HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hilker, R. Articles by Heiss, W. D. Search for Related Content PubMed PubMed Citation Articles by Hilker, R. Articles by Heiss, W. D. Related Collections PET Parkinson's disease/Parkinsonism

Dementia in Parkinson disease

Functional imaging of cholinergic and dopaminergic pathways

From the Department of Neurology (Drs. Hilker, Thomas, Burghaus, Jacobs, Herholz, and Heiss), University of Cologne; and Max Planck-Institute for Neurological Research (Drs. Thomas, Klein, Weisenbach, Kalbe, Jacobs, and Heiss), Cologne, Germany.

Address correspondence and reprint requests to Dr. Ruediger Hilker, Department of Neurology, University Hospital, Kerpener Str. 62, D-50924 Cologne, Germany; e-mail: hilker{at}pet.mpin-koeln.mpg.de

Objective: To assess neurochemical deficits in patients with Parkinson disease (PD) associated dementia (PDD) in vivo.

Methods: The authors performed combined PET with N-[¹¹C]-methyl-4-piperidyl acetate (MP4A) and ¹⁸F-fluorodopa (FDOPA) for evaluation of cholinergic and dopaminergic transmitter changes in 17 non-demented patients with PD and 10 patients with PDD. Data were compared to 31 age-matched controls by a combined region-of-interest and voxel-based Statistical Parametric Mapping analysis.

Results: The striatal FDOPA uptake was significantly decreased in PD and PDD without differences between the groups. The global cortical MP4A binding was severely reduced in PDD (29.7%, p < 0.001 vs controls) and moderately decreased in PD (10.7%, p < 0.01 vs controls). The PDD group had lower parietal MP4A uptake rates than did patients with PD. Frontal and temporo-parietal cortices showed a significant covariance of striatal FDOPA reduction and decreased MP4A binding in patients with PDD.

Conclusions: While non-demented patients with Parkinson disease had a moderate cholinergic dysfunction, subjects with Parkinson disease associated dementia (PDD) presented with a severe cholinergic deficit in various cortical regions. The finding of a closely associated striatal FDOPA and cortical MP4A binding reduction suggests a common disease process leading to a complex transmitter deficiency syndrome in PDD.

*The first two authors contributed equally to this work.

Supported by the project Network for Efficiency and Standardization of Dementia Diagnosis (NEST-DD).

Disclosure: The authors report no conflicts of interest.

Received May 10, 2005. Accepted in final form August 16, 2005.

This article has been cited by other articles:

				C. Huang, P. Mattis, K. Perrine, N. Brown, V. Dhawan, and D. Eidelberg Metabolic abnormalities associated with mild cognitive impairment in Parkinson disease Neurology, April 15, 2008; 70(16_Part_2): 1470 - 1477. [Abstract] [Full Text] [PDF]

				K HERHOLZ, S F CARTER, and M JONES Positron emission tomography imaging in dementia Br. J. Radiol., December 1, 2007; 80(Special_Issue_2): S160 - S167. [Abstract] [Full Text] [PDF]

				C. H. Williams-Gray, T. Foltynie, C. E. G. Brayne, T. W. Robbins, and R. A. Barker Evolution of cognitive dysfunction in an incident Parkinson's disease cohort Brain, July 1, 2007; 130(7): 1787 - 1798. [Abstract] [Full Text] [PDF]