Highlights
- •Burden of non-motor symptoms is similar in Parkinson's disease and parkinsonism with normal brain dopamine function
- •Total burden of non-motor symptoms may not be used in differential diagnosis between Parkinson's disease and non-dopaminergic parkinsonism
- •Total non-motor symptom burden does not correlate with striatal brain dopamine transporter binding in patients with Parkinson's disease
Abstract
Background
Non-motor symptoms (NMSs) are clearly more prevalent in Parkinson's disease (PD) patients
compared to healthy individuals. However, NMSs are also common in the elderly and
other neurological conditions, and thus, it is not known whether NMSs could be used
to differentiate PD from parkinsonism/tremor without dopamine deficiency.
Methods
We prospectively evaluated NMSs immediately before brain dopamine transporter (DAT)
[123I]FP-CIT SPECT scanning in 193 patients with unclear parkinsonism/tremor. According
to the clinical follow-up and imaging results, 84 patients had PD. NMSs and their
correlations with striatal DAT binding were investigated in PD patients and in parkinsonism/tremor
patients with normal dopamine function.
Results
Total NMS burden, anxiety or depression did not differ between PD patients and patients
with normal DAT binding. DAT-normal patients reported more perception-related (p = 0.045)
and attention/memory-related NMSs than PD patients (p < 0.001). Total NMS score did
not correlate with striatal DAT binding in either group.
Conclusions
In clinically uncertain cases, the total NMS burden cannot be used as a tool in distinguishing
PD patients from patients with non-dopaminergic parkinsonism/tremor. Clinical screening
of NMSs appears equally important in all patients with parkinsonism.
Keywords
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Article info
Publication history
Published online: July 19, 2019
Accepted:
July 18,
2019
Received in revised form:
June 20,
2019
Received:
April 3,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
