TY - JOUR T1 - Progressive changes of clinical Parkinson's disease symptoms JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 1495 LP - 1495 VL - 60 IS - supplement 1 AU - Song Yoo Sung AU - Won-Woo Lee AU - Byung Chul Lee AU - Sang Eun Kim Y1 - 2019/05/01 UR - http://jnm.snmjournals.org/content/60/supplement_1/1495.abstract N2 - 1495Objectives: Parkinson's disease (PD) is a neurodegenerative disorder that is mainly known for its deterioration of motor functions. However, it is also associated with a broad spectrum of non-motor symptoms such as cognitive decline, mood disorders, sensory dysfunctions, and autonomic dysfunctions. Also, analysis of the broad clinical spectrum identified different subtypes of PD, such as the tremor dominant (TD) type and the postural instability and gait disorder (PIGD) type. The final aim of this study was to compare the progressive pattern between subtypes, by evaluating clinical symptoms and dopaminergic denervation at regular time intervals. Methods: Subject data were downloaded from the Parkinson's Progression Markers Initiative (PPMI) database (http://www.ppmi-info.org) in April, 2018. 325 PD patients (age 61.2 ± 9.7, M: F = 215: 110) were enrolled. (MDS-UPDRS) scores and Scale for Outcomes in Parkinson's disease-Autonomic (SCOPA-AUT), Montreal Cognitive Assessment (MOCA) were evaluated at baseline, 1, 2, and 4 years of follow up. Specific binding ratios (SBRs, (target region/reference region)-1) of each caudate and putamen were acquired from I-123 FP-CIT SPECT. Results: Among our PD cohort of 325 patients, 221 patients were classified as TD (68%), 29 patients as indeterminant type (9%), and 75 patients as PIGD type (23%) based on the UPDRS definitions. H&Y stage and MDS-UPDRS Part III scores of the indeterminant group were significantly worse at baseline, compared with the TD and PIGD groups. MDS-UPDRS Part II scores and striatal SBRs of the TD group were significantly worse at baseline, compared with the indeterminant and PIGD groups. The SCOPA-AUT scores of the indeterminant group was only significantly worse than that of the TD group. H&Y stage of the indeterminant group was significantly higher than the TD and PIGD groups at 2 years of follow up (p < 0.01), but there were no significant differences at 4 years of follow up. MDS-UPDRS part II scores of the indeterminant group were significantly higher than the TD group until 4 years of follow up (p< 0.05), but there were no significant differences of the MDS-UPDRS part III scores between any groups at 4 years of follow up. The SCOPA-AUT of the indeterminant group was significantly higher than the TD group at 1 year follow up, but there were no significant differences of SCOPA-AUT between any groups at 2 and 4 years of follow up. There were no significant differences of MOCA scores between any groups at throughout the follow up. There was a significantly higher portion of LID development in the indeterminant group after 4 years of follow up, with a higher score of MDS-UPDRS part IV question 4.1. ER -