Postural instability gait disorder (PIGD) subtype in Parkinson's disease (PD) is a major cause of morbidity. We quantified whole-brain structural changes in PIGD patients, PD patients and controls using an automated volume-based morphometry algorithm that is objective and reproducible. Compared to PD and controls, PIGD subgroup demonstrated a significant decrease in brain and globus pallidus volume, as well as grey matter content in both caudate and thalamus; but an increase in ventricular size, abnormal white matter volume and relative caudate size. MRI findings also correlate with gait imbalance severity in PIGD, suggesting a mechanism of temporal differences in segmental volume loss.
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