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Neuromelanin or DaT‐ SPECT : which is the better marker for discriminating advanced Parkinson's disease?
Author(s) -
Okuzumi A.,
Hatano T.,
Kamagata K.,
Hori M.,
Mori A.,
Oji Y.,
Taniguchi D.,
Daida K.,
Shimo Y.,
Yanagisawa N.,
Nojiri S.,
Aoki S.,
Hattori N.
Publication year - 2019
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.14009
Subject(s) - neuromelanin , receiver operating characteristic , pars compacta , medicine , nuclear medicine , substantia nigra , hazard ratio , parkinson's disease , magnetic resonance imaging , gastroenterology , single photon emission computed tomography , pathology , disease , radiology , confidence interval
Background and purpose Whether the neuromelanin‐positive substantia nigra pars compacta area ( NM ‐ SN c) on neuromelanin magnetic resonance imaging ( NM ‐ MRI ) and the specific binding ratio ( SBR ) on 123 I‐N‐v‐fluoropropyl‐2b‐carbomethoxy3b‐(4‐iodophenyl)nortropane single photon emission computed tomography (DaT‐ SPECT ) can be correlated with motor fluctuations ( MF s) in advanced Parkinson's disease ( PD ) was investigated. Methods Thirty‐five PD patients (60 ± 13 years) and 23 healthy individuals as controls (59 ± 19 years) were enrolled. The relationships between NM ‐ MRI and DaT‐ SPECT were prospectively examined in two subgroups divided according to the presence or absence of MF s. Multivariate analysis was performed using the Cox proportional hazard model to screen for association factors. Results The NM ‐ SN c size was correlated with the SBR (Spearman's ρ = 0.43, P < 0.05). The NM ‐ SN c size was significantly reduced in PD with MF s compared with the subgroup without ( P < 0.001), whereas the SBR did not significantly differ between the groups. NM ‐ SN c size was a significant association factor for MF s (hazard ratio 0.94, P = 0.04). In receiver operating characteristic analysis of the factors for MF occurrence, the area under the receiver operating characteristic curve of the NM ‐ SN c size showed a significant difference of 0.89 ( P < 0.05) but no significant difference was found in the SBR . Conclusions NM‐SNc size was significantly correlated with the SBR in PD , but several factors in advanced PD were more closely associated with NM ‐ SN c size than the SBR . NM ‐ MRI might reflect the status of advanced PD more accurately than DaT‐ SPECT . Therefore, NM ‐ MRI appears to provide a better marker for discriminating advanced PD than DaT‐ SPECT .