Format

Send to

Choose Destination
Neurology. 2014 Nov 4;83(19):1739-46. doi: 10.1212/WNL.0000000000000960. Epub 2014 Oct 8.

Imaging prodromal Parkinson disease: the Parkinson Associated Risk Syndrome Study.

Author information

1
From the Institute for Neurodegenerative Disorders (D.J., J.S., K.M.), New Haven, CT; Parkinson's Disease and Movement Disorders Center (M.S.), Department of Neurology, University of Pennsylvania, Philadelphia; Department of Biostatistics and Computational Biology (S.E., D.O.), University of Rochester, NY; and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA. djennings@indd.org.
2
From the Institute for Neurodegenerative Disorders (D.J., J.S., K.M.), New Haven, CT; Parkinson's Disease and Movement Disorders Center (M.S.), Department of Neurology, University of Pennsylvania, Philadelphia; Department of Biostatistics and Computational Biology (S.E., D.O.), University of Rochester, NY; and Avid Radiopharmaceuticals (A.S.), Philadelphia, PA.

Abstract

OBJECTIVES:

The purpose of this study is to evaluate the relative risk of abnormal dopamine transporter (DAT) imaging for subjects with and without hyposmia and the feasibility of acquiring a large, community-based, 2-tiered biomarker assessment strategy to detect prodromal Parkinson disease (PD).

METHODS:

In this observational study, individuals without a diagnosis of PD, recruited through 16 movement disorder clinics, underwent tier 1 assessments (olfactory testing, questionnaires). Tier 2 assessments (neurologic examination, DAT imaging, and other biomarker assessments) were completed by 303 subjects. The main outcome of the study is to compare age-expected [(123)I]β-CIT striatal binding ratio in hyposmic and normosmic subjects.

RESULTS:

Tier 1 assessments were mailed to 9,398 eligible subjects and returned by 4,999; 669 were hyposmic. Three hundred three subjects (203 hyposmic, 100 normosmic) completed baseline evaluations. DAT deficit was present in 11% of hyposmic subjects compared with 1% of normosmic subjects. Multiple logistic regression demonstrates hyposmia (odds ratio [OR] 12.4; 95% confidence interval [CI] 1.6, 96.1), male sex (OR 5.5; 95% CI 1.7, 17.2), and constipation (OR 4.3; 95% CI 1.6, 11.6) as factors predictive of DAT deficit. Combining multiple factors (hyposmia, male sex, and constipation) increased the percentage of subjects with a DAT deficit to >40%.

CONCLUSION:

Subjects with DAT deficit who do not meet criteria for a diagnosis of PD can be identified by olfactory testing. Sequential biomarker assessment may identify those at risk of PD. Selecting hyposmic individuals enriches the population for DAT deficit, and combining hyposmia with other potential risk factors (male sex, constipation) increases the percentage of subjects with a DAT deficit compatible with prodromal PD.

PMID:
25298306
PMCID:
PMC4239830
DOI:
10.1212/WNL.0000000000000960
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center