Brain, Vol. 125, No. 6, 1358-1365,
June 2002
© 2002 Guarantors of Brain
Striatal and extrastriatal dysfunction in Parkinson’s disease with dementia: a 6-[18F]fluoro-L-dopa PET study
1 Department of Biofunctional Research, National Institute for Longevity Sciences and 2 Department of Neurology, Chubu National Hospital, Obu, Japan, 3 MRC Clinical Sciences Centre, Imperial College School of Medicine, Hammersmith Hospital, London and 4 Institute of Neurology, Queen Square, London, UK
Correspondence to: Dr Kengo Ito, Department of Biofunctional Research, National Institute for Longevity Sciences, 36-3 Gengo, Morioka-cho, Obu, Aichi Prefecture, 474-8522, Japan E-mail: kito{at}nils.go.jp
We investigated the relative differences in dopaminergic function through the whole brain in patients with Parkinson’s disease without dementia (PD) and with dementia (PDD) using 6-[18F]fluoro-L-dopa (18F-dopa) PET and a voxel-by-voxel analysis. The 10 PD and 10 PDD patients were equivalently disabled, having mean scores of 3.2 ± 0.6 and 3.2 ± 0.7, respectively, on the Hoehn and Yahr rating scale. 18F-dopa influx constant (Ki) images of those patients and 15 normal age-matched subjects were transformed into standard stereotactic space. The significant differences between the groups (expressed in mean regional Ki values) were localized with statistical parametric mapping (SPM) on a voxel-by-voxel basis. Compared with the normal group, SPM localized declines of the 18F-dopa Ki bilaterally in the putamen, the right caudate nucleus and the left ventral midbrain for the PD group (P < 0.01, corrected). Com pared with the normal group, the PDD group showed reduced 18F-dopa Ki bilaterally in the striatum, midbrain and anterior cingulate area (P < 0.01, corrected). A relative difference in 18F-dopa uptake between PD and PDD was the bilateral decline in the anterior cingulate area and ventral striatum and in the right caudate nucleus in the PDD group (P < 0.001, corrected). Accordingly, we conclude that dementia in PD is associated with impaired mesolimbic and caudate dopaminergic function.
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