Objective: To investigate the patterns of striatal ¹⁸F-AV133 uptake in relation to disease progression across different stages of PD and to examine its relationship with motor symptom severity.

Background: Parkinson’s disease (PD) is characterized by progressive dopaminergic depletion in the nigrostriatal pathway, but biomarkers for monitoring progression are limited.

Method: We recruited 152 PD patients and performed assessments including the MDS-UPDRS-III, MoCA, Hoehn & Yahr Stage, and ¹⁸F-AV133 PET imaging more than 12 hours after medication withdrawal. The occipital lobe served as the reference region to calculate the standardized uptake value ratio (SUVR) of ¹⁸F-AV133. Non-linear multivariate regression models, SUVR(t) = a×e^(-bt – cA), were applied, where t represents disease duration, A represents age at symptom onset, and a, b, and c are regression parameters. The Striatal Asymmetry Index (SAI) was used to evaluate striatal asymmetry, calculated as (L−R)/(L+R)×2×100, where L and R are the sums of SUVR values for the left and right putamen and caudate nucleus, respectively.

Results: Results showed significant negative correlations between striatal ¹⁸F-AV133 uptake and clinical features, including disease duration, MDS-UPDRS-III, and Hoehn & Yahr Stage. Age at symptom onset was negatively correlated with binding in the bilateral caudate nucleus and ventral putamen regions. Partial correlation analysis, controlling for age at onset, revealed significant negative associations between striatal subregional ¹⁸F-AV133 uptake and disease duration and motor severity. Additionally, the SAI showed a negative correlation with the Hoehn & Yahr Stage in both Pearson (P = 0.002, r = -0.247) and partial correlation analysis (P = 0.002, r = -0.244). Striatal ¹⁸F-AV133 binding exhibited a non-linear reduction dependent on disease duration and age of onset.

Conclusion: Our results suggest striatal ¹⁸F-AV133 binding correlates with motor severity, with exponential models highlighting its potential as a biomarker for PD progression. However, longitudinal studies are needed to validate its utility over time.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/striatal-dysfunction-in-parkinsons-disease-progression-a-18f-9-fluoropropyl-dihydrotetrabenazine18f-av133-pet-study/