Longitudinal follow-up of SWEDD subjects in the PRECEPT Study
Longitudinal follow-up of SWEDD subjects in the PRECEPT Study
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DOI：
10.1212/wnl.0000000000000424
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发表时间：
2014-05-20
期刊：
影响因子：
9.9
通讯作者：
Jennings, Danna
中科院分区：
文献类型：
--
作者：
Marek, Kenneth;Seibyl, John;Jennings, Danna
目的：比较在研究基线和22个月随访期间，那些在PRECEPT（Parkinson Research Examination of CEP-1347 Trial，帕金森研究检查）中没有多巴胺能缺陷（SWEDD）证据的受试者和那些多巴胺转运蛋白（DAT）缺陷的受试者的临床和影像学特征。比较SWEDD和DAT缺陷受试者的[I-123] -CIT纹状体结合率的百分比变化、需要多巴胺能治疗的受试者百分比、统一帕金森病评定量表（UNITED Parkinson's Disease Rating Scale，简称UNITED）评分的变化以及研究终止时PRECEPT研究者的诊断。与DAT缺陷受试者（n = 708）相比，SWEDD受试者（n = 91）显示基线时的WSRS评分降低（18.7 [SD 8.5] vs 25.5 [SD 10.5]，p < 0.05）和[I-123] -CIT纹状体结合率的最小变化随访评估时，两组患者的平均体重（-0.2% [SD 12.2] vs -8.5% [SD 11.9]，p < 0.0001）和平均体重（0.5 [SD 6.9] vs 10.5 [SD 8.9]，p < 0.0001）。在PRECEPT终止时，研究者的诊断从帕金森病（PD）变为与DAT缺陷无关的其他疾病（44%）（95%置信区间34.2，54.7）与3.6%（95%可信区间2.3，5.1）。结论：这些结果表明，DAT成像在正常范围内的SWEDD受试者的临床或影像学PD进展证据极少。这些数据强烈表明SWEDD受试者不太可能患有特发性PD。
Objective:To compare the clinical and imaging characteristics of those PRECEPT (Parkinson Research Examination of CEP-1347 Trial) subjects with a scan without evidence of dopaminergic deficit (SWEDD) to those with dopamine transporter (DAT) deficit scans at study baseline and during a 22-month follow-up.Methods:Baseline (n = 799) and 22-month follow-up (n = 701) [I-123] -CIT SPECT scans were acquired. The percent change in [I-123] -CIT striatal binding ratio, the percentage of subjects requiring dopaminergic therapy, the change in Unified Parkinson's Disease Rating Scale (UPDRS) score, and the PRECEPT Study investigators' diagnosis at study termination were compared between SWEDD and DAT deficit subjects.Results:SWEDD subjects (n = 91) compared with DAT deficit subjects (n = 708) showed reduced UPDRS score at baseline (18.7 [SD 8.5] vs 25.5 [SD 10.5], p < 0.05) and minimal change in both [I-123] -CIT striatal binding ratio (-0.2% [SD 12.2] vs -8.5% [SD 11.9], p < 0.0001) and UPDRS score (0.5 [SD 6.9] vs 10.5 [SD 8.9], p < 0.0001) at follow-up assessments. At PRECEPT termination, the diagnosis by study investigators was changed from Parkinson disease (PD) to other disorders not associated with DAT deficit in 44% (95% confidence interval 34.2, 54.7) of SWEDD subjects compared with 3.6% (95% confidence interval 2.3, 5.1) of DAT deficit subjects.Conclusion:These results indicate that subjects identified as having a SWEDD, with DAT imaging within the normal range, have minimal evidence of clinical or imaging PD progression. These data strongly suggest that SWEDD subjects are unlikely to have idiopathic PD.