Dopamine Transporter Imaging Is Associated With Long-Term Outcomes in Parkinson's Disease
Identifieur interne : 000213 ( PascalFrancis/Checkpoint ); précédent : 000212; suivant : 000214Dopamine Transporter Imaging Is Associated With Long-Term Outcomes in Parkinson's Disease
Auteurs : Bernard Ravina [États-Unis] ; Kenneth Marek [États-Unis] ; Shirley Eberly [États-Unis] ; David Oakes [États-Unis] ; Roger Kurlan [États-Unis] ; Alberto Ascherio [États-Unis] ; Flint Beal [États-Unis] ; James Beck [États-Unis] ; Emily Flagg [États-Unis] ; Wendy R. Galpern [États-Unis] ; Jennifer Harman [États-Unis] ; Anthony E. Lang [Canada] ; Michael Schwarzschild [États-Unis] ; Caroline Tanner [États-Unis] ; Ira Shoulson [États-Unis]Source :
- Movement disorders [ 0885-3185 ] ; 2012.
Descripteurs français
- Pascal (Inist)
English descriptors
Abstract
Dopamine (DA) transporter (DAT) imaging has been studied as a diagnostic tool for degenerative parkinsonism. Our aim was to measure the prognostic value of imaging for motor and nonmotor outcomes in Parkinson's disease (PD). We prospectively evaluated a Parkinson's cohort after enrollment in a de novo clinical trial with a battery of motor (UPDRS), cognitive (Montreal Cognitive Assessment), and behavioral measures. DAT imaging with [123I][β]-CIT and single-photon emission computerized tomography (SPECT) was performed at baseline and after 22 months. In total, 491 (91 %) of the 537 subjects had evidence of DA deficiency on their baseline scan, consistent with PD, and were included in the analyses. The cohort was followed for 5.5 (0.8) years, with a mean duration of diagnosis of 6.3 (1.2). Lower striatal binding at baseline was independently associated with higher risk for clinical milestones and measures of disease severity, including motorrelated disability, falling and postural instability, cognitive impairment, psychosis, and clinically important depressive symptoms. Subjects in the bottom quartile for striatal binding, compared to the top quartile, had an odds ratio (95% confidence interval) of 3.3 (1.7, 6.7) for cognitive impairment and 12.9 (2.6, 62.4) for psychosis. Change from baseline in imaging after 22 months was also independently associated with motor, cognitive, and behavioral outcomes. DAT imaging with [123I][β]-CIT and SPECT, shortly after the diagnosis of PD, was independently associated with clinically important long-term motor and nonmotor outcomes. These results should be treated as hypothesis generating and require confirmation.
Affiliations:
- Canada, États-Unis
- Californie, Connecticut, Maryland, Massachusetts, New Jersey, Ontario, État de New York
- Toronto
- Université de Toronto
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Dopamine Transporter Imaging Is Associated With Long-Term Outcomes in Parkinson's Disease</title><author><name sortKey="Ravina, Bernard" sort="Ravina, Bernard" uniqKey="Ravina B" first="Bernard" last="Ravina">Bernard Ravina</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Biogen Idec</s1><s2>Cambridge, Massachusetts</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>9 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Marek, Kenneth" sort="Marek, Kenneth" uniqKey="Marek K" first="Kenneth" last="Marek">Kenneth Marek</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Institute for Neurodegenerative Disorders</s1><s2>New Haven, Connecticut</s2><s3>USA</s3><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Connecticut</region></placeName></affiliation></author><author><name sortKey="Eberly, Shirley" sort="Eberly, Shirley" uniqKey="Eberly S" first="Shirley" last="Eberly">Shirley Eberly</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>University of Rochester School of Medicine and Dentistry</s1><s2>Rochester, New York</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Oakes, David" sort="Oakes, David" uniqKey="Oakes D" first="David" last="Oakes">David Oakes</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>University of Rochester School of Medicine and Dentistry</s1><s2>Rochester, New York</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Kurlan, Roger" sort="Kurlan, Roger" uniqKey="Kurlan R" first="Roger" last="Kurlan">Roger Kurlan</name><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Atlantic Neuroscience Institute</s1><s2>Summit, New Jersey</s2><s3>USA</s3><sZ>5 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">New Jersey</region></placeName></affiliation></author><author><name sortKey="Ascherio, Alberto" sort="Ascherio, Alberto" uniqKey="Ascherio A" first="Alberto" last="Ascherio">Alberto Ascherio</name><affiliation wicri:level="2"><inist:fA14 i1="05"><s1>Massachusetts General Hospital</s1><s2>Boston, Massachusetts</s2><s3>USA</s3><sZ>6 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Beal, Flint" sort="Beal, Flint" uniqKey="Beal F" first="Flint" last="Beal">Flint Beal</name><affiliation wicri:level="2"><inist:fA14 i1="06"><s1>Cornell University School of Medicine</s1><s2>New York, New York</s2><s3>USA</s3><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Beck, James" sort="Beck, James" uniqKey="Beck J" first="James" last="Beck">James Beck</name><affiliation wicri:level="2"><inist:fA14 i1="07"><s1>The Parkinson's Disease Foundation</s1><s2>New York, New York</s2><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Flagg, Emily" sort="Flagg, Emily" uniqKey="Flagg E" first="Emily" last="Flagg">Emily Flagg</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Biogen Idec</s1><s2>Cambridge, Massachusetts</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>9 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Galpern, Wendy R" sort="Galpern, Wendy R" uniqKey="Galpern W" first="Wendy R." last="Galpern">Wendy R. Galpern</name><affiliation wicri:level="2"><inist:fA14 i1="08"><s1>The National Institute of Neurological Disorders and Stroke</s1><s2>, Bethesda, Maryland</s2><s3>USA</s3><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Harman, Jennifer" sort="Harman, Jennifer" uniqKey="Harman J" first="Jennifer" last="Harman">Jennifer Harman</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>University of Rochester School of Medicine and Dentistry</s1><s2>Rochester, New York</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name><affiliation wicri:level="4"><inist:fA14 i1="09"><s1>The University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>12 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Schwarzschild, Michael" sort="Schwarzschild, Michael" uniqKey="Schwarzschild M" first="Michael" last="Schwarzschild">Michael Schwarzschild</name><affiliation wicri:level="2"><inist:fA14 i1="05"><s1>Massachusetts General Hospital</s1><s2>Boston, Massachusetts</s2><s3>USA</s3><sZ>6 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Tanner, Caroline" sort="Tanner, Caroline" uniqKey="Tanner C" first="Caroline" last="Tanner">Caroline Tanner</name><affiliation wicri:level="2"><inist:fA14 i1="10"><s1>The Parkinson's Institute</s1><s2>Sunnyvale, California</s2><s3>USA</s3><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Shoulson, Ira" sort="Shoulson, Ira" uniqKey="Shoulson I" first="Ira" last="Shoulson">Ira Shoulson</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Biogen Idec</s1><s2>Cambridge, Massachusetts</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>9 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">12-0393087</idno><date when="2012">2012</date><idno type="stanalyst">PASCAL 12-0393087 INIST</idno><idno type="RBID">Pascal:12-0393087</idno><idno type="wicri:Area/PascalFrancis/Corpus">000072</idno><idno type="wicri:Area/PascalFrancis/Curation">002C42</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000213</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Dopamine Transporter Imaging Is Associated With Long-Term Outcomes in Parkinson's Disease</title><author><name sortKey="Ravina, Bernard" sort="Ravina, Bernard" uniqKey="Ravina B" first="Bernard" last="Ravina">Bernard Ravina</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Biogen Idec</s1><s2>Cambridge, Massachusetts</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>9 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Marek, Kenneth" sort="Marek, Kenneth" uniqKey="Marek K" first="Kenneth" last="Marek">Kenneth Marek</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Institute for Neurodegenerative Disorders</s1><s2>New Haven, Connecticut</s2><s3>USA</s3><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Connecticut</region></placeName></affiliation></author><author><name sortKey="Eberly, Shirley" sort="Eberly, Shirley" uniqKey="Eberly S" first="Shirley" last="Eberly">Shirley Eberly</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>University of Rochester School of Medicine and Dentistry</s1><s2>Rochester, New York</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Oakes, David" sort="Oakes, David" uniqKey="Oakes D" first="David" last="Oakes">David Oakes</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>University of Rochester School of Medicine and Dentistry</s1><s2>Rochester, New York</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Kurlan, Roger" sort="Kurlan, Roger" uniqKey="Kurlan R" first="Roger" last="Kurlan">Roger Kurlan</name><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Atlantic Neuroscience Institute</s1><s2>Summit, New Jersey</s2><s3>USA</s3><sZ>5 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">New Jersey</region></placeName></affiliation></author><author><name sortKey="Ascherio, Alberto" sort="Ascherio, Alberto" uniqKey="Ascherio A" first="Alberto" last="Ascherio">Alberto Ascherio</name><affiliation wicri:level="2"><inist:fA14 i1="05"><s1>Massachusetts General Hospital</s1><s2>Boston, Massachusetts</s2><s3>USA</s3><sZ>6 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Beal, Flint" sort="Beal, Flint" uniqKey="Beal F" first="Flint" last="Beal">Flint Beal</name><affiliation wicri:level="2"><inist:fA14 i1="06"><s1>Cornell University School of Medicine</s1><s2>New York, New York</s2><s3>USA</s3><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Beck, James" sort="Beck, James" uniqKey="Beck J" first="James" last="Beck">James Beck</name><affiliation wicri:level="2"><inist:fA14 i1="07"><s1>The Parkinson's Disease Foundation</s1><s2>New York, New York</s2><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Flagg, Emily" sort="Flagg, Emily" uniqKey="Flagg E" first="Emily" last="Flagg">Emily Flagg</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Biogen Idec</s1><s2>Cambridge, Massachusetts</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>9 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Galpern, Wendy R" sort="Galpern, Wendy R" uniqKey="Galpern W" first="Wendy R." last="Galpern">Wendy R. Galpern</name><affiliation wicri:level="2"><inist:fA14 i1="08"><s1>The National Institute of Neurological Disorders and Stroke</s1><s2>, Bethesda, Maryland</s2><s3>USA</s3><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Harman, Jennifer" sort="Harman, Jennifer" uniqKey="Harman J" first="Jennifer" last="Harman">Jennifer Harman</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>University of Rochester School of Medicine and Dentistry</s1><s2>Rochester, New York</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name><affiliation wicri:level="4"><inist:fA14 i1="09"><s1>The University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>12 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Schwarzschild, Michael" sort="Schwarzschild, Michael" uniqKey="Schwarzschild M" first="Michael" last="Schwarzschild">Michael Schwarzschild</name><affiliation wicri:level="2"><inist:fA14 i1="05"><s1>Massachusetts General Hospital</s1><s2>Boston, Massachusetts</s2><s3>USA</s3><sZ>6 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Tanner, Caroline" sort="Tanner, Caroline" uniqKey="Tanner C" first="Caroline" last="Tanner">Caroline Tanner</name><affiliation wicri:level="2"><inist:fA14 i1="10"><s1>The Parkinson's Institute</s1><s2>Sunnyvale, California</s2><s3>USA</s3><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Shoulson, Ira" sort="Shoulson, Ira" uniqKey="Shoulson I" first="Ira" last="Shoulson">Ira Shoulson</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Biogen Idec</s1><s2>Cambridge, Massachusetts</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>9 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Dopamine</term><term>Long term</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Prognosis</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term><term>Pathologie du système nerveux</term><term>Dopamine</term><term>Long terme</term><term>Pronostic</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Dopamine (DA) transporter (DAT) imaging has been studied as a diagnostic tool for degenerative parkinsonism. Our aim was to measure the prognostic value of imaging for motor and nonmotor outcomes in Parkinson's disease (PD). We prospectively evaluated a Parkinson's cohort after enrollment in a de novo clinical trial with a battery of motor (UPDRS), cognitive (Montreal Cognitive Assessment), and behavioral measures. DAT imaging with [<sup>123</sup>I][β]-CIT and single-photon emission computerized tomography (SPECT) was performed at baseline and after 22 months. In total, 491 (91 %) of the 537 subjects had evidence of DA deficiency on their baseline scan, consistent with PD, and were included in the analyses. The cohort was followed for 5.5 (0.8) years, with a mean duration of diagnosis of 6.3 (1.2). Lower striatal binding at baseline was independently associated with higher risk for clinical milestones and measures of disease severity, including motorrelated disability, falling and postural instability, cognitive impairment, psychosis, and clinically important depressive symptoms. Subjects in the bottom quartile for striatal binding, compared to the top quartile, had an odds ratio (95% confidence interval) of 3.3 (1.7, 6.7) for cognitive impairment and 12.9 (2.6, 62.4) for psychosis. Change from baseline in imaging after 22 months was also independently associated with motor, cognitive, and behavioral outcomes. DAT imaging with [<sup>123</sup>I][β]-CIT and SPECT, shortly after the diagnosis of PD, was independently associated with clinically important long-term motor and nonmotor outcomes. These results should be treated as hypothesis generating and require confirmation.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0885-3185</s0></fA01><fA03 i2="1"><s0>Mov. disord.</s0></fA03><fA05><s2>27</s2></fA05><fA06><s2>11</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Dopamine Transporter Imaging Is Associated With Long-Term Outcomes in Parkinson's Disease</s1></fA08><fA11 i1="01" i2="1"><s1>RAVINA (Bernard)</s1></fA11><fA11 i1="02" i2="1"><s1>MAREK (Kenneth)</s1></fA11><fA11 i1="03" i2="1"><s1>EBERLY (Shirley)</s1></fA11><fA11 i1="04" i2="1"><s1>OAKES (David)</s1></fA11><fA11 i1="05" i2="1"><s1>KURLAN (Roger)</s1></fA11><fA11 i1="06" i2="1"><s1>ASCHERIO (Alberto)</s1></fA11><fA11 i1="07" i2="1"><s1>BEAL (Flint)</s1></fA11><fA11 i1="08" i2="1"><s1>BECK (James)</s1></fA11><fA11 i1="09" i2="1"><s1>FLAGG (Emily)</s1></fA11><fA11 i1="10" i2="1"><s1>GALPERN (Wendy R.)</s1></fA11><fA11 i1="11" i2="1"><s1>HARMAN (Jennifer)</s1></fA11><fA11 i1="12" i2="1"><s1>LANG (Anthony E.)</s1></fA11><fA11 i1="13" i2="1"><s1>SCHWARZSCHILD (Michael)</s1></fA11><fA11 i1="14" i2="1"><s1>TANNER (Caroline)</s1></fA11><fA11 i1="15" i2="1"><s1>SHOULSON (Ira)</s1></fA11><fA14 i1="01"><s1>Biogen Idec</s1><s2>Cambridge, Massachusetts</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>9 aut.</sZ><sZ>15 aut.</sZ></fA14><fA14 i1="02"><s1>Institute for Neurodegenerative Disorders</s1><s2>New Haven, Connecticut</s2><s3>USA</s3><sZ>2 aut.</sZ></fA14><fA14 i1="03"><s1>University of Rochester School of Medicine and Dentistry</s1><s2>Rochester, New York</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>11 aut.</sZ></fA14><fA14 i1="04"><s1>Atlantic Neuroscience Institute</s1><s2>Summit, New Jersey</s2><s3>USA</s3><sZ>5 aut.</sZ></fA14><fA14 i1="05"><s1>Massachusetts General Hospital</s1><s2>Boston, Massachusetts</s2><s3>USA</s3><sZ>6 aut.</sZ><sZ>13 aut.</sZ></fA14><fA14 i1="06"><s1>Cornell University School of Medicine</s1><s2>New York, New York</s2><s3>USA</s3><sZ>7 aut.</sZ></fA14><fA14 i1="07"><s1>The Parkinson's Disease Foundation</s1><s2>New York, New York</s2><s3>USA</s3><sZ>8 aut.</sZ></fA14><fA14 i1="08"><s1>The National Institute of Neurological Disorders and Stroke</s1><s2>, Bethesda, Maryland</s2><s3>USA</s3><sZ>10 aut.</sZ></fA14><fA14 i1="09"><s1>The University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>12 aut.</sZ></fA14><fA14 i1="10"><s1>The Parkinson's Institute</s1><s2>Sunnyvale, California</s2><s3>USA</s3><sZ>14 aut.</sZ></fA14><fA20><s1>1392-1397</s1></fA20><fA21><s1>2012</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000502036870140</s5></fA43><fA44><s0>0000</s0><s1>© 2012 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>30 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>12-0393087</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Movement disorders</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Dopamine (DA) transporter (DAT) imaging has been studied as a diagnostic tool for degenerative parkinsonism. Our aim was to measure the prognostic value of imaging for motor and nonmotor outcomes in Parkinson's disease (PD). We prospectively evaluated a Parkinson's cohort after enrollment in a de novo clinical trial with a battery of motor (UPDRS), cognitive (Montreal Cognitive Assessment), and behavioral measures. DAT imaging with [<sup>123</sup>I][β]-CIT and single-photon emission computerized tomography (SPECT) was performed at baseline and after 22 months. In total, 491 (91 %) of the 537 subjects had evidence of DA deficiency on their baseline scan, consistent with PD, and were included in the analyses. The cohort was followed for 5.5 (0.8) years, with a mean duration of diagnosis of 6.3 (1.2). Lower striatal binding at baseline was independently associated with higher risk for clinical milestones and measures of disease severity, including motorrelated disability, falling and postural instability, cognitive impairment, psychosis, and clinically important depressive symptoms. Subjects in the bottom quartile for striatal binding, compared to the top quartile, had an odds ratio (95% confidence interval) of 3.3 (1.7, 6.7) for cognitive impairment and 12.9 (2.6, 62.4) for psychosis. Change from baseline in imaging after 22 months was also independently associated with motor, cognitive, and behavioral outcomes. DAT imaging with [<sup>123</sup>I][β]-CIT and SPECT, shortly after the diagnosis of PD, was independently associated with clinically important long-term motor and nonmotor outcomes. These results should be treated as hypothesis generating and require confirmation.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17</s0></fC02><fC02 i1="02" i2="X"><s0>002B17G</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Maladie de Parkinson</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Parkinson disease</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Parkinson enfermedad</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Pathologie du système nerveux</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Dopamine</s0><s2>NK</s2><s2>FR</s2><s5>09</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Dopamine</s0><s2>NK</s2><s2>FR</s2><s5>09</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Dopamina</s0><s2>NK</s2><s2>FR</s2><s5>09</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Long terme</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Long term</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Largo plazo</s0><s5>10</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Pronostic</s0><s5>11</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Prognosis</s0><s5>11</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Pronóstico</s0><s5>11</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Catécholamine</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Catecholamine</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Catecolamina</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Neurotransmetteur</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Neurotransmitter</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Neurotransmisor</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Pathologie de l'encéphale</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Cerebral disorder</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Encéfalo patología</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Syndrome extrapyramidal</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Maladie dégénérative</s0><s5>41</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Degenerative disease</s0><s5>41</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0><s5>41</s5></fC07><fC07 i1="06" i2="X" l="FRE"><s0>Pathologie du système nerveux central</s0><s5>42</s5></fC07><fC07 i1="06" i2="X" l="ENG"><s0>Central nervous system disease</s0><s5>42</s5></fC07><fC07 i1="06" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0><s5>42</s5></fC07><fN21><s1>303</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>Canada</li><li>États-Unis</li></country><region><li>Californie</li><li>Connecticut</li><li>Maryland</li><li>Massachusetts</li><li>New Jersey</li><li>Ontario</li><li>État de New York</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><country name="États-Unis"><region name="Massachusetts"><name sortKey="Ravina, Bernard" sort="Ravina, Bernard" uniqKey="Ravina B" first="Bernard" last="Ravina">Bernard Ravina</name></region><name sortKey="Ascherio, Alberto" sort="Ascherio, Alberto" uniqKey="Ascherio A" first="Alberto" last="Ascherio">Alberto Ascherio</name><name sortKey="Beal, Flint" sort="Beal, Flint" uniqKey="Beal F" first="Flint" last="Beal">Flint Beal</name><name sortKey="Beck, James" sort="Beck, James" uniqKey="Beck J" first="James" last="Beck">James Beck</name><name sortKey="Eberly, Shirley" sort="Eberly, Shirley" uniqKey="Eberly S" first="Shirley" last="Eberly">Shirley Eberly</name><name sortKey="Flagg, Emily" sort="Flagg, Emily" uniqKey="Flagg E" first="Emily" last="Flagg">Emily Flagg</name><name sortKey="Galpern, Wendy R" sort="Galpern, Wendy R" uniqKey="Galpern W" first="Wendy R." last="Galpern">Wendy R. Galpern</name><name sortKey="Harman, Jennifer" sort="Harman, Jennifer" uniqKey="Harman J" first="Jennifer" last="Harman">Jennifer Harman</name><name sortKey="Kurlan, Roger" sort="Kurlan, Roger" uniqKey="Kurlan R" first="Roger" last="Kurlan">Roger Kurlan</name><name sortKey="Marek, Kenneth" sort="Marek, Kenneth" uniqKey="Marek K" first="Kenneth" last="Marek">Kenneth Marek</name><name sortKey="Oakes, David" sort="Oakes, David" uniqKey="Oakes D" first="David" last="Oakes">David Oakes</name><name sortKey="Schwarzschild, Michael" sort="Schwarzschild, Michael" uniqKey="Schwarzschild M" first="Michael" last="Schwarzschild">Michael Schwarzschild</name><name sortKey="Shoulson, Ira" sort="Shoulson, Ira" uniqKey="Shoulson I" first="Ira" last="Shoulson">Ira Shoulson</name><name sortKey="Tanner, Caroline" sort="Tanner, Caroline" uniqKey="Tanner C" first="Caroline" last="Tanner">Caroline Tanner</name></country><country name="Canada"><region name="Ontario"><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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