (DC), cortical thickness, cortical gray matter (GM) volumes, and subcortical GM volumes among these groups were detected, and the relationship between altered indicators and depression was analyzed. Moreover, the receiver operating characteristic (ROC) analysis was performed to assess the diagnostic efficacy of altered indicators for DPD.

Results: Compared to NDPD and HC, DPD showed significantly increased ReHo in left dorsolateral superior frontal gyrus (DSFG) and DC in left inferior temporal gyrus (ITG), and decreased GM volumes in left temporal lobe and right Amygdala. Among these altered indicators, ReHo value in left DSFG and DC values in left ITG and left DSFG were significantly correlated with the severity of depression in PD patients. Comparing DPD and NDPD, the ROC analysis revealed a better area under the curve value for the combination of ReHo value in left DSFG and DC value in left ITG, followed by each independent indicator. However, the difference is not statistically significant.

Conclusion: This study demonstrates that both functional and structural impairments are present in DPD. Among them, ReHo value of left DSFG and DC value of left ITG are equally well suited for the diagnosis and differential diagnosis of DPD, with a combination of them being slightly preferable. The multimodal MRI technique represents a promising approach for the classification of subjects with PD.

Keywords: Parkinson’s disease; depression; differential diagnosis; resting state functional magnetic resonance imaging; structural magnetic resonance imaging.

Grants and funding

This work was supported by the National Natural Science Foundation of China (NSFC) (Nos. 81571348, 81701675, 81903589, and 81701671), the National Key Research and Development Program of China (Nos. 2017YFC1310300, 2017YFC1310302, and 2016YFC1306600), the Key Project supported by Medical Science and Technology Development Foundation, Nanjing Department of Health (No. JQX21006), the Science and Technology Program of Jiangsu Province (Nos. BE2019611 and BE2018608), and the Jiangsu Provincial Natural Science Foundation of China (BK20151077).