Estimation of further disease progression of Parkinson’s disease by dopamin transporter scan vs clinical rating

Abstract

Background Imaging techniques like ß-CIT Scan are valuable diagnostic tools for Parkinson’s disease (PD) and correlate in most cases with clinical symptoms. In some patients, however, clinical and imaging data are conflicting. It has not yet been evaluated, which parameter provide more information about severity and disease progression in those patients. Aim To estimate the predictive value of UPDRS and ß-CIT in PD on clinical impairment at follow up. Design and methods In a longitudinal study, 44 PD patients who underwent ß-CIT Scan for diagnostic purpose were followed up for a mean of 44 months. At baseline we assessed UPDRS motor score as well as the subtype of PD, presence of dementia or motor complications. Disease staging at follow up was displayed by UPDRS II (ADL) and III (motor score) as well as by Hoehn & Yahr classification. Results ß-CIT could significantly discriminate PD patients from controls and the tracer uptake ratios (UR) correlated well with UPDRS motor score at baseline. There was, however, only a weak correlation between UR and staging parameters at follow up, whereas UPDRS at baseline was highly correlated with impairment at follow up. Conclusion The data suggest a more significant predictive value of UPDRS motor score on disability in the course of disease progression than ß-CIT Scan. Low receptor binding may not be mistaken for a bad prognosis.