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

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.