Objective: To clarify the Single photon emission computed tomography (SPECT) findings for evaluating currently unknown antiparkinsonian drug efficacy in Parkinson’s disease (PD) patients.

Background: Little is known about the relationship between motor improvement and regional cerebral blood flow (rCBF) changes in PD patients treated with antiparkinsonian drugs. Additionally, the SPECT findings to evaluate antiparkinsonian drug efficacy has not been established.

Methods: Thirty PD patients {19 men, 11 women; 16 without dementia, 14 with dementia; age when examined 73.5 ± 8.2 years; disease duration 6.4 ± 6.3 years; Movement Disorder Society’s Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) total score in off-stage 65.4 ± 31.9 points; Hoehn & Yahr stage 2.6 ± 0.9, daily dosage of antiparkinsonian drugs was 445.1 ± 241.6 mg (Levodopa Equivalent Dose)} were scanned with 99mTc labelled ECD SPECT twice a day, to measure rCBF both in the off- and on-stages of pre and 3.5 hours after their antiparkinsonian drugs administration (“One-day protocol”). Prior to each scanning, their motor performance was assessed using the MDS-UPDRS part III score. Imaging data were processed with SPM2, eZIS®, vbSEE® software. The study was approved by the ethical committee of our institute. We have obtained permission to use MDS-UPDRS from the International Parkinson and Movement Disorder Society.

Results: The MDS-UPDRS part III score was improved in every patient (off-stage 31.8 ± 17.0, on-stage 20.5 ± 14.0; Wilcoxon signed-rank test, p<0.05). Improvements in the score of motor performance were significantly correlated with rCBF changes in the anterior cingulate cortex, lateral geniculate body (LG), medial geniculate body (MG), substantia nigra, and ventral posterior nucleus, in that, improvement in the motor score was significantly correlated with rCBF in the LG, MG, and putamen in the 16 subpopulation without dementia, and also, improvement in the motor score significantly correlated with rCBF changes in the MG in the 14 dementia subpopulation (Spearman's rank correlation coefficient, p<0.05, respectively).

Conclusions: The present study on SPECT shows the correlations between the rCBF change and motor improvement by antiparkinsonian drugs. The topology of rCBF change relating to the motor improvement may be a candidate for a clinical indicator of antiparkinsonian drug efficacy. Then the SPECT findings in PD patients will be valuable and useful for evaluating the parkinsonian therapy.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/potential-indicator-of-antiparkinsonian-drug-efficacy-an-attempt-to-explore-imaging-findings/