Measuring the rate of progression of Parkinson's disease over a 5-year period with beta-CIT SPECT.
Recent imaging studies suggest a rapid degeneration of the dopaminergic system in early Parkinson's disease (PD), followed by a slowing of the degenerative process in advanced disease. In the present study, a group of early-stage PD patients underwent three sequential [123I]beta-CIT SPECT studies to assess the decline of striatal dopamine transporter binding over a 5-year period. Twenty-one of a cohort of 24 early PD patients who participated in an earlier longitudinal beta-CIT SPECT imaging study [Mov Disord 2002;17:45-53] were included. Scan intervals were 26 +/- 11 months (scan 1-2) and 38 +/- 15 months (scan 2-3), respectively. The relative annual rate of decline of striatal beta-CIT binding from age-expected normal values at the time of Scan 1 was used as primary outcome variable. The relative annual decline of striatal binding from Scan 1 to Scan 2 (4.5 +/- 4.6%) and from Scan 2 to Scan 3 (3.0 +/- 3.0%) was not significantly different. The non-significant difference in progression rate was due mainly to the rapid early decline of striatal binding in 1 patient who subsequently developed a severe dysexecutive dementia syndrome. These data are not suggestive of substantial change in the course of dopaminergic degeneration in PD within the first 5 to 7 years after symptom onset.
Pirker
Walter
W
Department of Neurology, University of Vienna, Vienna, Austria. walter.pirker@univie.ac.at
Holler
Iris
I
Gerschlager
Willibald
W
Asenbaum
Susanne
S
Zettinig
Georg
G
Brücke
Thomas
T
D001665:Binding Sites; D003042:Cocaine / Q000031:analogs & derivatives / Q000493:pharmacokinetics; D003072:Cognition Disorders / Q000175:diagnosis; D003342:Corpus Striatum / Q000378:metabolism / Q000503:physiopathology*; D018450:Disease Progression; D050483:Dopamine Plasma Membrane Transport Proteins; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008562:Membrane Glycoproteins; D026901:Membrane Transport Proteins / Q000378:metabolism; D008875:Middle Aged; D009419:Nerve Tissue Proteins; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon
D050483:Dopamine Plasma Membrane Transport Proteins; D008562:Membrane Glycoproteins; D026901:Membrane Transport Proteins; D009419:Nerve Tissue Proteins; D019275:Radiopharmaceuticals; C069723:2beta-carbomethoxy-3beta-(4-iodophenyl)tropane; D003042:Cocaine