La maladie de Parkinson au Canada (serveur d'exploration)

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Longitudinal follow-up of SWEDD subjects in the PRECEPT Study

Identifieur interne : 001736 ( Ncbi/Merge ); précédent : 001735; suivant : 001737

Longitudinal follow-up of SWEDD subjects in the PRECEPT Study

Auteurs : Kenneth Marek ; John Seibyl ; Shirley Eberly ; David Oakes ; Ira Shoulson ; Anthony E. Lang ; Chris Hyson ; Danna Jennings

Source :

RBID : PMC:4035714

English descriptors

Abstract

Objective:

To compare the clinical and imaging characteristics of those PRECEPT (Parkinson Research Examination of CEP-1347 Trial) subjects with a scan without evidence of dopaminergic deficit (SWEDD) to those with dopamine transporter (DAT) deficit scans at study baseline and during a 22-month follow-up.

Methods:

Baseline (n = 799) and 22-month follow-up (n = 701) [123I] β-CIT SPECT scans were acquired. The percent change in [123I] β-CIT striatal binding ratio, the percentage of subjects requiring dopaminergic therapy, the change in Unified Parkinson's Disease Rating Scale (UPDRS) score, and the PRECEPT Study investigators’ diagnosis at study termination were compared between SWEDD and DAT deficit subjects.

Results:

SWEDD subjects (n = 91) compared with DAT deficit subjects (n = 708) showed reduced UPDRS score at baseline (18.7 [SD 8.5] vs 25.5 [SD 10.5], p < 0.05) and minimal change in both [123I] β-CIT striatal binding ratio (−0.2% [SD 12.2] vs −8.5% [SD 11.9], p < 0.0001) and UPDRS score (0.5 [SD 6.9] vs 10.5 [SD 8.9], p < 0.0001) at follow-up assessments. At PRECEPT termination, the diagnosis by study investigators was changed from Parkinson disease (PD) to other disorders not associated with DAT deficit in 44% (95% confidence interval 34.2, 54.7) of SWEDD subjects compared with 3.6% (95% confidence interval 2.3, 5.1) of DAT deficit subjects.

Conclusion:

These results indicate that subjects identified as having a SWEDD, with DAT imaging within the normal range, have minimal evidence of clinical or imaging PD progression. These data strongly suggest that SWEDD subjects are unlikely to have idiopathic PD.


Url:
DOI: 10.1212/WNL.0000000000000424
PubMed: 24759846
PubMed Central: 4035714

Links toward previous steps (curation, corpus...)


Links to Exploration step

PMC:4035714

Le document en format XML

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<p>Baseline (n = 799) and 22-month follow-up (n = 701) [
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<sup>123</sup>
I] β-CIT striatal binding ratio, the percentage of subjects requiring dopaminergic therapy, the change in Unified Parkinson's Disease Rating Scale (UPDRS) score, and the PRECEPT Study investigators’ diagnosis at study termination were compared between SWEDD and DAT deficit subjects.</p>
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< 0.05) and minimal change in both [
<sup>123</sup>
I] β-CIT striatal binding ratio (−0.2% [SD 12.2] vs −8.5% [SD 11.9],
<italic>p</italic>
< 0.0001) and UPDRS score (0.5 [SD 6.9] vs 10.5 [SD 8.9],
<italic>p</italic>
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</sec>
<sec>
<title>Conclusion:</title>
<p>These results indicate that subjects identified as having a SWEDD, with DAT imaging within the normal range, have minimal evidence of clinical or imaging PD progression. These data strongly suggest that SWEDD subjects are unlikely to have idiopathic PD.</p>
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<div type="abstract" xml:lang="en">
<sec>
<title>Objective:</title>
<p>To compare the clinical and imaging characteristics of those PRECEPT (Parkinson Research Examination of CEP-1347 Trial) subjects with a scan without evidence of dopaminergic deficit (SWEDD) to those with dopamine transporter (DAT) deficit scans at study baseline and during a 22-month follow-up.</p>
</sec>
<sec>
<title>Methods:</title>
<p>Baseline (n = 799) and 22-month follow-up (n = 701) [
<sup>123</sup>
I] β-CIT SPECT scans were acquired. The percent change in [
<sup>123</sup>
I] β-CIT striatal binding ratio, the percentage of subjects requiring dopaminergic therapy, the change in Unified Parkinson's Disease Rating Scale (UPDRS) score, and the PRECEPT Study investigators’ diagnosis at study termination were compared between SWEDD and DAT deficit subjects.</p>
</sec>
<sec>
<title>Results:</title>
<p>SWEDD subjects (n = 91) compared with DAT deficit subjects (n = 708) showed reduced UPDRS score at baseline (18.7 [SD 8.5] vs 25.5 [SD 10.5],
<italic>p</italic>
< 0.05) and minimal change in both [
<sup>123</sup>
I] β-CIT striatal binding ratio (−0.2% [SD 12.2] vs −8.5% [SD 11.9],
<italic>p</italic>
< 0.0001) and UPDRS score (0.5 [SD 6.9] vs 10.5 [SD 8.9],
<italic>p</italic>
< 0.0001) at follow-up assessments. At PRECEPT termination, the diagnosis by study investigators was changed from Parkinson disease (PD) to other disorders not associated with DAT deficit in 44% (95% confidence interval 34.2, 54.7) of SWEDD subjects compared with 3.6% (95% confidence interval 2.3, 5.1) of DAT deficit subjects.</p>
</sec>
<sec>
<title>Conclusion:</title>
<p>These results indicate that subjects identified as having a SWEDD, with DAT imaging within the normal range, have minimal evidence of clinical or imaging PD progression. These data strongly suggest that SWEDD subjects are unlikely to have idiopathic PD.</p>
</sec>
</div>
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<country xml:lang="fr">Canada</country>
<wicri:regionArea>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario</wicri:regionArea>
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<country xml:lang="fr">Canada</country>
<wicri:regionArea>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario</wicri:regionArea>
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<country xml:lang="fr">Canada</country>
<wicri:regionArea>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario</wicri:regionArea>
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<nlm:affiliation>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario</wicri:regionArea>
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<name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E" last="Lang">Anthony E. Lang</name>
<affiliation wicri:level="1">
<nlm:affiliation>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario</wicri:regionArea>
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<name sortKey="Hyson, Chris" sort="Hyson, Chris" uniqKey="Hyson C" first="Chris" last="Hyson">Chris Hyson</name>
<affiliation wicri:level="1">
<nlm:affiliation>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario</wicri:regionArea>
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<name sortKey="Jennings, Danna" sort="Jennings, Danna" uniqKey="Jennings D" first="Danna" last="Jennings">Danna Jennings</name>
<affiliation wicri:level="1">
<nlm:affiliation>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario</wicri:regionArea>
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<title xml:lang="en">Longitudinal follow-up of SWEDD subjects in the PRECEPT Study.</title>
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<name sortKey="Marek, Kenneth" sort="Marek, Kenneth" uniqKey="Marek K" first="Kenneth" last="Marek">Kenneth Marek</name>
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<nlm:affiliation>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario, Canada. kmarek@indd.org.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario</wicri:regionArea>
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<name sortKey="Seibyl, John" sort="Seibyl, John" uniqKey="Seibyl J" first="John" last="Seibyl">John Seibyl</name>
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<nlm:affiliation>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario</wicri:regionArea>
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<name sortKey="Eberly, Shirley" sort="Eberly, Shirley" uniqKey="Eberly S" first="Shirley" last="Eberly">Shirley Eberly</name>
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<nlm:affiliation>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario</wicri:regionArea>
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<name sortKey="Oakes, David" sort="Oakes, David" uniqKey="Oakes D" first="David" last="Oakes">David Oakes</name>
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<nlm:affiliation>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario</wicri:regionArea>
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<name sortKey="Shoulson, Ira" sort="Shoulson, Ira" uniqKey="Shoulson I" first="Ira" last="Shoulson">Ira Shoulson</name>
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<nlm:affiliation>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario</wicri:regionArea>
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<name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E" last="Lang">Anthony E. Lang</name>
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<nlm:affiliation>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
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<name sortKey="Hyson, Chris" sort="Hyson, Chris" uniqKey="Hyson C" first="Chris" last="Hyson">Chris Hyson</name>
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<nlm:affiliation>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
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<name sortKey="Jennings, Danna" sort="Jennings, Danna" uniqKey="Jennings D" first="Danna" last="Jennings">Danna Jennings</name>
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<nlm:affiliation>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario, Canada.</nlm:affiliation>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>From the Institute for Neurodegenerative Disorders (K.M., J.S., D.J.), University of Rochester (S.E., D.O.), Rochester, NY; Georgetown University (I.S.), Washington, DC; University of Toronto (A.E.L.); and Western University (C.H.), London, Ontario</wicri:regionArea>
<wicri:noRegion>Ontario</wicri:noRegion>
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<series>
<title level="j">Neurology</title>
<idno type="eISSN">1526-632X</idno>
<imprint>
<date when="2014" type="published">2014</date>
</imprint>
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<keywords scheme="KwdEn" xml:lang="en">
<term>Adult</term>
<term>Aged</term>
<term>Antiparkinson Agents (therapeutic use)</term>
<term>Brain (diagnostic imaging)</term>
<term>Brain (metabolism)</term>
<term>Dopamine Plasma Membrane Transport Proteins (metabolism)</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Levodopa (therapeutic use)</term>
<term>Longitudinal Studies</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Parkinson Disease (diagnostic imaging)</term>
<term>Parkinson Disease (drug therapy)</term>
<term>Parkinson Disease (metabolism)</term>
<term>Radionuclide Imaging</term>
<term>Randomized Controlled Trials as Topic</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="metabolism" xml:lang="en">
<term>Dopamine Plasma Membrane Transport Proteins</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en">
<term>Antiparkinson Agents</term>
<term>Levodopa</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en">
<term>Brain</term>
<term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en">
<term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="metabolism" xml:lang="en">
<term>Brain</term>
<term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" xml:lang="en">
<term>Adult</term>
<term>Aged</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Longitudinal Studies</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Radionuclide Imaging</term>
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<front>
<div type="abstract" xml:lang="en">To compare the clinical and imaging characteristics of those PRECEPT (Parkinson Research Examination of CEP-1347 Trial) subjects with a scan without evidence of dopaminergic deficit (SWEDD) to those with dopamine transporter (DAT) deficit scans at study baseline and during a 22-month follow-up.</div>
</front>
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