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Clinical and Dopamine Depletion Patterns in Hyposmia- and Dysautonomia-Dominant Parkinson's Disease

Authors
 Han Soo Yoo  ;  Sangwon Lee  ;  Seong Ho Jeong  ;  Byoung Seok Ye  ;  Young H Sohn  ;  Mijin Yun  ;  Phil Hyu Lee 
Citation
 JOURNAL OF PARKINSONS DISEASE, Vol.11(4) : 1703-1713, 2021-10 
Journal Title
JOURNAL OF PARKINSONS DISEASE
ISSN
 1877-7171 
Issue Date
2021-10
MeSH
Aged ; Anosmia ; Cross-Sectional Studies ; Dopamine ; Humans ; Olfaction Disorders* / etiology ; Parkinson Disease* / complications ; Primary Dysautonomias* / complications ; Prodromal Symptoms
Keywords
Olfaction ; Parkinson’s disease ; autonomic function ; dysautonomia ; hyposmia
Abstract
Background: Olfactory or autonomic dysfunction is one of the earliest prodromal symptoms of Parkinson's disease (PD). It has not been investigated whether PD patients have different phenotypes depending on the presence of these prodromal symptoms.

Objective: To investigate whether hyposmia-dominant and dysautonomia-dominant patients with early PD have different clinical manifestations and nigrostriatal degeneration.

Methods: This cross-sectional study recruited 168 drug-naive PD patients and 34 control subjects. PD patients were classified as patients without hyposmia and dysautonomia (PD-H-D-, n = 51), hyposmia-dominant patients (PD-H+D-, n = 36), dysautonomia-dominant patients (PD-H-D+, n = 33), and patients with hyposmia and dysautonomia (PD-H+D+, n = 48). We then compared the baseline clinical characteristics, striatal specific to non-specific binding ratio (SNBR), neuropsychological performance, and neuropsychiatric symptoms among the groups.

Results: The PD-H+D-group had a lower SNBR in the ventral striatum (p = 0.013), a greater asymmetric index of striatal SNBRs, and higher prevalence of apathy (p = 0.021) than the PD-H-D+ group. The PD-H-D+ group had older age at onset (p = 0.043) and a higher prevalence of REM sleep behavior disorder (p = 0.041) than the PD-H+D-group. The PD-H+D+ group had higher motor deficits, lower cognitive function, and lower SNBRs in all striatal subregions than the PD-H-D-group. Decreased SNBRs in the anterior caudate, posterior caudate, and ventral striatum were associated with the presence of apathy.

Conclusion: The present study suggests that hyposmia-dominant and dysautonomia-dominant PD have different clinical characteristics and patterns of striatal dopamine depletion.
Full Text
https://content.iospress.com/articles/journal-of-parkinsons-disease/jpd212747
DOI
10.3233/JPD-212747
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
Yonsei Authors
Sohn, Young Ho(손영호) ORCID logo https://orcid.org/0000-0001-6533-2610
Ye, Byoung Seok(예병석) ORCID logo https://orcid.org/0000-0003-0187-8440
Yoo, Han Soo(유한수) ORCID logo https://orcid.org/0000-0001-7846-6271
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Lee, Phil Hyu(이필휴) ORCID logo https://orcid.org/0000-0001-9931-8462
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187838
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