Objective: This study aims to explore the difference between C-methyl-N-2β-carbomethoxy-3β-(4-fluorophenyl)-tropanel (C-CFT) positron emission tomography (PET) imaging in the early-onset Parkinson's disease (EOPD) and late-onset Parkinson's disease (LOPD), and to analyze the correlation between C-CFT PET imaging and disease duration, Hoehn & Yahr (H&Y) stage, motor symptoms, and non-motor symptoms in patients with idiopathic Parkinson's disease (PD), so as to explore its application value in assessing the severity of Parkinson's disease.
Materials And Methods: A total of 113 patients with idiopathic PD were included in this study. The patients were divided into EOPD and LOPD groups according to the age of 60 years, of which 58 were early-onset and 55 were late-onset. All patients underwent C-CFT PET imaging and manually sketched regions of interest (ROI) to delineate the caudate nucleus, anterior putamen, and posterior putamen ROI layer-by-layer, and the corresponding values were recorded. Clinical data [age of onset, disease duration, H&Y stage, total Unified Parkinson's Disease Rating Scale (UPDRS) score, UPDRS III score, tremor score, postural instability/gait difficulty (PIGD) score, rigidity score, bradykinesia score, and Montreal Cognitive Assessment (MoCA) score] were collected from all patients. The differences in striatal C-CFT uptake between patients with EOPD and LOPD were compared, and the correlation between striatal C-CFT uptake and the clinical data of patients with idiopathic PD was evaluated.
Results: The caudate nucleus C-CFT uptake was higher in EOPD than in the LOPD group ( = 3.002, = 0.003). C-CFT uptake in the caudate nucleus in patients with PD was negatively correlated with the age of onset, H&Y stage, disease duration, total UPDRS score, UPDRS III score, rigidity score, and bradykinesia score ( < 0.05). The anterior and posterior putamen C-CFT uptake was negatively correlated with H&Y stage, disease duration, total UPDRS score, UPDRS III score, PIGD score, rigidity score, and bradykinesia score ( < 0.05).
Conclusion: C-CFT PET provides an objective molecular imaging basis for the difference in disease progression rates between patients with EOPD and LOPD. Secondly, C-CFT PET can be used as an important objective indicator to assess disease severity and monitor disease progression.
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http://dx.doi.org/10.3389/fneur.2023.1195577 | DOI Listing |
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Department of Geriatric Medicine, Royal Free Hospital, London, UK.
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School of Computer Science, University of Birmingham, Birmingham B15 2TT, UK.
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Department of Medical Specialities I, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania.
Neurogenic orthostatic hypotension (NOH) is a significant non-motor manifestation of Parkinson's disease (PD), that substantially affects patient disability and has a powerful impact on the quality of life of PD patients, while also contributing to increased healthcare costs. This narrative review aims to summarize key insights into the diagnosis and management of NOH in individuals with PD. For diagnosing NOH, a recently introduced and valuable metric is the ΔHr/ΔSBP index.
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