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Differential Implications of Cerebral Hypoperfusion and Hyperperfusion in Parkinson's Disease

 Seong Ho Jeong  ;  Su Hong Kim  ;  Chan Wook Park  ;  Hye Sun Lee  ;  Phil Hyu Lee  ;  Yun Joong Ki  ;  Young H Sohn  ;  Yong Jeong  ;  Seok Jong Chung 
 MOVEMENT DISORDERS, Vol.38(10) : 1881-1890, 2023-10 
Journal Title
Issue Date
Dopamine Plasma Membrane Transport Proteins ; Gait Disorders, Neurologic* / complications ; Humans ; Parkinson Disease* / complications ; Parkinson Disease* / diagnostic imaging ; Positron-Emission Tomography ; Tomography, Emission-Computed, Single-Photon / methods ; Tropanes
Parkinson's disease ; cerebral perfusion ; prognosis
Background: Patients with Parkinson's disease (PD) exhibit widespread brain perfusion changes.

Objective: This study investigated whether cerebral regions with hypoperfusion and hyperperfusion have differential effects on motor and cognitive symptoms in PD using early-phase 18 F-N-(3-fluoropropyl)-2β-carboxymethoxy-3β-(4-iodophenyl) nortropane (18 F-FP-CIT) positron emission tomography (PET) scans.

Methods: We enrolled 394 patients with newly diagnosed PD who underwent dual-phase 18 F-FP-CIT PET scans. Indices reflecting associated changes in regional cerebral hypoperfusion and hyperperfusion on early-phase 18 F-FP-CIT PET scans were calculated as PD[hypo] and PD[hyper] , respectively. The associations of PD[hypo] and PD[hyper] on motor and cognitive symptoms at baseline were assessed using multivariate linear regression. Also, Cox regression and linear mixed models were performed to investigate the effects of baseline PD[hypo] and PD[hyper] on longitudinal outcomes.

Results: There was a weak correlation between PD[hypo] and PD[hyper] (γ = -0.19, P < 0.001). PD[hypo] was associated with baseline Unified Parkinson's Disease Rating Scale Part III scores (β = -1.02, P = 0.045), rapid increases in dopaminergic medications (β = -18.02, P < 0.001), and a higher risk for developing freezing of gait (hazard ratio [HR] = 0.67, P = 0.019), whereas PD[hyper] was not associated. Regarding cognitive function, PD[hypo] was more relevant to the baseline cognitive performance levels of visuospatial, memory, and frontal/executive function than PD[hyper] . However, greater PD[hyper] was associated with future dementia conversion (HR = 1.43, P = 0.004), whereas PD[hypo] was not associated.

Conclusions: These findings suggest that PD[hypo] and PD[hyper] may differentially affect motor and cognitive functions in patients with PD. © 2023 International Parkinson and Movement Disorder Society.
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Appears in Collections:
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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