Dzialas Verena, Bischof Gérard N, Möllenhoff Kathrin, Drzezga Alexander, van Eimeren Thilo
Department of Nuclear Medicine, Faculty of Medicine, and University Hospital Cologne, University of Cologne, Cologne, Germany.
Faculty of Mathematics and Natural Sciences, University of Cologne, Cologne, Germany.
Ann Neurol. 2025 Jul;98(1):120-135. doi: 10.1002/ana.27223. Epub 2025 Mar 27.
Although dopamine transporter (DaT) imaging is a valuable diagnostic biomarker, few studies have investigated its utility in objectively monitoring disease progression in patients with Parkinson's disease (PD). To date, no study has established a longitudinal relationship between the DaT signal decline and the motor symptom increase, potentially due to neglected factors such as brain regions, disease laterality, and symptom subtypes, which this study addresses.
This cohort study included participants who met the Movement Disorder Society (MDS) criteria for PD, with longitudinal imaging and clinical data from the Parkinson's Progression Markers Initiative Database. Linear mixed model analyses were used to investigate the relationship between the DaT signal decline and the motor symptom severity increase over time. We hypothesized that a decline in putaminal DaT availability in the less affected hemisphere would be associated with increasing contralateral motor symptoms, measured by the Unified Parkinson's Disease Rating Scale (UPDRS). Additional models explored the effects of different brain regions (caudate and putamen), symptom categories (MDS UPDRSIII score with and without tremor items), and disease onset laterality (left or right hemisphere).
We included 719 participants (443 male patients and 276 female patients; mean age = 62.2 ± 9.5 years) with 1,981 available data points. As hypothesized, we observed a significant association between the decrease in the less affected putaminal DaT signal and motor symptom increase in the contralateral body side, independent of including or excluding tremor scores.
Our findings support the use of repetitive DaT imaging for objectively monitoring PD progression. This could facilitate personalized disease tracking, subtyping, and intervention testing in the future. ANN NEUROL 2025;98:120-135.
尽管多巴胺转运体（DaT）成像作为一种有价值的诊断生物标志物，但很少有研究探讨其在客观监测帕金森病（PD）患者疾病进展中的效用。迄今为止，尚无研究确立DaT信号下降与运动症状增加之间的纵向关系，这可能是由于诸如脑区、疾病偏侧性和症状亚型等因素被忽视，而本研究正是针对这些因素展开。
这项队列研究纳入了符合运动障碍协会（MDS）PD标准的参与者，并使用了帕金森病进展标志物倡议数据库中的纵向成像和临床数据。采用线性混合模型分析来研究DaT信号下降与运动症状严重程度随时间增加之间的关系。我们假设，通过统一帕金森病评定量表（UPDRS）测量，受影响较小半球的壳核DaT可用性下降将与对侧运动症状增加相关。其他模型探讨了不同脑区（尾状核和壳核）症状类别（含和不含震颤项目的MDS UPDRSIII评分）以及疾病起病偏侧性（左半球或右半球）的影响。
我们纳入了719名参与者（443名男性患者和276名女性患者；平均年龄 = 62.2 ± 9.5岁），共有1981个可用数据点。正如所假设的，我们观察到受影响较小的壳核DaT信号下降与对侧身体侧运动症状增加之间存在显著关联，且与是否纳入震颤评分无关。
我们的研究结果支持使用重复DaT成像来客观监测PD进展。这可能有助于未来的个性化疾病追踪、亚型分类和干预测试。《神经病学年鉴》2025年；98:120 - 135。
