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Войти в исследования AJNR. American journal of neuroradiology · 2026
Classifying Parkinson Disease Progression via Latent Trajectories of Striatal Specific Binding Ratios from 123I FP-CIT SPECT in Association with Levodopa-Induced Dyskinesia.
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Lee Kee Yeun, Jeong Eun Hye, Lee Won Woo, Song Yoo Sung
Аннотация
BACKGROUND AND PURPOSE: Levodopa-induced dyskinesia (LID) remains one of the most challenging complications of long-term dopaminergic therapy in Parkinson disease (PD), but reliable markers for identifying patients at higher risk remain uncertain. The purpose of this study was to determine whether longitudinal imaging trajectories derived from 123I FP-CIT SPECT using latent class growth analysis (LCGA) show associations with LID occurrence when considered with clinical characteristics.
MATERIALS AND METHODS: Two hundred seventy-six patients with PD underwent 123I FP-CIT scans at baseline, 1-year, 2-year, and 4-year follow-up periods. Specific binding ratios (SBRs) of the caudate and putamen were measured. LCGA was performed to classify patients into trajectory-based subgroups according to the patterns of dopaminergic denervation. Clinical variables including demographic characteristics, levodopa equivalent daily dose (LEDD), Movement Disorder Society-Unified Parkinson Disease Rating Scale scores, and motor subtypes (tremor-dominant, postural instability/gait difficulty, and indeterminate), were assessed. Occurrence of LID within 4 years was the primary end point. Multivariate logistic regression was used to assess associations between baseline clinical/imaging variables and 4-year LID occurrence.
RESULTS: LCGA identified 2 distinct trajectory classes among 276 patients, a gradual decline group (class 1, n = 241, 87.3%) and a rapid decline group (class 2, n = 35, 12.7%). Class 1 showed significantly lower baseline caudate (1.84 ± 0.46 versus 2.90 ± 0.37, P < .001) and putamen (0.70 ± 0.23 versus 1.33 ± 0.37, P < .001) SBRs compared with class 2, but the 4-year decline of SBRs was steeper in class 2 (caudate -0.43 versus -0.92; putamen -0.20 versus -0.61). Class 2 was independently associated with LID in multivariate logistic regression (OR = 11.41; 95% CI: 1.04-125.35; P = .047), along with the indeterminate motor subtype (OR = 10.56; 95% CI: 1.809-61.682; P = .009). Area under the curve of the multivariate model was 0.876 for 4-year LID occurrence.
CONCLUSIONS: Longitudinal imaging trajectories demonstrate contemporaneous associations with LID occurrence in PD and may provide clinically relevant insights when combined with clinical characteristics.
MATERIALS AND METHODS: Two hundred seventy-six patients with PD underwent 123I FP-CIT scans at baseline, 1-year, 2-year, and 4-year follow-up periods. Specific binding ratios (SBRs) of the caudate and putamen were measured. LCGA was performed to classify patients into trajectory-based subgroups according to the patterns of dopaminergic denervation. Clinical variables including demographic characteristics, levodopa equivalent daily dose (LEDD), Movement Disorder Society-Unified Parkinson Disease Rating Scale scores, and motor subtypes (tremor-dominant, postural instability/gait difficulty, and indeterminate), were assessed. Occurrence of LID within 4 years was the primary end point. Multivariate logistic regression was used to assess associations between baseline clinical/imaging variables and 4-year LID occurrence.
RESULTS: LCGA identified 2 distinct trajectory classes among 276 patients, a gradual decline group (class 1, n = 241, 87.3%) and a rapid decline group (class 2, n = 35, 12.7%). Class 1 showed significantly lower baseline caudate (1.84 ± 0.46 versus 2.90 ± 0.37, P < .001) and putamen (0.70 ± 0.23 versus 1.33 ± 0.37, P < .001) SBRs compared with class 2, but the 4-year decline of SBRs was steeper in class 2 (caudate -0.43 versus -0.92; putamen -0.20 versus -0.61). Class 2 was independently associated with LID in multivariate logistic regression (OR = 11.41; 95% CI: 1.04-125.35; P = .047), along with the indeterminate motor subtype (OR = 10.56; 95% CI: 1.809-61.682; P = .009). Area under the curve of the multivariate model was 0.876 for 4-year LID occurrence.
CONCLUSIONS: Longitudinal imaging trajectories demonstrate contemporaneous associations with LID occurrence in PD and may provide clinically relevant insights when combined with clinical characteristics.