Voxel-Based and Surface-Based Morphometry Study of the Early Stage of Carbon Monoxide Poisoning-Induced Parkinsonism

Abstract Grey matter (GM) volume changes in carbon monoxide poisoning (COP)-induced parkinsonism have been investigated in previous studies. However, a combined analysis of GM and white matter (WM) volume, cortical thickness, and shape is lacking. Eighteen COP-induced parkinsonism patients and 22 matched healthy controls (HCs) were enrolled in this study. All MRI scans were performed within 3 months after COP and analysed with a combination of voxel- and surface-based morphometry (VBM and SBM) analyses. Relationships between structural changes and clinical scores were detected with partial correlation analysis. VBM analysis showed reduced GM volumes in the bilateral frontal and temporal lobes, anterior cingulate cortex (ACC), amygdala, striatum, thalamus, and cerebellum (FDR-corrected P < 0.001) and a trend towards WM atrophy in the anterior cerebral and medial mesencephalon but swelling in the posterior cerebral and motor cortical areas (uncorrected P < 0.001) in the patients. SBM analysis showed widespread cortical thinning that extended beyond the frontotemporal regions and involved the occipitoparietal areas and regional shallow sulcal depth in the left supramarginal gyrus in the patients (FWE-corrected P < 0.05). The severity of motor disorders was correlated with GM atrophy in the medial orbital superior frontal gyrus (SFG), ACC, caudate, thalamus, and caudal middle frontal gyrus, while nonmotor disorders were correlated with atrophy in the SFG, ACC, thalamus, amygdala, and cerebellum crus I (all P < 0.05). Early-stage COP-induced parkinsonism is characterised by widespread GM atrophy. A combination of VBM and SBM analyses contributes to revealing its imaging pathological feature.