Parkinson subtypes progress differently in clinical course and imaging pattern.
Parkinson subtypes progress differently in clinical course and imaging pattern.
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DOI：
10.1371/journal.pone.0046813
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Timmermann L
中科院分区：
文献类型：
--
作者：
Eggers C;Pedrosa DJ;Kahraman D;Maier F;Lewis CJ;Fink GR;Schmidt M;Timmermann L
阐明帕金森病（PD）亚型在病程中是否表现出FP-CIT-SPECT结合的差异模式。我们对27名患者（10名女性，17名男性，平均年龄61.68±11.24岁，14名震颤性，13名运动性僵硬）进行了[123 I]FP-CIT-SPECT检查，并在基线和平均2.47年后进行了包括UPDRS III在内的临床评级。根据“震颤评分”和“非震颤评分”，患者在基线时被分类为震颤显性或运动不能僵硬。比较这些亚组的疾病进展差异。计算同侧和对侧壳核和尾状核的临床评级和FP-CIT-SPECT定量分析的平均值，并在基线和随访之间进行比较。两个亚组之间在年龄、疾病持续时间、L-多巴等效剂量、疾病严重程度（ALS III）或基线FP-CIT-SPECT中的多巴胺能摄取方面无统计学差异。在随访时，运动不能僵硬患者表现出与临床症状显著进展相关的多巴胺能摄取的明显和统计学显著性降低（CAFRS III）。相比之下，在震颤患者中，临床症状和多巴胺能缺陷的加重不太明显，在评估中没有统计学意义。这项研究首次显示，随着时间的推移，震颤性PD患者的临床症状和体内多巴胺能缺陷的运动不能刚性相比，相当大的进展。我们的数据可能有助于改善进一步治疗试验的战略规划，并为患者提供更清晰的疾病预后。
To elucidate whether Parkinson’s disease (PD) subtypes show a differential pattern of FP-CIT-SPECT binding during the disease course. We examined 27 patients (10 female, 17 male, mean age 61.68±11.24 years, 14 tremordominant, 13 akinetic-rigid) with [123I]FP-CIT-SPECT and clinical ratings including UPDRS III after at baseline and after a mean period of 2.47 years. Patients had been classified at baseline as tremordominant or akinetic-rigid according to a “tremor score” and “non-tremor score”. These subgroups were compared for differences in disease progression. Means of clinical ratings and the quantitative analyses of FP-CIT-SPECT for ipsi- and contralateral putamen and caudate nucleus were calculated and compared between baseline and follow-up. There were no statistical differences concerning age, disease duration, L-Dopa equivalent dose, disease severity (UPDRS III) or dopaminergic uptake in FP-CIT-SPECT at baseline between both subgroups. At follow-up, akinetic-rigid patients showed a distinct and statistically significant reduction of the dopaminergic uptake associated with significant progression of the clinical symptoms (UPDRS III). In contrast, in tremor patients the aggravation of clinical symptoms and dopaminergic deficit was less pronounced without statistical significance among assessments. This study shows for the first time a considerable progression of clinical symptoms and in-vivo dopaminergic deficit of akinetic-rigid compared to tremordominant PD patients over time. Our data may help to improve strategic planning of further therapeutic trials and to provide a clearer prognosis for patients regarding the perspective of their disease.
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影响因子：
9.9
作者：
Doder, M;Rabiner, EA;Brooks, DJ
通讯作者：
Brooks, DJ
影响因子：
2.3
作者：
KAUFMAN, MJ;MADRAS, BK
通讯作者：
MADRAS, BK
影响因子：
9.9
作者：
JANKOVIC, J;MCDERMOTT, M;WEINER, W
通讯作者：
WEINER, W
影响因子：
4.1
作者：
Kalbe, Elke;Calabrese, Pasquale;Kessler, Josef
通讯作者：
Kessler, Josef
影响因子：
3.5
作者：
Hariz, G-M.;Forsgren, L.
通讯作者：
Forsgren, L.