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Neurology. 2005 Dec 13;65(11):1716-22.

Dementia in Parkinson disease: functional imaging of cholinergic and dopaminergic pathways.

Author information

  • 1Department of Neurology, University of Cologne, Cologne, Germany. hilker@pet.mpin-koeln.mpg.de

Abstract

OBJECTIVE:

To assess neurochemical deficits in patients with Parkinson disease (PD) associated dementia (PDD) in vivo.

METHODS:

The authors performed combined PET with N-[11C]-methyl-4-piperidyl acetate (MP4A) and 18F-fluorodopa (FDOPA) for evaluation of cholinergic and dopaminergic transmitter changes in 17 non-demented patients with PD and 10 patients with PDD. Data were compared to 31 age-matched controls by a combined region-of-interest and voxel-based Statistical Parametric Mapping analysis.

RESULTS:

The striatal FDOPA uptake was significantly decreased in PD and PDD without differences between the groups. The global cortical MP4A binding was severely reduced in PDD (29.7%, p < 0.001 vs controls) and moderately decreased in PD (10.7%, p < 0.01 vs controls). The PDD group had lower parietal MP4A uptake rates than did patients with PD. Frontal and temporo-parietal cortices showed a significant covariance of striatal FDOPA reduction and decreased MP4A binding in patients with PDD.

CONCLUSIONS:

While non-demented patients with Parkinson disease had a moderate cholinergic dysfunction, subjects with Parkinson disease associated dementia (PDD) presented with a severe cholinergic deficit in various cortical regions. The finding of a closely associated striatal FDOPA and cortical MP4A binding reduction suggests a common disease process leading to a complex transmitter deficiency syndrome in PDD.

PMID:
16344512
[PubMed - indexed for MEDLINE]
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