Objective: Patients with Parkinson’s disease have different patterns of stiratal dopamine loss by age onf onset.

Background: Ample evidence has suggested that age at onset of Parkinson’s disease (PD) is associated with heterogeneous clinical features in individuals. We hypothesized that this may be attributed to different patterns of nigrostriatal dopamine loss.

Method: A total of 205 consecutive patients with de novo PD, who underwent 18F-FP-CIT PET scans (mean follow-up duration, 6.31 years), were divided into three tertile groups according to their age at onset of parkinsonian motor symptoms. Striatal dopamine transporter (DAT) availability was compared between the old- (n = 73) and young-onset (n = 66) groups. In addition, long-term motor outcomes in relation to the risk of developing freezing of gait (FOG) and longitudinal requirements for dopaminergic medications were examined.

Results: The old-onset PD group (mean age at onset, 72.66 years) exhibited more severe parkinsonian motor signs than the young-onset group (52.58 years), despite comparable DAT availability in the posterior putamen; moreover, the old-onset group exhibited more severely decreased DAT availability in the caudate. A Cox regression model revealed that the old-onset PD group had a higher risk for developing FOG than the young-onset group (hazard ratio 2.574, 95% CI [1.279‒5.179]). The old-onset group required higher doses of dopaminergic medications for symptom control than the young-onset group over time.

Conclusion: The present study demonstrated that the old-onset PD group exhibited relatively diffuse dopamine loss throughout the striatum and poorer long-term motor outcomes, suggesting that age at onset may be one of major determinants of heterogeneous patterns of striatal dopamine depletion and clinical features in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/heterogeneous-patterns-of-striatal-dopamine-loss-in-patients-with-young-versus-old-onset-parkinsons-disease/