An [ 18 F]dopa-PET and clinical study of the rate of progression in Parkinson's disease

Summary We have studied disease progression in a group of 10 patients with recent onset idiopathic Parkinson's disease [mean age 53.7±J2.6 years, mean duration J8.3±6.5 months, mean unified Parkinson s disease rating scale (UPDRS) 19.0±9.5], and a group of seven patients with established Parkinson's disease (mean age 60.1 ±15.1 years, mean duration 70.8±35.5 months, mean UPDRS 47.9±18.1), using both clinical assessment and [ l8 F]dopa-PET. Results were compared with those of a group of 10 normal subjects (age 66±16 years). Mean putamen [ l8 F]dopa influx constant (K,) was a reliable measurement (R = 0.82) and the most sensitive The mean annual rate of in in the Parkinson's 12.5% per annum, whereas the group no significant in a of 32 months follow The rate of progression was more rapid in compared the disease but not statistical Assuming a linear progression for the entire group we estimate symptom onset at a putamen K, 79% of normal with a preclinical years.

[1]  R A Robb,et al.  A software system for interactive and quantitative visualization of multidimensional biomedical images. , 1991, Australasian physical & engineering sciences in medicine.

[2]  M Schulzer,et al.  Longitudinal fluorodopa positron emission tomographic studies of the evolution of idiopathic parkinsonism , 1994, Annals of neurology.

[3]  M. Torrens.  Co-Planar Stereotaxic Atlas of the Human Brain—3-Dimensional Proportional System: An Approach to Cerebral Imaging, J. Talairach, P. Tournoux. Georg Thieme Verlag, New York (1988), 122 pp., 130 figs. DM 268 , 1990 .

[4]  C D Marsden,et al.  The relationship between locomotor disability, autonomic dysfunction, and the integrity of the striatal dopaminergic system in patients with multiple system atrophy, pure autonomic failure, and Parkinson's disease, studied with PET. , 1990, Brain : a journal of neurology.

[5]  J. Holden,et al.  Reproducibility of fluorine-18-6-fluorodopa positron emission tomography in normal human subjects. , 1994, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[6]  W. Gibb,et al.  The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson's disease. , 1988, Journal of neurology, neurosurgery, and psychiatry.

[7]  K. Jellinger,et al.  Brain dopamine and the syndromes of Parkinson and Huntington. Clinical, morphological and neurochemical correlations. , 1973, Journal of the neurological sciences.

[8]  C S Patlak,et al.  Graphical Evaluation of Blood-to-Brain Transfer Constants from Multiple-Time Uptake Data , 1983, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[9]  V. Dhawan,et al.  Input functions for 6-[fluorine-18]fluorodopa quantitation in parkinsonism: comparative studies and clinical correlations. , 1994, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[10]  A. Lees,et al.  Ageing and Parkinson's disease: substantia nigra regional selectivity. , 1991, Brain : a journal of neurology.

[11]  D J Brooks,et al.  Clinical and [18F] dopa PET findings in early Parkinson's disease. , 1995, Journal of neurology, neurosurgery, and psychiatry.

[12]  W. Koller,et al.  When does Parkinson's disease begin? , 1992, Neurology.

[13]  William C. Koller, MD, PhD.  When does Parkinson's disease begin? , 1992 .

[14]  Douglas G. Altman,et al.  Practical statistics for medical research , 1990 .

[15]  C. Patlak,et al.  Striatal 18F-DOPA Uptake: Absence of an Aging Effect , 1993, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[16]  S. Fahn.  Members of the UPDRS Development Committee. Unified Parkinson's Disease Rating Scale , 1987 .

[17]  G. Sawle,et al.  The effect of entacapone (OR‐611) on brain [18F]‐6‐L‐fluorodopa metabolism , 1994, Neurology.

[18]  H. Kimura,et al.  Human positron emission tomographic [18F]Fluorodopa studies correlate with dopamine cell counts and levels , 1993, Annals of neurology.

[19]  Haruhiko Akiyama,et al.  Rate of cell death in parkinsonism indicates active neuropathological process , 1988, Annals of neurology.

[20]  A. Bonnet,et al.  [The Unified Parkinson's Disease Rating Scale]. , 2000, Revue neurologique.