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Clinical and Imaging Progression in the PARS Cohort: Long-Term Follow-up.
Mov Disord. 2020 09; 35(9):1550-1557.MD

Abstract

BACKGROUND AND OBJECTIVES

The PARS (Parkinson Associated Risk Syndrome) study was designed to test whether screening for hyposmia followed by dopamine transporter imaging can identify risk for conversion to clinical PD, and to evaluate progression markers during the prodromal period.

METHODS

Subjects with hyposmia completed annual clinical evaluations and biennial [123 I]β-CIT single-photon emission computed tomography scans. Subjects were categorized as normal (>80% age-expected tracer uptake; n = 134), indeterminate (>65-80%; n = 30), and dopamine transporter deficit (≤65%; n = 21) by their baseline scan, and survival analysis was used to compare risk of conversion to motor PD. Progressing to a scan with a dopamine transporter deficit was assessed for those subjects with either normal or indeterminate baseline imaging.

RESULTS

Over a mean of 6.3 [standard deviation: 2.2] years of follow-up, 67% (n = 14) of dopamine transporter deficit subjects, 20% (n = 6) of dopamine transporter indeterminate subjects, and 4% (n = 6) of dopamine transporter normal subjects converted to a PD diagnosis (P < 0.0001). Among subjects without dopamine transporter deficit at baseline, a reduction to ≤65% age-expected uptake occurred in 12 of 30 (40%) with indeterminate dopamine transporter and 7 of 134 (5%) with no dopamine transporter DAT deficit (P < 0.0001). Imaging conversion during follow-up was associated with subsequent clinical conversion (hazard ratio: 9.6; P = 0.0157).

DISCUSSION AND CONCLUSIONS

Long-term follow-up of the PARS cohort demonstrated a high rate of conversion to clinical PD in subjects who either had abnormal dopamine transporter imaging at baseline or developed abnormal imaging during follow-up. These data extend the earlier PARS findings and present new results showing the sequence of incident imaging deficit, imaging progression, and clinical changes that occur in prodromal PD. © 2020 International Parkinson and Movement Disorder Society.

Authors+Show Affiliations

Parkinson's Disease and Movement Disorders Center, Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.Institute for Neurodegenerative Disorders, New Haven, Connecticut, USA.Parkinson's Disease and Movement Disorders Center, Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.Institute for Neurodegenerative Disorders, New Haven, Connecticut, USA.Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York, USA.Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York, USA.Institute for Neurodegenerative Disorders, New Haven, Connecticut, USA.No affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

32657461

Citation

Siderowf, Andrew, et al. "Clinical and Imaging Progression in the PARS Cohort: Long-Term Follow-up." Movement Disorders : Official Journal of the Movement Disorder Society, vol. 35, no. 9, 2020, pp. 1550-1557.
Siderowf A, Jennings D, Stern M, et al. Clinical and Imaging Progression in the PARS Cohort: Long-Term Follow-up. Mov Disord. 2020;35(9):1550-1557.
Siderowf, A., Jennings, D., Stern, M., Seibyl, J., Eberly, S., Oakes, D., & Marek, K. (2020). Clinical and Imaging Progression in the PARS Cohort: Long-Term Follow-up. Movement Disorders : Official Journal of the Movement Disorder Society, 35(9), 1550-1557. https://doi.org/10.1002/mds.28139
Siderowf A, et al. Clinical and Imaging Progression in the PARS Cohort: Long-Term Follow-up. Mov Disord. 2020;35(9):1550-1557. PubMed PMID: 32657461.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and Imaging Progression in the PARS Cohort: Long-Term Follow-up. AU - Siderowf,Andrew, AU - Jennings,Danna, AU - Stern,Matthew, AU - Seibyl,John, AU - Eberly,Shirley, AU - Oakes,David, AU - Marek,Kenneth, AU - ,, Y1 - 2020/07/13/ PY - 2020/03/03/received PY - 2020/04/27/revised PY - 2020/05/17/accepted PY - 2020/7/14/pubmed PY - 2021/4/28/medline PY - 2020/7/14/entrez KW - Parkinson's disease KW - biomarkers KW - dopamine transporter imaging KW - prodromal SP - 1550 EP - 1557 JF - Movement disorders : official journal of the Movement Disorder Society JO - Mov Disord VL - 35 IS - 9 N2 - BACKGROUND AND OBJECTIVES: The PARS (Parkinson Associated Risk Syndrome) study was designed to test whether screening for hyposmia followed by dopamine transporter imaging can identify risk for conversion to clinical PD, and to evaluate progression markers during the prodromal period. METHODS: Subjects with hyposmia completed annual clinical evaluations and biennial [123 I]β-CIT single-photon emission computed tomography scans. Subjects were categorized as normal (>80% age-expected tracer uptake; n = 134), indeterminate (>65-80%; n = 30), and dopamine transporter deficit (≤65%; n = 21) by their baseline scan, and survival analysis was used to compare risk of conversion to motor PD. Progressing to a scan with a dopamine transporter deficit was assessed for those subjects with either normal or indeterminate baseline imaging. RESULTS: Over a mean of 6.3 [standard deviation: 2.2] years of follow-up, 67% (n = 14) of dopamine transporter deficit subjects, 20% (n = 6) of dopamine transporter indeterminate subjects, and 4% (n = 6) of dopamine transporter normal subjects converted to a PD diagnosis (P < 0.0001). Among subjects without dopamine transporter deficit at baseline, a reduction to ≤65% age-expected uptake occurred in 12 of 30 (40%) with indeterminate dopamine transporter and 7 of 134 (5%) with no dopamine transporter DAT deficit (P < 0.0001). Imaging conversion during follow-up was associated with subsequent clinical conversion (hazard ratio: 9.6; P = 0.0157). DISCUSSION AND CONCLUSIONS: Long-term follow-up of the PARS cohort demonstrated a high rate of conversion to clinical PD in subjects who either had abnormal dopamine transporter imaging at baseline or developed abnormal imaging during follow-up. These data extend the earlier PARS findings and present new results showing the sequence of incident imaging deficit, imaging progression, and clinical changes that occur in prodromal PD. © 2020 International Parkinson and Movement Disorder Society. SN - 1531-8257 UR - https://www.unboundmedicine.com/medline/citation/32657461/Clinical_and_Imaging_Progression_in_the_PARS_Cohort:_Long_Term_Follow_up_ L2 - https://doi.org/10.1002/mds.28139 DB - PRIME DP - Unbound Medicine ER -