The topography of brain damage at different stages of parkinson's disease

Federica Agosta, Elisa Canu, Tanja Stojković, Michela Pievani, Aleksandra Tomić, Lidia Sarro, Nataša Dragašević, Massimiliano Copetti, Giancarlo Comi, Vladimir S. Kostić, Massimo Filippi

Research output: Contribution to journalArticlepeer-review


This study investigated gray matter (GM) and white matter (WM) damage in 89 patients at different clinical stages of Parkinson's disease (PD) (17 early, 46 mild, 14 moderate, and 12 severe) to differentiate the trajectories of tissue injury in this condition. PD patients had a very little GM atrophy even at the more advanced stages of the disease. Microstructural damage to the WM occurs with increasing PD severity and involves the brainstem, thalamocortical pathways, olfactory tracts, as well as the major interhemispheric, limbic, and extramotor association tracts. The most marked WM damage was found in moderate vs. mild cases. WM damage correlated with the degree of global cognitive deficits. WM abnormalities beyond the nigrostriatal system accumulate with increasing PD severity. WM damage is likely to contribute to the more severe motor and nonmotor dysfunctions occurring in patients at the later stages.

Original languageEnglish
Pages (from-to)2798-2807
Number of pages10
JournalHuman Brain Mapping
Issue number11
Publication statusPublished - Nov 2013


  • Brain atrophy
  • DT MRI
  • Parkinson's disease
  • VBM
  • White matter damage

ASJC Scopus subject areas

  • Clinical Neurology
  • Anatomy
  • Neurology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Medicine(all)


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