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

E Canu, F Agosta, V Markovic, I Petrovic, I Stankovic, F Imperiale, T Stojkovic, M Copetti, VS Kostic, M Filippi

Research output: Contribution to journalArticlepeer-review


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. © 2017 Elsevier Ltd.
Original languageEnglish
Pages (from-to)85-91
Number of pages7
JournalParkinsonism and Related Disorders
Issue number6
Publication statusPublished - 2017


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