Objective: The aim of this study is to examine how baseline dopamine transporter imaging, DAT SPECT, is related to the long-term outcome of STN DBS treated patients with Parkinson’s disease.

Background: DAT SPECT visualizes presynaptic dopamine transporters and provides semi-quantitative information on the extent of dopaminergic degeneration in the basal ganglia.

Methods: Patients with levodopa responsive PD evaluated for STN DBS in Copenhagen, underwent examination with DAT SPECT with [123I]FP-CIT before surgery. Patients, who underwent STN-DBS surgery between 2002 and 2008 were included for long-term follow-up (n=55). Patients were clinically assessed before surgery and at follow-ups one year after surgery, and 8-15 years after surgery. At the clinical evaluations patients were rated using the UPDRS with and without stimulation and medicine. Furthermore, neuropsychological testing was performed. Depression and dementia was reported when patients were medically treated for depression or dementia or received the diagnosis after neuropsychological testing.

Results: Preoperatively, all patients had substantial signs of severe nigrostriatal neuronal loss as determined from the [123I]FP-CIT SPECT scans. Patients who developed clinically reported dementia before the 8-15-year follow-up had a significantly higher mean putamen/caudate ratio before surgery compared to non-demented patients. This corresponds to a relatively higher affection of the caudate nucleus (p=0.036). A significant interaction between the preoperative striatum affection and the progression of disease according to the OFF UPDRS was found (p<0.0001). No significant difference in the striatum uptake was found between the depressed and the non-depressed groups. No significant associations between the striatum uptake and the DBS effect or the age at death were found.

Conclusions: This is the first study to evaluate long-term effects of DBS in PD patients with preoperative, presynaptic dopaminergic imaging. The study supports that baseline specific binding of [123I]FP-CIT may predict long-term outcome of PD. The preoperative DAT imaging significantly interacted with progression of disease and was significantly different in patients who later developed dementia. However, the preoperative DAT scans did not predict the effect of stimulation.

« Back to 2018 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/can-preoperative-dopamine-transporter-imaging-predict-the-long-term-outcome-of-deep-brain-stimulation-in-patients-with-parkinsons-disease/