Dopamine Transporter, Age, and Motor Complications in Parkinson's Disease: A Clinical and Single-Photon Emission Computed Tomography Study
Dopamine Transporter, Age, and Motor Complications in Parkinson's Disease: A Clinical and Single-Photon Emission Computed Tomography Study
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DOI：
10.1002/mds.28008
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发表时间：
2020-06-01
影响因子：
8.6
通讯作者：
Ceravolo, Roberto
中科院分区：
文献类型：
--
作者：
Palermo, Giovanni;Giannoni, Sara;Ceravolo, Roberto
研究背景早发性帕金森病患者和晚发性帕金森病患者体内多巴胺功能的分子成像研究显示出相互矛盾的结果，可能是由于黑质纹状体功能的老化所致。目的(1)研究早发性帕金森病(70岁)患者的多巴胺转运体的基线可用性，计算壳核和尾状核[I-123]-碘氟烷摄取的z-积分值，以校正早期突触前代偿机制和年龄相关的多巴胺神经元丢失；(2)研究基线单光子发射计算机断层扫描测量与晚期疾病运动并发症的出现之间的关系。方法对105例确诊时行[I-123]-Iflupane单光子发射计算机断层扫描的初发PD患者按发病年龄分为三组(早发组35例，晚发组40例)。比较两组间的Z评分，并使用COX比例风险模型评估它们对运动并发症(平均随访7年)的预测力。结果尽管早发性帕金森病患者的运动表型较轻，但其壳核中的[I-123]-碘氟烷结合量降低，并较晚发型帕金森病患者更早、更高地发生运动并发症。壳核和尾状核摄取较低的[I-123]-碘氟烷增加了运动并发症的风险。结论早发性帕金森病患者多巴胺转运体结合量降低预示着运动并发症的晚期发展，但与运动症状的严重程度无关，提示帕金森病患者纹状体代偿机制与年龄相关。(C)2020年国际帕金森病和运动障碍协会
Background Previous molecular imaging studies comparing dopamine function in vivo between early-onset PD and late-onset PD patients have shown contradictory results, presumably attributable to the aging-related decline in nigrostriatal function. Objectives (1) To investigate baseline dopamine transporter availability in early-onset PD (70 years) patients, z-scores values of putamen and caudate [I-123]-ioflupane uptake were calculated using the respective age-matched controls in order to correct for early presynaptic compensatory mechanisms and age-related dopamine neuron loss; (2) to examine the associations of such baseline single-photon emission computed tomography measures with the emergence of late-disease motor complications. Methods In this retrospective study, 105 de novo PD patients who underwent [I-123]-ioflupane single-photon emission computed tomography at time of diagnosis were divided into three tertile groups according to age at disease onset (35 early-onset PD and 40 late-onset PD patients). Z-scores were compared between the two groups, and their predictive power for motor complications (during a mean follow-up of 7 years) was evaluated using Cox proportional hazard models. Results Despite a less-severe motor phenotype, early-onset PD patients exhibited more reduced [I-123]-ioflupane binding in the putamen and had a higher and earlier risk for developing motor complications than those with late-onset PD. Lower [I-123]-Ioflupane uptake in the putamen and caudate increased the risk of motor complications. Conclusions Our findings indicate that a lower dopamine transporter binding in early-onset PD predicts the later development of motor complications, but it is not related to severity of motor symptoms, suggesting age-related differences in striatal compensatory mechanisms in PD. (c) 2020 International Parkinson and Movement Disorder Society