117 Diagnostic FP-CIT SPECT and clinical progression in Parkinson's disease. Issue 3 (9th February 2012) - Newman, E
Abstract : Background: Functional imaging of striatal dopamine transporters (DaT) is abnormal at presentation in Parkinson's disease (PD). While there is a cross-sectional relationship between the severity of bradykinesia and rigidity, and the degree of DaT loss, prospective studies have not been conducted. Aim: To assess for correlation between dopaminergic deficiency on FP-CIT SPECT and motor symptoms and complications after 3 years. Methods: Patients with PD, abnormal baseline FP-CIT SPECT and at least 3 years clinical follow-up were classified as: akinetic-rigid, tremor-dominant, or mixed. UPDRS-III motor scores at baseline and 3 years, and time-to-onset of motor complications were recorded. Results: 42 patients, 63% male, median age at onset 61.6 years (IQR 52.5–69.1) were included. Motor complications were seen in 54.7% (21.4% motor fluctuations, 11.9% dyskinesias, 21.4% combination). Clinical subtypes: seven tremor-dominant, 17 akinetic-rigid and 18 mixed. FP-CIT uptake was inversely correlated with 3 year UPDRS-III only for akinetic-rigid patients (r= −0.51, p=0.04). Time-to-onset of motor complications was inversely correlated with UPDRS-III subscores for bradykinesia and rigidity at baseline (r= −0.52, p=0.02) and at 3 years (r= −0.54, p=0.01). Conclusion: The degree of dopaminergic deficiency on FP-CIT SPECT correlates with worse motor status, and the development and severity of complications, after 3 years in akinetic-rigid PD patients.