Background:Striatal dopamine deficits play a key role in the pathogenesis of Parkinson’s disease (PD), and several non-motor symptoms (NMSs) have a dopaminergic component. Objective:To investigate the association between early NMS burden and the patterns of striatal dopamine depletion in patients with de novo PD. Methods:We consecutively recruited 255 patients with drug-naïve early-stage PD who underwent 18F-FP-CIT PET scans. The NMS burden of each patient was assessed using the NMS Questionnaire (NMSQuest), and patients were divided into the mild NMS burden (PDNMS-mild) (NMSQuest score <6; n = 91) and severe NMS burden groups (PDNMS-severe) (NMSQuest score >9; n = 90). We compared the striatal dopamine transporter (DAT) activity between the groups. Results:Patients in the PDNMS-severe group had more severe parkinsonian motor signs than those in the PDNMS-mild group, despite comparable DAT activity in the posterior putamen. DAT activity was more severely depleted in the PDNMS-severe group in the caudate and anterior putamen compared to that in the PDMNS-mild group. The inter-sub-regional ratio of the associative/limbic striatum to the sensorimotor striatum was lower in the PDNMS-severe group, although this value itself lacked fair accuracy for distinguishing between the patients with different NMS burdens. Conclusion:This study demonstrated that PD patients with severe NMS burden exhibited severe motor deficits and relatively diffuse dopamine depletion throughout the striatum. These findings suggest that the level of NMS burden could be associated with distinct patterns of striatal dopamine depletion, which could possibly indicate the overall pathological burden in PD.

中文翻译：

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非运动负荷与新发帕金森病纹状体多巴胺损失模式的关联。

背景：纹状体多巴胺缺陷在帕金森病 (PD) 的发病机制中起关键作用，并且一些非运动症状 (NMS) 具有多巴胺能成分。目的：探讨早期 NMS 负荷与新发 PD 患者纹状体多巴胺耗竭模式之间的关系。方法：我们连续招募了 255 名接受 18F-FP-CIT PET 扫描的未经药物治疗的早期 PD 患者。使用NMS问卷（NMSQuest）评估每位患者的NMS负担，将患者分为轻度NMS负担（PDNMS-mild）（NMSQuest评分<6；n = 91）和重度NMS负担组（PDNMS-severe） （NMSQuest 得分 >9；n = 90）。我们比较了各组之间的纹状体多巴胺转运蛋白 (DAT) 活性。结果：尽管后壳核的 DAT 活性相当，但 PDNMS 重度组患者的帕金森运动症状比 PDNMS 轻度组更严重。与 PDMNS 轻度组相比，PDNMS 重度组尾状核和前壳核中的 DAT 活性消耗更严重。在 PDNMS 严重组中，关联/边缘纹状体与感觉运动纹状体的亚区域间比率较低，尽管该值本身缺乏区分具有不同 NMS 负担的患者的公平准确性。结论：本研究表明，具有严重 NMS 负担的 PD 患者表现出严重的运动缺陷和整个纹状体中相对弥散的多巴胺耗竭。这些发现表明 NMS 负担的水平可能与纹状体多巴胺耗竭的不同模式有关，