Abstract
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Objectives: Depression is the most common non-motor symptom in Parkinson’s disease (PD) that could be presented in an early stage of the disease and affected the quality of life of the patient. Among several hypotheses about depression in PD, neurologic changes in the brain caused by PD is thought to be the main cause. In this study, we compared the imaging findings of early and delayed images of F-18 FP-CIT PET, and the degree of depression in drug naïve patients with PD.
Methods: A total of Fifty-five PD patients (M = 30, 65.3 ± 10.1 years) who suffered over 2 years and underwent F-18 FP-CIT PET at initial diagnosis were included. Patients who were suspected of having cognitive dysfunction (less than 23 points of the MMSE score), or who were taking medicines related to PD or depression were excluded. PET images were acquired twice at 5 min (perfusion) and 2 hours (delayed) after administration of radiotracer. Geriatric depression scale (GDS) were used to evaluate the degree of depression, and the patients were classified into three groups using the GDS score as follows; 0-9 points: normal group (n=24), 10-19 points: mild depression group (n=18), and 20-30 points: moderate depression group (n=13). Disease duration, UPDRS III score, and H&Y stage were also evaluated in all patients. Firstly, among these three groups, we compared the status of cerebral perfusion and dopamine transporter (DAT), respectively. Secondly, in all patients, we analyzed the correlation between the GDS scores and the status of cerebral perfusion and DAT.
Results: : The range of the GDS score were 2-29 points in all patients. The GDS score were mildly correlated with H&Y stage significantly (r=0.32, p=0.03), but not correlated with disease duration (r=-0.02, p=0.90) and UPDRS III score (r=0.10, p=0.59). (1) In cerebral perfusion analysis, comparing with the normal group, cerebral perfusions of the frontal, occipital, parietal, temporal lobes were lower in the mild depression group, and the perfusion of the frontal, parietal, temporal lobes, parahippocampal, cingulate gyri, insula, thalamus, claustrum were lower in the moderate depression group. In DAT analysis, comparing with the normal group, the DAT uptakes of the frontal & temporal lobes, cingulate, insula was lower in the mild depression group, and them of the parahippocampal gyrus, uncus, putamen, caudate, thalamus was lower in the moderate depression group. (2) In perfusion image, there was statistically significant negative correlation between the GDS score and the degree of hypoperfusion in the both caudate. And there was a positive correlation between them in the both frontal lobes (superior, middle, inferior, medial, rectal, orbital and precentral gyri), temporal lobes (hippocampal and fusiform gyri), both cerebellum, left anterior cingulate, both putamen, both thalamus, midbrain, and pons. In delayed image, the GDS score was correlated positively with the degree of decreased DAT uptake in the both putamen, right caudate and left amygdala, and was correlated negatively with that in the right amygdala and right putamen.
Conclusion: We could evaluate the status of cerebral perfusion and DAT simultaneously using dual-time F-18 FP-CIT imaging. In patients with PD, there were a characteristic change in cerebral perfusion and DAT and were a significant correlation between clinical and F-18 FP-CIT imaging parameters. Research Support: None