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Is the cingulate island sign a marker for early dementia conversion in Parkinson's disease?

 Seok Jong Chung  ;  Su Hong Kim  ;  Chan Wook Park  ;  Hye Sun Lee  ;  Yun Joong Kim  ;  Phil Hyu Lee  ;  Yong Jeong  ;  Young H Sohn 
 EUROPEAN JOURNAL OF NEUROLOGY, Vol.30(12) : 3732-3740, 2023-12 
Journal Title
Issue Date
Dementia* / diagnostic imaging ; Dementia* / etiology ; Humans ; Parkinson Disease* / complications ; Parkinson Disease* / diagnostic imaging ; Positron-Emission Tomography ; Tropanes
18F-FP-CIT PET ; Parkinson's disease ; cerebral perfusion ; cingulate island sign ; dementia
Background: To investigate whether the cingulate island sign (CIS) ratio (i.e., the ratio of regional uptake in the posterior cingulate cortex relative to the precuneus and cuneus on cerebral perfusion scans) is associated with early dementia conversion in Parkinson's disease (PD).

Methods: We enrolled 226 patients with newly diagnosed PD and 48 healthy controls who underwent dual-phase 18 F-FP-CIT PET scans. Patients with PD were classified into three groups according to the CIS ratio on early-phase 18 F-FP-CIT PET images: a PD group with CIS or high CIS ratios (PD-CIS; n = 96), a PD group with inverse CIS or low CIS ratios (PD-iCIS; n = 40), and a PD group consisting of the remaining patients with normal CIS ratios (PD-nCIS; n = 90). We compared the risk of dementia conversion within a 5-year time point between the groups.

Results: There were no significant differences in age, sex, education, or baseline cognitive function between the PD groups. The PD-CIS group had higher Unified Parkinson's Disease Rating Scale (UPDRS) motor scores and more severely decreased dopamine transporter availability in the putamen. The PD-iCIS group had a smaller hippocampal volume compared with the other groups. The risk of dementia conversion in the PD-CIS group did not differ from that in the PD-iCIS and PD-nCIS groups. Meanwhile, the PD-iCIS group had a higher risk of dementia conversion than the PD-nCIS group.

Conclusion: The results of this study suggest that inverse CIS, rather than CIS, is relevant to early dementia conversion in patients with PD.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kim, Yun Joong(김윤중) ORCID logo https://orcid.org/0000-0002-2956-1552
Park, Chan Wook(박찬욱) ORCID logo https://orcid.org/0000-0002-0208-5189
Sohn, Young Ho(손영호) ORCID logo https://orcid.org/0000-0001-6533-2610
Lee, Phil Hyu(이필휴) ORCID logo https://orcid.org/0000-0001-9931-8462
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Chung, Seok Jong(정석종) ORCID logo https://orcid.org/0000-0001-6086-3199
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