Striatal Dopamine Loss in Early Parkinson's Disease: Systematic Review and Novel Analysis of Dopamine Transporter Imaging

Anahita Nodehi*, Michael A Lawton, Yoav Ben-Shlomo, Donald G. Grosset, Katherine A. Grosset, Vanessa Pitz, Naveed Malek, Nicholas Heng*

*Corresponding author for this work

Research output: Contribution to journalReview article (Academic Journal)peer-review

6 Citations (Scopus)

Abstract

Background
Neuropathological studies, based on small samples, suggest that symptoms of Parkinson's disease (PD) emerge when dopamine/nigrostriatal loss is around 50–80%. Functional neuroimaging can be applied in larger numbers during life, which allows analysis of the extent of dopamine loss more directly.

Objective
To quantify dopamine transporter (DaT) activity by neuroimaging in early PD.

Methods
Systematic review and novel analysis of DaT imaging studies in early PD.

Results
In our systematic review, in 423 unique cases from 27 studies with disease duration of less than 6 years, mean age 58.0 (SD 11.5) years, and mean disease duration 1.8 (SD 1.2) years, striatal loss was 43.5% (95% CI 41.6, 45.4) contralaterally, and 36.0% (95% CI 33.6, 38.3) ipsilaterally. For unilateral PD, in 436 unique cases, mean age 57.5 (SD 10.2) years, and mean disease duration 1.8 (SD 1.4) years, striatal loss was 40.6% (95% CI 38.8, 42.4) contralaterally, and 31.6% (95% CI 29.4, 33.8) ipsilaterally. In our novel analysis of the Parkinson's Progressive Marker Initiative study, 413 cases had 1436 scans performed. For a disease duration of less than 1 year, age was 61.8 (SD 9.8) years, and striatal loss was 51.2% (95% CI 49.1, 53.3) contralaterally and 39.5% (36.9, 42.1) ipsilaterally, giving an overall striatal loss of 45.3% (43.0, 47.6).

Conclusions
Loss of striatal DaT activity in early PD is less at 35–45%, rather than the 50–80% striatal dopamine loss estimated to be present at the time of symptom onset, based on backwards extrapolation from autopsy studies.
Original languageEnglish
Pages (from-to)539-546
Number of pages8
JournalMovement Disorders Clinical Practice
Volume10
Issue number4
Early online date6 Feb 2023
DOIs
Publication statusPublished - 1 Apr 2023

Bibliographical note

Publisher Copyright:
© 2023 The Authors. Movement Disorders Clinical Practice published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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