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Insula Volume and Salience Network are Associated with Memory Decline in Parkinson Disease: Complementary Analyses of Voxel-Based Morphometry versus Volume of Interest
Objective: We investigated structural brain change in subjects with a clinical diagnosis of Parkinson disease with mild cognitive impairment (PD-MCI) and examined its relationship with memory impairment. Methods: Twenty-three PD-MCI patients were enrolled and underwent cognitive evaluation and 3-dimensional T1-weighted imaging. Voxel-based morphometry (VBM) was used to assess brain-behavior correlations and examine the relationship between insula and memory score. VOI methods replicated results obtained from VBM. Results: VBM uncovered the notion that memory scores were positively correlated with the gray matter (GM) density in the insular cortex and a significant positive correlation between overall cognitive performance and concentration of GM within the lateral temporal cortex. In VOI analyses, our results suggested a positive correlation between the insula and composite free-recall verbal memory (p = 0.617, p = 0.003) and the delayed free-recall verbal memory subdomain (p = 0.725, p < 0.001). Furthermore, we found a positive correlation between the insula and caudate σ = 0.570, p = 0.006) and putamen volume (σ = 0.683, p < 0.001). Conclusions: In patients with PD-MCI, atrophic changes in the insula may be related to memory deficits, and the brain-behavior correlation may be associated with atrophic change in the striatum within the salience network.
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