Clinical correlation of semiquantitative parameters using FP-CIT template-based analysis in de novo idiopathic Parkinson's disease

초록

Objectives In our previous study, FP-CIT template-based semiautomatic analysis showed a feasible method using a reference of occipital cortex. The aim of this study was to evaluate the correlation between the parameters from FP-CIT template-based analysis and clinically assessed disease severity in patients with de novo idiopathic Parkinson's disease. Methods We enrolled 45 de novo PD patients (68.6 ± 8.9y; M:F=17:28; H&Y 2.0±0.7; UPDRS III 21±10; symptom duration 18±12 mo) who initially underwent F-18 FP-CIT PET. A standardized FP-CIT template was transposed onto PET images. Probability-weighted mean counts of putamen, caudate and occipital cortex were obtained from the quantification program, Korean Structural Statistical Probabilistic Anatomical Map (KSPAM). Putamen-to-caudate ratio (PCR), asymmetry index (ASI) and specific-to-nonspecific ratios with 3 specific ROIs in putamen, caudate, striatum; V3″(P), V3″(C), V3″(S), respectively, were used. Clinical severity was assessed with H&Y stage, UPDRS III (motor) score and duration of symptoms. Spearman’s rho correlation coefficient was determined. Results Mean ± SD's were 1.48±0.52, 11.4±9.5, 1.66±0.80, 0.90±0.59, 1.30±0.59 for PCR, ASI, V3″(P), V3″(C), V3″(S), respectively. V3″(C) was inversely correlated with H&Y and UPDRS III score (rho=-0.32, p=0.03, each). PCR also showed a significant correlation with H&Y (rho=0.33, p=0.03) and UPDRS III score (rho=0.41, p=0.01). However, neither V3″(S) nor V3″(P) correlated with any clinically assessed scores. Conclusions V3″(C), PCR and ASI were significant parameters correlating with the severity of clinical motor symptoms. V3″(C) could predict the clinical scores better than V3″(P), which explained that PCR, known as a good value in differential diagnosis of Parkinsonism on dopamine transporter imagings, was correlated with disease severity in confirmed PD patients