Progression from Unilateral to Bilateral Parkinsonism in Early Parkinson Disease: Implication of Mesocortical Dopamine Dysfunction by PET

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FIGURE 1.
¹¹C-CFT PET images and ROI setting. (A) Irregular ROIs, drawn bilaterally on concerned regions on MR images, were placed on corresponding PET images. (B) PD patient with longer conversion period from HY stage 1 to HY stage 2. (C) PD patient with shorter conversion period from HY stage 1 to HY stage 2. Arrow indicates reduction in ¹¹C-CFT binding in nucleus accumbens. Color bar indicates quantified level of RI (from 0 to 3). Ac = nucleus accumbens; Cd = caudate; Ce = cerebellum; DP = dorsal putamen; O = orbitofrontal cortex; VP = ventral putamen.
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FIGURE 2.
Correlations between UPDRS score at HY stage 1 and ¹¹C-CFT RI values. Dashed lines for ○ and chain lines for ▲ show all tendencies of negative correlations. ○ = affected side; ▲ = unaffected side.
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FIGURE 3.
Correlations between conversion interval (y) and ¹¹C-CFT RI values. Straight lines for ▲ show significant correlations (P < 0.05). ○ = affected side; ▲ = unaffected side.

TABLE 1.

Characteristics of PD Patients

↵* Duration between disease onset and PET examination.
UPDRS scores in parentheses are mentation/activities of daily living/motor examination.
UL = upper limb; LL = lower limb.

TABLE 2.

Levels of ¹¹C-CFT Uptake in PD Patients and Controls

Each value is expressed as ratio index. % reduction denotes level of change in ratio index of PD patient compared with healthy control.

TABLE 3.

Details of PD Patients at Time of Progression to HY Stage 2

↵* Interval of conversion from HY stage 1 to stage 2.
↵† % increase of UPDRS = [UPDRS at HY stage 2 (“on” state) − initial UPDRS at HY stage 1]/initial UPDRS at HY stage 1 × 100.
No information was available for patient 10 because patient dropped out of study.