Alterations of subcortical structures are associated with anxiety in early Parkinson’s disease patients: a cross-sectional 7T MRI study

Anxiety is a prevalent non-motor symptom in Parkinson’s disease (PD), yet its neurobiological markers remain poorly understood. This study aimed to identify volumetric and morphological changes in subcortical structures associated with anxiety in early PD. In this cross-sectional study from the TRACK-PD cohort (Dutch Trial Register - NL7558), 105 non-demented PD patients (31 with anxiety [AnxPD], 74 without [nonAnxPD]) and 37 healthy controls (HC) underwent 7 T MRI.

Subcortical regions including the amygdala, hippocampus, accumbens, caudate, putamen, and thalamus were segmented using FastSurfer. Shape analyses were performed via the Spherical Harmonics Point Distribution Model (SPHARM-PDM). Anxiety severity in PD was significantly associated with a bilateral reduction in caudate volume.

Furthermore, AnxPD patients exhibited distinct shape deformations in the bilateral caudate, bilateral thalamus, left nucleus accumbens, and left amygdala compared to non-anxious patients. Significant shape differences in the left amygdala and left thalamus were also observed between AnxPD and HC groups. PD-related anxiety is linked to distinct structural remodeling of the striatum, thalamus, and amygdala.

These morphometric changes represent potential imaging markers for the occurrence and progression of anxiety in early PD. The authors thank all participants of the study for their patience and cooperation and all the staff of Maastricht University Medical Center and Institute of Mental Health and Neurosciences (MHeNs) involved in the TRACK-PD study. MRI data included in this study were acquired on the 7 T scanner at Scannexus (Maastricht, the Netherlands).

The authors thank the French association “France Parkinson” for their financial support, interest, and trust in this research work (https://www.franceparkinson.fr/). The Track-PD study is funded by a grant from the Weijerhorst Foundation (Stichting de Weijerhorst). This Dutch foundation supports and promotes activities in the public interest, in particular scientific research.

The sponsor has no role in the design of the study and collection, analysis, and interpretation of data. Also, the sponsor was not involved in writing this manuscript. A grant from the association “FRANCE PARKINSON” was earned to financially support the research activity of the first author (G.C.).