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Case Report
Nearly Abolished Dopamine Transporter Uptake in a Patient With a Novel FBXO7 Mutation
Eun Young Kim, Seon Young Kim, Youngduk Seo, Chaewon Shin
J Mov Disord. 2022;15(3):269-272.   Published online July 26, 2022
DOI: https://doi.org/10.14802/jmd.22006
  • 2,232 View
  • 89 Download
  • 3 Web of Science
  • 2 Crossref
AbstractAbstract PDFSupplementary Material
Mutations in the F-box only protein 7 (FBXO7) gene are the cause of autosomal recessive parkinsonian-pyramidal syndrome. Herein, we report a patient with a novel FBXO7 mutation with a unique clinical presentation. A 43-year-old male visited our hospital with complaints of progressing gait disturbance since a generalized tonic clonic seizure. There were no past neurological symptoms or familial disorders. Neurological examination revealed bradykinesia, masked face, stooped posture, parkinsonian gait, and postural instability. The bilateral uptake by dopamine transporters was nearly abolished, as determined by N-(3-[18F]fluoropropyl)- 2β-carbon ethoxy-3β-(4-iodophenyl) nortropane positron emission tomography (18F-FP-CIT PET). Next-generation sequencing revealed a heterozygous c.1066_1069delTCTG (p.Ser356ArgfsTer56) frameshift variant and a heterozygous c.80G>A (p.Arg27His) missense variant of the FBXO7 gene. The patient’s specific clinical features, medication-refractory parkinsonism and seizures further broaden the spectrum of FBXO7 mutations. The nearly abolished dopamine transporter uptake identified by 18F-FP-CIT PET is frequently found in patients with FBXO7 mutations, which is different from the usual rostrocaudal gradient that is observed in patients with Parkinson’s disease.

Citations

Citations to this article as recorded by  
  • Imaging Procedure and Clinical Studies of [18F]FP-CIT PET
    Changhwan Sung, Seung Jun Oh, Jae Seung Kim
    Nuclear Medicine and Molecular Imaging.2024;[Epub]     CrossRef
  • The characteristics of FBXO7 and its role in human diseases
    Yeling Zhong, Jinyun Li, Meng Ye, Xiaofeng Jin
    Gene.2023; 851: 146972.     CrossRef
Review Article
Emerging Concepts of Motor Reserve in Parkinson’s Disease
Seok Jong Chung, Jae Jung Lee, Phil Hyu Lee, Young H. Sohn
J Mov Disord. 2020;13(3):171-184.   Published online August 31, 2020
DOI: https://doi.org/10.14802/jmd.20029
  • 9,670 View
  • 308 Download
  • 26 Web of Science
  • 26 Crossref
AbstractAbstract PDF
The concept of cognitive reserve (CR) in Alzheimer’s disease (AD) explains the differences between individuals in their susceptibility to AD-related pathologies. An enhanced CR may lead to less cognitive deficits despite severe pathological lesions. Parkinson’s disease (PD) is also a common neurodegenerative disease and is mainly characterized by motor dysfunction related to striatal dopaminergic depletion. The degree of motor deficits in PD is closely correlated to the degree of dopamine depletion; however, significant individual variations still exist. Therefore, we hypothesized that the presence of motor reserve (MR) in PD explains the individual differences in motor deficits despite similar levels of striatal dopamine depletion. Since 2015, we have performed a series of studies investigating MR in de novo patients with PD using the data of initial clinical presentation and dopamine transporter PET scan. In this review, we summarized the results of these published studies. In particular, some premorbid experiences (i.e., physical activity and education) and modifiable factors (i.e., body mass index and white matter hyperintensity on brain image studies) could modulate an individual’s capacity to tolerate PD pathology, which can be maintained throughout disease progression.

Citations

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  • How long have you exercised in your life? The effect of motor reserve and current physical activity on cognitive performance
    Veronica Pucci, Carolina Guerra, Amanda Barsi, Massimo Nucci, Sara Mondini
    Journal of the International Neuropsychological Society.2024; 30(1): 11.     CrossRef
  • Hippocampal Perfusion Affects Motor and Cognitive Functions in Parkinson Disease: An Early Phase 18F‐FP‐CIT Positron Emission Tomography Study
    Min Young Chun, Seok Jong Chung, Su Hong Kim, Chan Wook Park, Seong Ho Jeong, Hye Sun Lee, Phil Hyu Lee, Young H. Sohn, Yong Jeong, Yun Joong Kim
    Annals of Neurology.2024; 95(2): 388.     CrossRef
  • Clinical severity in Parkinson’s disease is determined by decline in cortical compensation
    Martin E Johansson, Ivan Toni, Roy P C Kessels, Bastiaan R Bloem, Rick C Helmich
    Brain.2024; 147(3): 871.     CrossRef
  • Differences in [123I]Ioflupane Striatal Binding Between African American and White Patients
    Juebin Huang, Kevin J. Sullivan, Vani Vijayakumar
    Journal of Nuclear Medicine Technology.2024; : jnmt.123.265806.     CrossRef
  • Motor progression marker for newly diagnosed drug‐naïve patients with Parkinson's disease: A resting‐state functional MRI study
    Yanbing Hou, Lingyu Zhang, Ruwei Ou, Qianqian Wei, Xiaojing Gu, Kuncheng Liu, Junyu Lin, Tianmi Yang, Yi Xiao, Qiyong Gong, Huifang Shang
    Human Brain Mapping.2023; 44(3): 901.     CrossRef
  • The Concept of Motor Reserve in Parkinson's Disease: New Wine in Old Bottles?
    Merle C. Hoenig, Verena Dzialas, Alexander Drzezga, Thilo van Eimeren
    Movement Disorders.2023; 38(1): 16.     CrossRef
  • Patterns of striatal dopamine depletion and motor deficits in de novo Parkinson’s disease
    Seong Ho Jeong, Chan Wook Park, Hye Sun Lee, Yun Joong Kim, Mijin Yun, Phil Hyu Lee, Young H. Sohn, Seok Jong Chung
    Journal of Neural Transmission.2023; 130(1): 19.     CrossRef
  • Sex Differences in Brain Structure in de novo Parkinson’s Disease: A Cross-Sectional and Longitudinal Neuroimaging Study
    Hui Li, Xuejia Jia, Min Chen, Xiuqin Jia, Qi Yang
    Journal of Parkinson's Disease.2023; 13(5): 785.     CrossRef
  • Exploring the Complex Phenotypes of Impaired Finger Dexterity in Mild-to-moderate Stage Parkinson’s Disease: A Time-Series Analysis
    Pattamon Panyakaew, Kotchakorn Duangjino, Apiwoot Kerddonfag, Teerit Ploensin, Krerk Piromsopa, Chanon Kongkamol, Roongroj Bhidayasiri
    Journal of Parkinson's Disease.2023; 13(6): 975.     CrossRef
  • Prevention of Falls in Parkinson's Disease: Guidelines and Gaps
    Richard Camicioli, Meg E. Morris, Frederico Pieruccini‐Faria, Manuel Montero‐Odasso, Surim Son, David Buzaglo, Jeffrey M. Hausdorff, Alice Nieuwboer
    Movement Disorders Clinical Practice.2023; 10(10): 1459.     CrossRef
  • The incidence of deep venous thrombosis in Parkinson’s disease
    Emine Afsin, Zeliha Coşgun, Ramazan Kurul, Şule Aydın Türkoğlu
    Neurological Research.2023; 45(11): 1050.     CrossRef
  • Premorbid Educational Attainment and Long-Term Motor Prognosis in Parkinson’s Disease
    Seong Ho Jeong, Seok Jong Chung, Han Soo Yoo, Jin Ho Jung, Kyoungwon Baik, Yang Hyun Lee, Phil Hyu Lee, Young H. Sohn
    Journal of Parkinson's Disease.2022; 12(1): 129.     CrossRef
  • Parkinsonism and cerebrovascular disease
    Manisha Narasimhan, Raymond Schwartz, Glenda Halliday
    Journal of the Neurological Sciences.2022; 433: 120011.     CrossRef
  • Impact of α‐synuclein spreading on the nigrostriatal dopaminergic pathway depends on the onset of the pathology
    Fanfan Sun, Armando G. Salinas, Severin Filser, Sonja Blumenstock, Jose Medina‐Luque, Jochen Herms, Carmelo Sgobio
    Brain Pathology.2022;[Epub]     CrossRef
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    Yoon-Sang Oh, Sang-Won Yoo, Chul Hyoung Lyoo, Kwang-Soo Lee, Joong-Seok Kim
    Scientific Reports.2022;[Epub]     CrossRef
  • Behavioral Reserve in Behavioral Variant Frontotemporal Dementia
    Su Hong Kim, Yae Ji Kim, Byung Hwa Lee, Peter Lee, Ji Hyung Park, Sang Won Seo, Yong Jeong
    Frontiers in Aging Neuroscience.2022;[Epub]     CrossRef
  • Identifying the white matter structural network of motor reserve in early Parkinson's disease
    Yae Ji Kim, Chan Wook Park, Hye Won Shin, Hye Sun Lee, Yun Joong Kim, Mijin Yun, Phil Hyu Lee, Young H. Sohn, Yong Jeong, Seok Jong Chung
    Parkinsonism & Related Disorders.2022; 102: 108.     CrossRef
  • Comparison of disease progression between brain-predominant Parkinson's disease versus Parkinson's disease with body-involvement phenotypes
    Dong-Woo Ryu, Sang-Won Yoo, Yoon-Sang Oh, Kwang-Soo Lee, Seunggyun Ha, Joong-Seok Kim
    Neurobiology of Disease.2022; 174: 105883.     CrossRef
  • Genetically-informed prediction of short-term Parkinson’s disease progression
    Hossein J. Sadaei, Aldo Cordova-Palomera, Jonghun Lee, Jaya Padmanabhan, Shang-Fu Chen, Nathan E. Wineinger, Raquel Dias, Daria Prilutsky, Sandor Szalma, Ali Torkamani
    npj Parkinson's Disease.2022;[Epub]     CrossRef
  • Potential Link Between Cognition and Motor Reserve in Patients With Parkinson’s Disease
    Seok Jong Chung, Yae Ji Kim, Yun Joong Kim, Hye Sun Lee, Mijin Yun, Phil Hyu Lee, Yong Jeong, Young H. Sohn
    Journal of Movement Disorders.2022; 15(3): 249.     CrossRef
  • Local striatal volume and motor reserve in drug-naïve Parkinson’s disease
    Seong Ho Jeong, Eun-Chong Lee, Seok Jong Chung, Hye Sun Lee, Jin Ho Jung, Young H. Sohn, Joon-Kyung Seong, Phil Hyu Lee
    npj Parkinson's Disease.2022;[Epub]     CrossRef
  • Effectiveness and safety of electroacupuncture in treating Parkinson disease
    Wei Xu, Sha OuYang, Zhenhai Chi, ZhiQin Wang, DaoCheng Zhu, RiXin Chen, GenPing Zhong, FengTing Zhang, GuiQin Zhou, SiWei Duan, Lin Jiao
    Medicine.2021; 100(10): e25095.     CrossRef
  • Differences in cause and 12-month follow-up outcome of parkinsonian symptoms in depressed older adults treated with antipsychotics: a case series
    Anastasios Politis, Nikolaos Kokras, Michael Souvatzoglou, Kostas Siarkos, Panagiotis Toulas, Constantin Potagas, Theodoros Hatzipanagiotou, Georgios Limouris, Panagiotis Alexopoulos
    BMC Psychiatry.2021;[Epub]     CrossRef
  • Effectiveness and safety of moxibustion for Parkinson disease
    Yonghui Hou, Baile Ning, Yamin Liu, Ying Liu, Wenbin Fu, Zehuai Wen
    Medicine.2021; 100(23): e26256.     CrossRef
  • Glucocerebrosidase Mutations and Motor Reserve in Parkinson’s Disease
    Seok Jong Chung, Phil Hyu Lee, Young H. Sohn, Yun Joong Kim
    Journal of Parkinson's Disease.2021; 11(4): 1715.     CrossRef
  • Analysis of pupillometer results according to disease stage in patients with Parkinson’s disease
    Sooyeoun You, Jeong-Ho Hong, Joonsang Yoo
    Scientific Reports.2021;[Epub]     CrossRef
Original Articles
Heterogeneous Patterns of Striatal Dopamine Loss in Patients with Young- versus Old-Onset Parkinson’s Disease: Impact on Clinical Features
Seok Jong Chung, Han Soo Yoo, Yang Hyun Lee, Phil Hyu Lee, Young H. Sohn
J Mov Disord. 2019;12(2):113-119.   Published online May 30, 2019
DOI: https://doi.org/10.14802/jmd.18064
  • 7,376 View
  • 156 Download
  • 22 Web of Science
  • 26 Crossref
AbstractAbstract PDFSupplementary Material
Objective
Ample evidence has suggested that age at onset of Parkinson’s disease (PD) is associated with heterogeneous clinical features in individuals. We hypothesized that this may be attributed to different patterns of nigrostriatal dopamine loss.
Methods
A total of 205 consecutive patients with de novo PD who underwent 18F-FP-CIT PET scans (mean follow-up duration, 6.31 years) were divided into three tertile groups according to their age at onset of parkinsonian motor symptoms. Striatal dopamine transporter (DAT) availability was compared between the old- (n = 73) and young-onset (n = 66) groups. In addition, the risk of developing freezing of gait (FOG) and longitudinal requirements for dopaminergic medications were examined.
Results
The old-onset PD group (mean age at onset, 72.66 years) exhibited more severe parkinsonian motor signs than the young-onset group (52.58 years), despite comparable DAT availability in the posterior putamen; moreover, the old-onset group exhibited more severely decreased DAT availability in the caudate than the young-onset group. A Cox regression model revealed that the old-onset PD group had a higher risk for developing FOG than the young-onset group [hazard ratio 2.523, 95% confidence interval (1.239–5.140)]. The old-onset group required higher doses of dopaminergic medications for symptom control than the young-onset group over time.
Conclusion
The present study demonstrated that the old-onset PD group exhibited more severe dopamine loss in the caudate and were more likely to develop gait freezing, suggesting that age at onset may be one of the major determinants of the pattern of striatal dopamine depletion and progression of gait disturbance in PD.

Citations

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  • Patterns of regional cerebral hypoperfusion in early Parkinson's disease: Clinical implications
    Seok Jong Chung, Su Hong Kim, Chan Wook Park, Hye Sun Lee, Mijin Yun, Yun Joong Kim, Young H. Sohn, Yong Jeong, Phil Hyu Lee
    Parkinsonism & Related Disorders.2024; 121: 106024.     CrossRef
  • Therapeutic Potential Effect of Glycogen Synthase Kinase 3 Beta (GSK-3β) Inhibitors in Parkinson Disease: Exploring an Overlooked Avenue
    Areej Turkistani, Hayder M. Al-kuraishy, Ali I. Al-Gareeb, Ali K. Albuhadily, Athanasios Alexiou, Marios Papadakis, Mohamed M. Elfiky, Hebatallah M. Saad, Gaber El-Saber Batiha
    Molecular Neurobiology.2024;[Epub]     CrossRef
  • Imaging Procedure and Clinical Studies of [18F]FP-CIT PET
    Changhwan Sung, Seung Jun Oh, Jae Seung Kim
    Nuclear Medicine and Molecular Imaging.2024;[Epub]     CrossRef
  • Association of Family History and Polygenic Risk Score With Longitudinal Prognosis in Parkinson Disease
    Mincheol Park, Young-gun Lee
    Neurology Genetics.2024;[Epub]     CrossRef
  • Hippocampal Perfusion Affects Motor and Cognitive Functions in Parkinson Disease: An Early Phase 18F‐FP‐CIT Positron Emission Tomography Study
    Min Young Chun, Seok Jong Chung, Su Hong Kim, Chan Wook Park, Seong Ho Jeong, Hye Sun Lee, Phil Hyu Lee, Young H. Sohn, Yong Jeong, Yun Joong Kim
    Annals of Neurology.2024; 95(2): 388.     CrossRef
  • The effects of cholesterol and statins on Parkinson’s neuropathology: a narrative review
    Hayder M. Al-kuraishy, Esraa H. Fahad, Salah Al-Windy, Suzy A. El-Sherbeni, Walaa A. Negm, Gaber El-Saber Batiha
    Inflammopharmacology.2024;[Epub]     CrossRef
  • The Concept of Motor Reserve in Parkinson's Disease: New Wine in Old Bottles?
    Merle C. Hoenig, Verena Dzialas, Alexander Drzezga, Thilo van Eimeren
    Movement Disorders.2023; 38(1): 16.     CrossRef
  • Memory Phenotypes In Early, De Novo Parkinson's Disease Patients with Mild Cognitive Impairment
    Mattia Siciliano, Rosa De Micco, Andrea Gerardo Russo, Fabrizio Esposito, Valeria Sant'Elia, Lucia Ricciardi, Francesca Morgante, Antonio Russo, Jennifer G. Goldman, Carlo Chiorri, Gioacchino Tedeschi, Luigi Trojano, Alessandro Tessitore
    Movement Disorders.2023; 38(8): 1461.     CrossRef
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    Naif H. Ali, Hayder M. Al-kuraishy, Ali I. Al-Gareeb, Saud A. Alnaaim, Hebatallah M. Saad, Gaber El-Saber Batiha
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    npj Parkinson's Disease.2023;[Epub]     CrossRef
  • Premorbid Educational Attainment and Long-Term Motor Prognosis in Parkinson’s Disease
    Seong Ho Jeong, Seok Jong Chung, Han Soo Yoo, Jin Ho Jung, Kyoungwon Baik, Yang Hyun Lee, Phil Hyu Lee, Young H. Sohn
    Journal of Parkinson's Disease.2022; 12(1): 129.     CrossRef
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    Yae Ji Kim, Chan Wook Park, Hye Won Shin, Hye Sun Lee, Yun Joong Kim, Mijin Yun, Phil Hyu Lee, Young H. Sohn, Yong Jeong, Seok Jong Chung
    Parkinsonism & Related Disorders.2022; 102: 108.     CrossRef
  • Potential Link Between Cognition and Motor Reserve in Patients With Parkinson’s Disease
    Seok Jong Chung, Yae Ji Kim, Yun Joong Kim, Hye Sun Lee, Mijin Yun, Phil Hyu Lee, Yong Jeong, Young H. Sohn
    Journal of Movement Disorders.2022; 15(3): 249.     CrossRef
  • Association Between White Matter Networks and the Pattern of Striatal Dopamine Depletion in Patients With Parkinson Disease
    Seok Jong Chung, Yae Ji Kim, Yun Joong Kim, Hye Sun Lee, Seong Ho Jeong, Ji-Man Hong, Young H. Sohn, Mijin Yun, Yong Jeong, Phil Hyu Lee
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    Seok Jong Chung, Yun Joong Kim, Han Soo Yoo, Jin Ho Jung, KyoungWon Baik, Hye Sun Lee, Yang Hyun Lee, Ji-Man Hong, Young H Sohn, Phil Hyu Lee, Jay Magaziner
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    久大 立花
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    Myung Jun Lee, Kyoungjune Pak, Han-Kyeol Kim, Kelly N. Nudelman, Jong Hun Kim, Yun Hak Kim, Junho Kang, Min Seok Baek, Chul Hyoung Lyoo
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    Giovanni Palermo, Sara Giannoni, Daniela Frosini, Riccardo Morganti, Duccio Volterrani, Ubaldo Bonuccelli, Nicola Pavese, Roberto Ceravolo
    Movement Disorders.2020; 35(6): 1028.     CrossRef
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    Xiaohong Li, Qizhou Zhang, Yongde Qin, Yubin Li, Nazimuguli Mutaerbieke, Xiaojia Zhao, Amina Yibulayin
    Medicine.2020; 99(14): e19662.     CrossRef
  • DaTSCAN (123I-FP-CIT SPECT) imaging in early versus mid and late onset Parkinson's disease: Longitudinal data from the PPMI study
    Christos Koros, Athina-Maria Simitsi, Andreas Prentakis, Nikolaos Papagiannakis, Anastasia Bougea, Ioanna Pachi, Dimitra Papadimitriou, Ion Beratis, Sokratis G. Papageorgiou, Maria Stamelou, Xenia Geronicola Trapali, Leonidas Stefanis
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  • Emerging Concepts of Motor Reserve in Parkinson’s Disease
    Seok Jong Chung, Jae Jung Lee, Phil Hyu Lee, Young H. Sohn
    Journal of Movement Disorders.2020; 13(3): 171.     CrossRef
Nonmotor and Dopamine Transporter Change in REM Sleep Behavior Disorder by Olfactory Impairment
Jee-Young Lee, Eun Jin Yoon, Yu Kyeong Kim, Chae Won Shin, Hyunwoo Nam, Jae Min Jeong, Han-Joon Kim, Beomseok Jeon
J Mov Disord. 2019;12(2):103-112.   Published online May 30, 2019
DOI: https://doi.org/10.14802/jmd.18061
  • 6,962 View
  • 203 Download
  • 18 Web of Science
  • 17 Crossref
AbstractAbstract PDFSupplementary Material
Objective
It is unclear whether the decline in dopamine transporters (DAT) differs among idiopathic rapid eye movement sleep behavior disorder (iRBD) patients with different levels of olfactory impairment. This study aimed to characterize DAT changes in relation to nonmotor features in iRBD patients by olfactory loss.
Methods
This prospective cohort study consisted of three age-matched groups: 30 polysomnography-confirmed iRBD patients, 30 drug-naïve Parkinson’s disease patients, and 19 healthy controls without olfactory impairment. The iRBD group was divided into two groups based on olfactory testing results. Participants were evaluated for reported prodromal markers and then underwent 18F-FP-CIT positron emission tomography and 3T MRI. Tracer uptakes were analyzed in the caudate, anterior and posterior putamen, substantia nigra, and raphe nuclei.
Results
Olfactory impairment was defined in 38.5% of iRBD patients. Mild parkinsonian signs and cognitive functions were not different between the two iRBD subgroups; however, additional prodromal features, constipation, and urinary and sexual dysfunctions were found in iRBD patients with olfactory impairment but not in those without. Tracer uptake showed significant group differences in all brain regions, except the raphe nuclei. The iRBD patients with olfactory impairment had uptake reductions in the anterior and posterior putamen, caudate, and substantia nigra (p < 0.016 in all, adjusted for age), which ranged from 0.6 to 0.8 of age-normative values. In contrast, those without olfactory impairment had insignificant changes in all regions ranging above 0.8.
Conclusion
There was a clear distinction in DAT loss and nonmotor profiles by olfactory status in iRBD.

Citations

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Clinical Features Indicating Nigrostriatal Dopaminergic Degeneration in Drug-Induced Parkinsonism
Seung Ha Lee, Han Kyeol Kim, Young Gun Lee, Chul Hyoung Lyoo, Sung Jun Ahn, Myung Sik Lee
J Mov Disord. 2017;10(1):35-39.   Published online December 27, 2016
DOI: https://doi.org/10.14802/jmd.16045
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AbstractAbstract PDFSupplementary Material
Objective
Patients with drug-induced parkinsonism (DIP) may have nigrostriatal dopaminergic degeneration. We studied the clinical features that may indicate nigrostriatal dopaminergic degeneration in patients with DIP.
Methods
Forty-one DIP patients were classified into normal and abnormal [18F] FP-CIT scan groups. Differences in 32 clinical features and drug withdrawal effects were studied.
Results
Twenty-eight patients had normal (Group I) and 13 patients had abnormal (Group II) scans. Eight patients of Group I, but none of Group II, had taken calcium channel blockers (p = 0.040). Three patients of Group I and six of Group II had hyposmia (p = 0.018). After drug withdrawal, Group I showed greater improvement in Unified Parkinson’s Disease Rating Scale total motor scores and subscores for bradykinesia and tremors than Group II. Only hyposmia was an independent factor associated with abnormal scans, but it had suboptimal sensitivity.
Conclusion
None of the clinical features were practical indicators of nigrostriatal dopaminergic degeneration in patients with DIP.

Citations

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    Wool Suh, Sung Uk Baek, Jungsu S. Oh, Seung Yeon Seo, Jae Seung Kim, You Mie Han, Min Seung Kim, Suk Yun Kang
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Gender Differences in Age-Related Striatal Dopamine Depletion in Parkinson’s Disease
Jae Jung Lee, Jee Hyun Ham, Phil Hyu Lee, Young H. Sohn
J Mov Disord. 2015;8(3):130-135.   Published online September 10, 2015
DOI: https://doi.org/10.14802/jmd.15031
  • 22,767 View
  • 122 Download
  • 28 Web of Science
  • 27 Crossref
AbstractAbstract PDFSupplementary Material
Objective Gender differences are a well-known clinical characteristic of Parkinson’s disease (PD). In-vivo imaging studies demonstrated that women have greater striatal dopamine transporter (DAT) activity than do men, both in the normal population and in PD patients. We hypothesize that women exhibit more rapid aging-related striatal DAT reduction than do men, as the potential neuroprotective effect of estrogen wanes with age.
Methods This study included 307 de novo PD patients (152 men and 155 women) who underwent DAT scans for an initial diagnostic work-up. Gender differences in age-related DAT decline were assessed in striatal sub-regions using linear regression analysis.
Results Female patients exhibited greater DAT activity compared with male patients in all striatal sub-regions. The linear regression analysis revealed that age-related DAT decline was greater in the anterior and posterior caudate, and the anterior putamen in women compared with men; we did not observe this difference in other sub-regions.
Conclusions This study demonstrated the presence of gender differences in age-related DAT decline in striatal sub-regions, particularly in the antero-dorsal striatum, in patients with PD, presumably due to aging-related decrease in estrogen. Because this difference was not observed in the sensorimotor striatum, this finding also suggests that women may not have a greater capacity to tolerate PD pathogenesis than do men.

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JMD : Journal of Movement Disorders