Turku Brain and Mind Center, University of Turku, Turku, Finland.
Clinical Neurosciences, Faculty of Medicine, University of Turku, Turku, Finland.
Mov Disord. 2024 Nov;39(11):2014-2025. doi: 10.1002/mds.29997. Epub 2024 Sep 3.
The cardinal motor symptoms of Parkinson's disease (PD) include rigidity, bradykinesia, and rest tremor. Rigidity and bradykinesia correlate with contralateral nigrostriatal degeneration and striatal dopamine deficit, but association between striatal dopamine function and rest tremor has remained unclear.
The aim of this study was to investigate the possible link between dopamine function and rest tremor using Parkinson's Progression Markers Initiative dataset, the largest prospective neuroimaging cohort of patients with PD.
Clinical, [I]N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane ([I]FP-CIT) single photon emission computed tomography (SPECT), and structural magnetic resonance imaging data from 354 early PD patients and 166 healthy controls were included in this study. We employed a novel approach allowing nonlinear registration of individual scans accurately to a standard space and voxelwise analyses of the association between motor symptoms and striatal dopamine transporter (DAT) binding.
Severity of both rigidity and bradykinesia was negatively associated with contralateral striatal DAT binding (P < 0.05 [FWE, family-wise error corrected]). However, rest tremor amplitude was positively associated with increased ipsilateral DAT binding (P < 0.05). The association between rest tremor and binding remained the same controlling for Hoehn & Yahr stage, Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III score, bradykinesia-rigidity score, or motor phenotype. The association between rest tremor and binding was independent of bradykinesia-rigidity and replicated using 2-year follow-up data (P < 0.05).
In agreement with the existing literature, we did not find a consistent association between rest tremor and contralateral dopamine defect. However, our results demonstrate a link between rest tremor and increased or less decreased ipsilateral DAT binding. Our findings provide novel information about the association between dopaminergic function and parkinsonian rest tremor. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
帕金森病（PD）的主要运动症状包括僵硬、运动迟缓以及静止性震颤。僵硬和运动迟缓与对侧黑质纹状体变性和纹状体多巴胺缺乏有关，但纹状体多巴胺功能与静止性震颤之间的关联仍不清楚。
本研究旨在使用帕金森进展标志物倡议数据集（最大的前瞻性 PD 患者神经影像学队列），调查多巴胺功能与静止性震颤之间的可能联系。
本研究纳入了 354 例早期 PD 患者和 166 例健康对照者的临床、[I]N-ω-氟丙基-2β-羧甲基-3β-(4-碘苯基)去甲托烷([I]FP-CIT)单光子发射计算机断层扫描（SPECT）和结构磁共振成像数据。我们采用了一种新方法，该方法可以将个体扫描准确地非线性注册到标准空间，并对运动症状与纹状体多巴胺转运体（DAT）结合之间的关联进行体素分析。
僵硬和运动迟缓的严重程度均与对侧纹状体 DAT 结合呈负相关（P<0.05[FWE，校正后的全方差检验]）。然而，静止性震颤幅度与同侧 DAT 结合增加呈正相关（P<0.05）。控制 Hoehn & Yahr 分期、运动障碍协会统一帕金森病评定量表（MDS-UPDRS）第 III 部分评分、运动迟缓-僵硬评分或运动表型后，静止性震颤与结合的相关性仍然相同。静止性震颤与结合的相关性独立于运动迟缓-僵硬，并使用 2 年随访数据得到复制（P<0.05）。
与现有文献一致，我们未发现静止性震颤与对侧多巴胺缺陷之间存在一致的关联。然而，我们的研究结果表明，静止性震颤与同侧 DAT 结合增加或减少较少有关。我们的发现提供了关于多巴胺能功能与帕金森静止性震颤之间关联的新信息。© 2024 国际帕金森病和运动障碍协会的 Wiley 期刊出版公司。
