Parkinson's disease with a predominant right-sided putaminal FP-CIT SPECT deficiency shows stronger decline of asymmetry over time

ObjectiveTo analyze Parkinson's disease (PD) patients with a distinct initial laterality for their course in the [123I]FP-β-CIT SPECT and their clinical progress.MethodsWe examined 26 PD patients (mean age 58.4 ± 11.3 years) with [123I]FP-β-CIT SPECT and clinical ratings (UPDRS, part III) and divided them into two groups (PD-Right, PD-Left) depending upon the more affected putamen. In a prospective study, both groups were re-evaluated in average after 2.46 ± .59 years. We ascertained differences on the change of putaminal asymmetry in both groups with non-parametric Mann–Whitney test. Moreover, clinical measurements were analyzed with a Wilcoxon matched pairs test.ResultsThere were no statistical differences for age, time between scans, disease duration, L-Dopa equivalent dose, disease severity or asymmetry indices of the dopaminergic uptake in the [123I]FP-β-CIT SPECT for both groups at baseline (p > .05). In the follow-up, the PD-Right group had a more pronounced asymmetry loss compared to the PD-Left group (p < .05). In addition, UPDRS motor scores demonstrated a worse clinical outcome only in the PD-Right group (p < .025).ConclusionsTo our best knowledge, this study shows for the first time a considerably faster clinical and in vivo progression of PD patients affected predominantly at the right hemisphere compared to PD-Left patients over time. Our data confirm the suspicion of different entities of one disease. Therefore, it may intensify the efforts of a more accurate and diversified stratification of patients suffering from parkinsonian symptoms.