Lower striatal binding of ß -CIT at baseline was linked with a greater risk of severe Parkinson’s disease.
SAN DIEGO—Dopamine transporter imaging performed near the time of Parkinson’s disease diagnosis may independently predict the severity of motor and nonmotor long-term outcomes in patients, according to research presented at the 136th Annual Meeting of the American Neurological Association.
The researchers, led by Bernard M. Ravina, MD, Medical Director in Translational Neurology at Biogen Idec in Cambridge, Massachusetts, prospectively evaluated a cohort of patients with Parkinson’s disease who were enrolled in a de nova clinical trial that measured motor, cognitive, and behavioral outcomes. Of the total 537 patients in the trial group, 491 (91%) showed dopamine deficiency indicative of Parkinson’s disease after undergoing dopamine transporter imaging with [123I] [ß]-CIT (ß-CIT) and SPECT at baseline and after 22 months. The patients were followed for a mean of 5.5 years and had a mean diagnosis of Parkinson’s disease of 6.3 years.
After evaluating patient data, the investigators observed an independent association between lower striatal binding of ß-CIT at baseline and a significantly increased risk for measures of Parkinson’s disease severity and clinical milestones. These disease severity measures and clinical milestones included motor outcomes such as motor-related disability, falling, and postural instability, as well as nonmotor outcomes such as cognitive impairment, psychosis, and clinically important depressive symptoms.
Furthermore, Dr. Ravina’s group found that patients in the bottom quartile for dopamine transporter imaging, compared with the top quartile, had an odds ratio of 3.5 for cognitive impairment and 12.8 for psychosis.
Overall, the researchers concluded that dopamine transporter imaging could serve as a valuable prognostic tool. “Near the time of Parkinson’s disease diagnosis, dopamine transporter imaging with ß-CIT and SPECT is an independent predictor of clinically important motor and nonmotor long-term outcomes,” the investigators said.
—Lauren LeBano