Objective: This study investigated the lateralization of dopamine in individuals with Parkinson’s disease, starting with a "normal" dopamine lateralization model developed from a sample of healthy controls. Methods: A total of 1,029 participants were included in the analysis: 191 healthy controls and 847 Parkinson’s disease patients. All data were collected from the Parkinson’s Progression Markers Initiative (PPMI) database. Dopamine levels and the Laterality Index were calculated using [123]FP-CIT SPECT (DaTSCAN) imaging from screening visit data. For each patients a full set of motor, non-motor, and cognitive tests were also available. Results: Approximately 26% of the PD patients were classified as Extreme Lateralized (EL), with the remainder categorized as Normal Lateralized (NL). Initial analysis revealed that greater asymmetry in dopamine function within the Putamen was associated with higher SBR values, alongside better cognitive, motor, and autonomic performance. Univariate analysis supported this hypothesis, showing that EL patients scored better on MDS-UPDRS part I, the SDMT, as well as gastrointestinal and urinary function assessments. Furthermore, longitudinal analysis highlighted a growing disparity between the groups over time, with EL patients experiencing a less pronounced progression of motor, cognitive and autonomic symptoms. Although differences between Right and Left Lateralization (EL_Right, EL_Left) were unexpected, patients with EL_Left symptoms exhibited more severe motor impairments in MDS-UPDRS part III, which was the only significant finding in this context. Conclusion The results suggest the presence of a compensatory mechanism in the EL group, where the less affected striatal hemisphere seems to increase dopamine production to compensate for the loss on the opposite side. This finding opens the possibility of using lateralization as a potential prognostic marker, providing the foundation for more personalized rehabilitation or therapeutic strategies. With further research, this understanding could help develop treatments that focus on each patient's unique dopamine distribution, improving the precision of Parkinson's disease therapies.
Objective: This study investigated the lateralization of dopamine in individuals with Parkinson’s disease, starting with a "normal" dopamine lateralization model developed from a sample of healthy controls. Methods: A total of 1,029 participants were included in the analysis: 191 healthy controls and 847 Parkinson’s disease patients. All data were collected from the Parkinson’s Progression Markers Initiative (PPMI) database. Dopamine levels and the Laterality Index were calculated using [123]FP-CIT SPECT (DaTSCAN) imaging from screening visit data. For each patients a full set of motor, non-motor, and cognitive tests were also available. Results: Approximately 26% of the PD patients were classified as Extreme Lateralized (EL), with the remainder categorized as Normal Lateralized (NL). Initial analysis revealed that greater asymmetry in dopamine function within the Putamen was associated with higher SBR values, alongside better cognitive, motor, and autonomic performance. Univariate analysis supported this hypothesis, showing that EL patients scored better on MDS-UPDRS part I, the SDMT, as well as gastrointestinal and urinary function assessments. Furthermore, longitudinal analysis highlighted a growing disparity between the groups over time, with EL patients experiencing a less pronounced progression of motor, cognitive and autonomic symptoms. Although differences between Right and Left Lateralization (EL_Right, EL_Left) were unexpected, patients with EL_Left symptoms exhibited more severe motor impairments in MDS-UPDRS part III, which was the only significant finding in this context. Conclusion The results suggest the presence of a compensatory mechanism in the EL group, where the less affected striatal hemisphere seems to increase dopamine production to compensate for the loss on the opposite side. This finding opens the possibility of using lateralization as a potential prognostic marker, providing the foundation for more personalized rehabilitation or therapeutic strategies. With further research, this understanding could help develop treatments that focus on each patient's unique dopamine distribution, improving the precision of Parkinson's disease therapies.
Exploring dopamine lateralization with SPECT imaging in Parkinson's Disease
ALUSHANI, TED
2023/2024
Abstract
Objective: This study investigated the lateralization of dopamine in individuals with Parkinson’s disease, starting with a "normal" dopamine lateralization model developed from a sample of healthy controls. Methods: A total of 1,029 participants were included in the analysis: 191 healthy controls and 847 Parkinson’s disease patients. All data were collected from the Parkinson’s Progression Markers Initiative (PPMI) database. Dopamine levels and the Laterality Index were calculated using [123]FP-CIT SPECT (DaTSCAN) imaging from screening visit data. For each patients a full set of motor, non-motor, and cognitive tests were also available. Results: Approximately 26% of the PD patients were classified as Extreme Lateralized (EL), with the remainder categorized as Normal Lateralized (NL). Initial analysis revealed that greater asymmetry in dopamine function within the Putamen was associated with higher SBR values, alongside better cognitive, motor, and autonomic performance. Univariate analysis supported this hypothesis, showing that EL patients scored better on MDS-UPDRS part I, the SDMT, as well as gastrointestinal and urinary function assessments. Furthermore, longitudinal analysis highlighted a growing disparity between the groups over time, with EL patients experiencing a less pronounced progression of motor, cognitive and autonomic symptoms. Although differences between Right and Left Lateralization (EL_Right, EL_Left) were unexpected, patients with EL_Left symptoms exhibited more severe motor impairments in MDS-UPDRS part III, which was the only significant finding in this context. Conclusion The results suggest the presence of a compensatory mechanism in the EL group, where the less affected striatal hemisphere seems to increase dopamine production to compensate for the loss on the opposite side. This finding opens the possibility of using lateralization as a potential prognostic marker, providing the foundation for more personalized rehabilitation or therapeutic strategies. With further research, this understanding could help develop treatments that focus on each patient's unique dopamine distribution, improving the precision of Parkinson's disease therapies.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/75162