Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Neurology, Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Republic of Korea.
Eur J Neurol. 2024 Oct;31(10):e16364. doi: 10.1111/ene.16364. Epub 2024 Jul 21.
The co-occurrence of amyloid-β pathology in Parkinson's disease (PD) is common; however, the role of amyloid-β deposition in motor prognosis remains elusive. This study aimed to investigate the association between striatal amyloid deposition, motor complications and motor prognosis in patients with PD.
Ninety-six patients with PD who underwent F florbetaben (FBB) positron emission tomography were retrospectively assessed. The ratio of the striatum to global (STG) FBB uptake was obtained for each individual, and patients were allotted into low and high STG groups according to the median value. The effect of STG group on regional amyloid deposition, the occurrence of motor complications and longitudinal change in levodopa equivalent dose (LED) requirement were investigated after controlling for age, sex, LED and disease duration at FBB scan.
The high STG group was associated with lower cortical FBB uptake in the parietal, occipital and posterior cingulate cortices and higher striatal FBB uptake compared to the low STG group. Patients in the high STG group had a higher risk of developing wearing off and levodopa-induced dyskinesia than those in the low STG group, whereas the risk for freezing of gait was comparable between the two groups. The high STG group showed a more rapid increase in LED requirements over time than the low STG group.
These findings suggest that relatively high striatal amyloid deposition is associated with poor motor outcomes in patients with PD.
淀粉样蛋白-β病理学在帕金森病(PD)中共同存在很常见;然而,淀粉样蛋白-β沉积在运动预后中的作用仍不清楚。本研究旨在探讨 PD 患者纹状体淀粉样蛋白沉积与运动并发症和运动预后之间的关系。
回顾性评估了 96 例接受 F 氟贝他滨(FBB)正电子发射断层扫描的 PD 患者。获得了每个个体的纹状体与全脑(STG)FBB 摄取的比值,并根据中位数将患者分为低 STG 组和高 STG 组。在控制 FBB 扫描时的年龄、性别、左旋多巴等效剂量(LED)和疾病持续时间后,研究了 STG 组对区域淀粉样蛋白沉积、运动并发症的发生和 LED 需求的纵向变化的影响。
与低 STG 组相比,高 STG 组患者的顶叶、枕叶和后扣带回皮质的皮质 FBB 摄取较低,纹状体 FBB 摄取较高。与低 STG 组相比,高 STG 组患者发生剂末现象和左旋多巴诱导的运动障碍的风险更高,而两组之间冻结步态的风险相当。与低 STG 组相比,高 STG 组的 LED 需求随着时间的推移增加更快。
这些发现表明,相对较高的纹状体淀粉样蛋白沉积与 PD 患者的运动预后不良有关。