Different Alterations of Cerebral Regional Homogeneity in Early-Onset and Late-Onset Parkinson's Disease.

Ke Sheng,Meilan Su,Guangying Shuai,Yu Han,Dezhi Zou,Weidong Fang,Yingcheng Zhu,Oumei Cheng

doi:10.3389/fnagi.2016.00165

Abstract

HIGHLIGHTS Eighteen EOPD, 21 LOPD and 37 age-matched normal control subjects participated in the resting state fMRI scans.Age at onset of PD modulates the distribution of cerebral regional homogeneity during resting state.Disproportionate putamen alterations are more prominent in PD patients with a younger age of onset.Objective: Early-onset Parkinson's disease (EOPD) is distinct from late-onset PD (LOPD) as it relates to the clinical profile and response to medication. The objective of current paper is to investigate whether characteristics of spontaneous brain activity in the resting state are associated with the age of disease onset.Methods: We assessed the correlation between neural activity and age-at-onset in a sample of 39 PD patients (18 EOPD and 21 LOPD) and 37 age-matched normal control subjects. Regional homogeneity (ReHo) approaches were employed using ANOVA with two factors: PD and age.Results: In the comparisons between LOPD and EOPD, EOPD revealed lower ReHo values in the right putamen and higher ReHo values in the left superior frontal gyrus. Compared with age-matched control subjects, EOPD exhibited lower ReHo values in the right putamen and higher ReHo values in the left inferior temporal gyrus; However, LOPD showed lower ReHo values in the right putamen and left insula. The ReHo values were negatively correlated with the UPDRS total scores in the right putamen in LOPD, but a correlation between the ReHo value and UPDRS score was not detected in EOPD.Conclusions: Our findings support the notion that age at onset is associated with the distribution of cerebral regional homogeneity in the resting state and suggest that disproportionate putamen alterations are more prominent in patients with a younger age of onset.

Highlights

Early-onset Parkinson’s disease (EOPD) usually refers to the form of PD in which the first symptoms appear before 40 years of age, but some studies consider a disease onset of up to 50 years of age to be EOPD (Schrag and Schott, 2006)
Kondo et al have suggested that the dopamine agonist therapies that are more commonly used in EOPD might reduce dopamine transporter (DAT) loss during PD disease progression (Kondo, 2002)
Neurological and psychiatric evaluations were conducted during the “off ” medication state and included the Hoehn and Yahr (H&Y) scale, the unified Parkinson’s disease rating total scale (UPDRS), the UPDRS Part III, the Mini-Mental State Examination (MMSE), and the HAMD

Summary

Introduction

Early-onset Parkinson’s disease (EOPD) usually refers to the form of PD in which the first symptoms appear before 40 years of age, but some studies consider a disease onset of up to 50 years of age to be EOPD (Schrag and Schott, 2006). EOPD had been long contrasted with the late-onset form of the disease (LOPD) until they became united under the same eponym (Spica et al, 2013). These two forms of PD refer to a single disease, previous studies have reported clinical and neuroimaging differences between EOPD and LOPD. The pathophysiological mechanisms that differentiate EOPD and LOPD disease progression are not yet clear (Shih et al, 2007)

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Conclusion