Interaction of caudate dopamine depletion and brain metabolic changes with cognitive dysfunction in early Parkinson's disease |
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Authors: | Polito Cristina Berti Valentina Ramat Silvia Vanzi Eleonora De Cristofaro Maria Teresa Pellicanò Giannantonio Mungai Francesco Marini Paolo Formiconi Andreas Robert Sorbi Sandro Pupi Alberto |
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Affiliation: | a Department of Clinical Pathophysiology, University of Florence, Florence, Italy b Department of Psychiatric and Neurological Sciences, University of Florence, Florence, Italy |
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Abstract: | Damage to nonmotor dopamine (DA)-mediated frontostriatal circuits has been proposed as the main pathophysiological basis of cognitive dysfunction in Parkinson's disease (PD). In the present study, 18 early nondemented drug naive PD patients were investigated, by dual-tracer N-ω-fluoropropyl-2β-carbomethoxy-3β-4-[123I]iodophenyl-nortropane ([123I]FP-CIT) single-photon emission computed tomography (SPECT)/[18F] fluoro-deoxyglucose (FDG) positron emission tomography (PET) imaging, to test whether an early and not yet treatment-modulated relation exists between cognitive functions, caudate nucleus (CN) DA impairment and brain metabolism (CMRglc) in associative frontostriatal circuits. Verbal fluency performance correlated with DA impairment in CN, and with CMRglc in dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC). Further, CMRglc in orbitofrontal cortex, DLPFC, and ACC was shown to be early modulated by the level of DA impairment in CN. The present study demonstrates in vivo the early functional disruption of nonmotor frontostriatal circuits in PD. The effect of CN DA impairment on DLPFC and ACC metabolism is proposed as a possible early pathophysiological and functional substrate for executive dysfunction in PD. |
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Keywords: | Parkinson's disease FP-CIT SPECT FDG PET Basal ganglia Cognitive functions |
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