Relationship between [123I]-FP-CIT SPECT and clinical progression in Parkinson's disease
2017
Background The demonstration of presynaptic
dopaminergicdeficiency on [123I]-
FP-CIT SPECT imaging is a useful ancillary tool in the diagnosis of Parkinson's disease (PD). Whilst there is evidence of a cross-sectional relationship between the degree of
dopaminergicdeficiency and severity of bradykinesia and rigidity, longitudinal studies are rare. Moreover, the relationship between motor subtypes and their
dopaminergicdeficient state is not well characterized. Aim Our primary aim was to assess the correlations between
dopaminergicdeficiency on
baseline[123I]-
FP-CIT SPECT imaging with the progression of motor severity in patients classified by motor subtype, and the development of motor complications. Our secondary aim was to assess the correlation between UPDRS-III subscores and the time to onset of motor complications. Methods 42 PD patients with abnormal
baseline[123I]-
FP-CIT SPECT scans and at least 3 years of clinical follow-up were classified by motor subtype:
akinetic–rigid, tremor-dominant or mixed. UPDRS-III scores at
baselineand at 3-year follow-up, and time to onset of motor complications were recorded. Results [123I]-
FP-CIT uptake ratios were inversely correlated with UPDRS-III scores at 3 years only in
akinetic–rigid patients (r=−.51, P=.04). Time to onset of motor complications was inversely correlated with UPDRS-III subscores for bradykinesia and rigidity at
baseline(r=−.52, P=.02) and at 3 years (r=−.54, P=.01). Conclusion The degree of
dopaminergicdeficiency on
baseline[123I]-
FP-CIT SPECT inversely correlates with motor severity at 3-year follow-up in
akinetic–rigid patients only. Furthermore, UPDRS-III subscores for bradykinesia and rigidity at
baselineshow an inverse correlation with time to onset of motor complications across all PD subtypes.
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