Objective: To evaluate the prognostic value of dopamine transporter (DAT) imaging in predicting future disability, as well as motor and non-motor burden, in Parkinson’s disease (PD).

Background: PD leads to progressive motor and non-motor impairments, causing functional disability. Disease progression varies widely, complicating the prediction of functional decline. The utility of DAT imaging early in the disease to forecast becoming dependency in daily activities remains unclear. Accurate prognostication could enable timely interventions and optimize resource allocation.

Method: Data used in the preparation of this abstract were obtained on April 12th 2019 from the Parkinson’s Progression Markers Initiative (PPMI) database (www.ppmi-info.org/access-data-specimens/download-data), RRID:SCR_006431. For up-to-date information on the PPMI study – a public-private partnership – funded by the Michael J. Fox Foundation for Parkinson’s Research, and funding partners, visit www.ppmi-info.org. Clinical baseline and follow-up data, and baseline [¹²³I]FP-CIT SPECT data of 341 early PD patients from the PPMI dataset were included. The median follow-up time was 11.7 years. Voxelwise Cox proportional hazard models assessed the association of baseline [¹²³I]FP-CIT binding with future dependency in daily activities, disease severity, and motor and non-motor burden.

Results: Lower baseline binding was associated with increased hazard of dependency in ≥50% of daily activities in the anterior striatum and globus pallidus (hazard ratio [HR] 4.70/SBR, P_FWE<0.05), Hoehn & Yahr stage ≥ 3 in the left anterior striatum (HR 2.75/SBR, P_FWE<0.05), mild cognitive impairment in the left nucleus accumbens and right anterior cingulate cortex (HR 4.46/SBR, P_FWE< 0.05), and severe non-motor burden (MDS-UPDRS-I≥22) in the right caudate (HR 2.57/SBR, P_FWE < 0.05). However, hazard of reaching severe functional motor symptom burden (MDS-UPDRS-II≥30) was not significantly associated with baseline binding. Results were independent of age, sex, and baseline symptom burden.

Conclusion: Lower DAT binding in specific brain regions predicts future functional outcomes in PD independent of baseline clinical status. These findings support the utility of DAT imaging for early identification of patients at high risk for functional decline.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/dopamine-transporter-imaging-as-a-predictor-of-functional-outcomes-in-parkinsons-disease/