Non-motor symptoms and striatal dopamine transporter binding in early Parkinson's disease
Document Type
Article
Abstract
Background: Non-motor symptoms (NMS) are common in Parkinson's disease (PD), but their relationships to nigrostriatal degeneration remain largely unexplored. Methods: We evaluated 18 NMS scores covering 5 major domains in relation to concurrent and future dopamine transporter (DAT) imaging in 344 PD patients from the Parkinson's Progression and Markers Initiative (PPMI). We standardized NMS assessments into z-scores for side-by-side comparisons. Patients underwent sequential DaTSCAN imaging at enrollment and at months 12, 24, and 48. Specific binding ratios (SBR) were calculated using the occipital lobe reference region. We evaluated the association of striatal DAT binding at the four time points with each baseline NMS using mixed-effects regression models. Results: Multiple baseline NMS were significantly associated with DAT binding at baseline and at follow-up scans. REM sleep behavior disorder (RBD) symptoms showed the strongest association – mean striatal SBR declined with increasing RBD symptom z-score (average of time-point-specific slopes per unit change in z-score: βAVG = −0.083, SE = 0.017; p < 0.0001). In addition, striatal DAT binding was linearly associated with increasing baseline z-scores: positively for the memory (βAVG=0.055, SE = 0.022; p = 0.01) and visuospatial (βAVG=0.044, SE = 0.020; p = 0.03) cognitive domains, and negatively for total anxiety (βAVG= −0.059, SE = 0.018; p = 0.001). Striatal DAT binding showed curvilinear associations with odor identification, verbal discrimination recognition, and autonomic dysfunction z-scores (p = 0.001, p = 0.0009, and p = 0.0002, respectively). Other NMS were not associated with DAT binding. Conclusions: Multiple NMS, RBD symptoms in particular, are associated with nigrostriatal dopaminergic changes in early PD.
Publication Date
3-1-2020
Publication Title
Parkinsonism and Related Disorders
ISSN
13538020
E-ISSN
18735126
Volume
72
First Page
23
Last Page
30
PubMed ID
32092703
Digital Object Identifier (DOI)
10.1016/j.parkreldis.2020.02.001
Recommended Citation
Liu, Rui; Umbach, David M.; Tröster, Alexander I.; Huang, Xuemei; and Chen, Honglei, "Non-motor symptoms and striatal dopamine transporter binding in early Parkinson's disease" (2020). Clinical Neuropsychology. 104.
https://scholar.barrowneuro.org/neuropsychology/104