Nuclear Imaging Data-Driven Classification of Parkinson's Disease

IF 7.4 1区医学 Q1 CLINICAL NEUROLOGY

Movement Disorders Pub Date : 2023-08-28 DOI:10.1002/mds.29582

Tomoko Totsune MD, PhD, Toru Baba MD, PhD, Yoko Sugimura MD, Hideki Oizumi MD, PhD, Hiroyasu Tanaka MD, PhD, Toshiaki Takahashi MD, PhD, Masaru Yoshioka MD, PhD, Ken-ichi Nagamatsu MD, PhD, Atsushi Takeda MD, PhD

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引用次数: 0

Abstract

BACKGROUND

Parkinson's disease (PD) is a heterogeneous neurodegenerative disorder characterized by motor and nonmotor symptoms. Several features have prognostic importance and have been used as key indicators for identifying clinical subtypes. However, the symptom-based classification approach has limitations with respect to the stability of the obtained subtypes.

OBJECTIVES

The purpose of this study was to identify subtypes of PD using nuclear imaging biomarkers targeting the cardiac sympathetic nervous and nigro-striatal systems and to compare patterns of cortical morphological change among obtained subtypes.

METHODS

We performed unbiased hierarchical cluster analysis using ¹²³I-metaiodobenzylguanidine cardiac scintigraphy and ¹²³I-N-(3-fluoropropyl)-2β-carbomethoxy-3β-(4-iodophenyl) nortropane single photon emission computed tomography data for 56 patients with PD. We compared clinical characteristics and the patterns of cortical atrophy in the obtained clusters.

RESULTS

Three clusters were identified and showed distinct characteristics in onset ages and dopamine-replacement therapy and deep brain stimulation requirements. According to the characteristics, clusters were classified into two subtypes, namely, “cardio-cortical impairment (CC)” and “dopaminergic-dominant dysfunction (DD)” subtype. The three clusters were named according to subtype and time since onset in which 14 patients were classified as “early DD,” 25 as “advanced DD,” and 17 as “early CC.” Compared with the early DD subtype, the early CC subtype showed parietal-dominant diffuse cortical atrophy and the advanced DD subtype showed left-side predominant mild cortical atrophy.

CONCLUSIONS

Nuclear imaging biomarker–based classification can be used to identify clinically and pathologically relevant PD subtypes with distinct disease trajectories. © 2023 International Parkinson and Movement Disorder Society.

Abstract Image

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核成像数据驱动的帕金森病分类。

背景:帕金森病(PD)是一种以运动和非运动症状为特征的异质性神经退行性疾病。一些特征具有预后重要性，并已被用作识别临床亚型的关键指标。然而，基于症状的分类方法在获得的亚型的稳定性方面存在局限性。目的:本研究的目的是利用针对心脏交感神经和黑质纹状体系统的核成像生物标志物来识别PD的亚型，并比较所获得亚型的皮层形态学变化模式。方法:对56例PD患者的123 i -甲氧十二苄基胍心脏显像和123 I-N-(3-氟丙基)-2β-碳甲氧基-3β-(4-碘苯基)北tropane单光子发射计算机断层扫描数据进行无偏分层聚类分析。我们比较临床特征和皮层萎缩的模式在获得的集群。结果:三组患者在发病年龄、多巴胺替代治疗和脑深部刺激需求方面表现出不同的特点。根据特征，将簇分为“心皮质损伤(CC)”和“多巴胺能显性功能障碍(DD)”两种亚型。这三组患者根据亚型和发病时间命名，其中14例为“早期DD”，25例为“晚期DD”，17例为“早期CC”。与早期DD亚型相比，早期CC亚型表现为顶叶为主的弥漫性皮质萎缩，晚期DD亚型表现为左侧为主的轻度皮质萎缩。结论:基于核成像生物标志物的分类可用于识别具有不同疾病轨迹的临床和病理相关PD亚型。©2023国际帕金森和运动障碍学会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Movement Disorders 医学-临床神经学

CiteScore

13.30

自引率

8.10%

发文量

371

审稿时长

12 months

期刊介绍： Movement Disorders publishes a variety of content types including Reviews, Viewpoints, Full Length Articles, Historical Reports, Brief Reports, and Letters. The journal considers original manuscripts on topics related to the diagnosis, therapeutics, pharmacology, biochemistry, physiology, etiology, genetics, and epidemiology of movement disorders. Appropriate topics include Parkinsonism, Chorea, Tremors, Dystonia, Myoclonus, Tics, Tardive Dyskinesia, Spasticity, and Ataxia.