Abstract

Objective

Parkinsonian motor signs are common and disabling in older adults without Parkinson’s disease (PD), but its risk factors are not completely understood. We assessed the influence of striatal dopamine levels, cerebral small vessel disease, and other factors on age-related parkinsonian motor signs in non-PD adults.

Methods

Striatal dopamine transporter (DAT) binding was quantified via [¹¹C]-CFT positron emission tomography in 87 neurologically intact adults (20–85 years, 57.47% female) with concurrent data on: Unified Parkinson’s Disease Rating Scale motor (UPDRSm), white matter hyperintensities (WMH), and other risk factors (grip strength, vibratory sensitivity, cardio- and cerebro-vascular comorbidities). Sex-adjusted nonparametric models first estimated the associations of age, DAT, WMH, and other factors with UPDRSm; next, interactions of age by DAT, WMH, or other factors were tested. To quantify the influence of DAT, WMH, and other risk factors on the main association of age with UPDRSm, multivariable mediation models with bootstrapped confidence intervals (CI) were used.

Results

Older age, lower DAT, higher WMH, and worse risk factors significantly predicted worse UPDRSm (sex-adjusted p < .04 for all). DAT, but not WMH or other factors, positively and significantly interacted with age (p = .02). DAT significantly reduced the age-UPDRSm association by 30% (results of fully adjusted mediation model: indirect effect: 0.027; bootstrapped 95% CI: 0.0007, 0.074).

Conclusions

Striatal dopamine appears to influence to some extent the relationship between age and parkinsonian signs. However, much of the variance of parkinsonian signs appears unexplained. Longitudinal studies to elucidate the multifactorial causes of this common condition of older age are warranted.

中文翻译：

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纹状体多巴胺，脑小血管疾病和其他危险因素对与年龄有关的帕金森氏运动征的影响。

抽象的

客观的

在没有帕金森氏病（PD）的老年人中，帕金森氏运动体征很常见且致残，但其危险因素尚未完全明了。我们评估了非PD成年人中纹状体多巴胺水平，脑小血管疾病和其他因素对与年龄相关的帕金森氏运动体征的影响。

方法

通过[ ¹¹ C] -CFT正电子发射断层扫描对87位神经学完好的成年人（20-85岁，女性57.47％）中的纹状体多巴胺转运蛋白（DAT）结合进行了定量，并发以下数据：帕金森氏病统一运动量表（UPDRSm），白色物质高血压（WMH）和其他危险因素（握力，振动敏感性，心脑血管合并症）。经过性别调整的非参数模型首先估算了年龄，DAT，WMH和其他因素与UPDRSm的关联；接下来，测试了DAT，WMH或其他因素对年龄的影响。为了量化DAT，WMH和其他风险因素对年龄与UPDRSm的主要关联的影响，使用了具有自举置信区间（CI）的多变量中介模型。

结果

老年人，较低的DAT，较高的WMH和较差的危险因素均显着预示了UPDRSm较差（所有因素均经过性别调整后的p <.04）。DAT与WMH或其他因素无关，与年龄呈显着正相关（p = .02）。DAT显着降低了年龄-UPDRSm关联30％（完全调解模型的结果：间接影响：0.027；自举95％CI：0.0007，0.074）。

结论

纹状体多巴胺似乎在一定程度上影响年龄和帕金森氏征之间的关系。但是，帕金森氏征的许多方差似乎无法解释。进行纵向研究以阐明这种老年人常见病的多因素原因。