Abstract：
BACKGROUND: Parkinson\'s disease (PD) manifests as a wide variety of clinical phenotypes and its progression varies greatly. However, the factors associated with different disease progression remain largely unknown.
METHODS: In this retrospective cohort study, we enrolled 113 patients who underwent 18F-FP-CIT PET scan twice. Given the negative exponential progression pattern of dopamine loss in PD, we applied the natural logarithm to the specific binding ratio (SBR) of two consecutive 18F-FP-CIT PET scans and conducted linear mixed model to calculate individual slope to define the progression rate of nigrostriatal degeneration. We investigated the clinical and dopamine transporter (DAT) availability patterns associated with the progression rate of dopamine depletion in each striatal sub-region.
RESULTS: More symmetric parkinsonism, the presence of dyslipidemia, lower K-MMSE total score, and lower anteroposterior gradient of the mean putaminal SBR were associated with faster progression rate of dopamine depletion in the caudate nucleus. More symmetric parkinsonism and lower anteroposterior gradient of the mean putaminal SBR were associated with faster depletion of dopamine in the anterior putamen. Older age at onset, more symmetric parkinsonism, the presence of dyslipidemia, and lower anteroposterior gradient of the mean putaminal SBR were associated with faster progression rate of dopamine depletion in the posterior putamen. Lower striatal mean SBR predicted the development of LID, while lower mean SBR in the caudate nuclei predicted the development of dementia.
CONCLUSIONS: Our results suggest that the evaluation of baseline clinical features and patterns of DAT availability can predict the progression of PD and its prognosis.
METHODS: In this retrospective cohort study, we enrolled 113 patients who underwent 18F-FP-CIT PET scan twice. Given the negative exponential progression pattern of dopamine loss in PD, we applied the natural logarithm to the specific binding ratio (SBR) of two consecutive 18F-FP-CIT PET scans and conducted linear mixed model to calculate individual slope to define the progression rate of nigrostriatal degeneration. We investigated the clinical and dopamine transporter (DAT) availability patterns associated with the progression rate of dopamine depletion in each striatal sub-region.
RESULTS: More symmetric parkinsonism, the presence of dyslipidemia, lower K-MMSE total score, and lower anteroposterior gradient of the mean putaminal SBR were associated with faster progression rate of dopamine depletion in the caudate nucleus. More symmetric parkinsonism and lower anteroposterior gradient of the mean putaminal SBR were associated with faster depletion of dopamine in the anterior putamen. Older age at onset, more symmetric parkinsonism, the presence of dyslipidemia, and lower anteroposterior gradient of the mean putaminal SBR were associated with faster progression rate of dopamine depletion in the posterior putamen. Lower striatal mean SBR predicted the development of LID, while lower mean SBR in the caudate nuclei predicted the development of dementia.
CONCLUSIONS: Our results suggest that the evaluation of baseline clinical features and patterns of DAT availability can predict the progression of PD and its prognosis.
摘要：
背景：帕金森病（PD）表现为多种临床表型，其进展变化很大。然而,与不同疾病进展相关的因素在很大程度上仍然未知.
方法：在这项回顾性队列研究中，我们纳入了113例接受了两次18F-FP-CITPET扫描的患者.鉴于PD中多巴胺损失的负指数进展模式，我们将自然对数应用于两次连续18F-FP-CITPET扫描的特异性结合比(SBR),并采用线性混合模型计算个体斜率,以确定黑质纹状体变性的进展率.我们调查了与每个纹状体亚区域多巴胺耗竭进展率相关的临床和多巴胺转运体（DAT）可用性模式。
结果：更多对称帕金森病，血脂异常的存在，较低的K-MMSE总分，和较低的前后梯度平均壳SBR与尾状核多巴胺耗竭的进展速度较快有关。更对称的帕金森病和平均壳核SBR的前后梯度较低与前壳核多巴胺的更快消耗有关。发病年龄较大，更对称的帕金森病，血脂异常的存在，和较低的平均壳核SBR前后梯度与后壳核多巴胺耗竭的更快进展有关。较低的纹状体平均SBR预测了LID的发展，而尾状核的平均SBR较低则预测了痴呆的发展。
结论：我们的结果表明，对DAT可用性的基线临床特征和模式的评估可以预测PD的进展及其预后。
方法：在这项回顾性队列研究中，我们纳入了113例接受了两次18F-FP-CITPET扫描的患者.鉴于PD中多巴胺损失的负指数进展模式，我们将自然对数应用于两次连续18F-FP-CITPET扫描的特异性结合比(SBR),并采用线性混合模型计算个体斜率,以确定黑质纹状体变性的进展率.我们调查了与每个纹状体亚区域多巴胺耗竭进展率相关的临床和多巴胺转运体（DAT）可用性模式。
结果：更多对称帕金森病，血脂异常的存在，较低的K-MMSE总分，和较低的前后梯度平均壳SBR与尾状核多巴胺耗竭的进展速度较快有关。更对称的帕金森病和平均壳核SBR的前后梯度较低与前壳核多巴胺的更快消耗有关。发病年龄较大，更对称的帕金森病，血脂异常的存在，和较低的平均壳核SBR前后梯度与后壳核多巴胺耗竭的更快进展有关。较低的纹状体平均SBR预测了LID的发展，而尾状核的平均SBR较低则预测了痴呆的发展。
结论：我们的结果表明，对DAT可用性的基线临床特征和模式的评估可以预测PD的进展及其预后。
