ArticleBMJ mental health2025
Decline in striatal binding ratio associated with accelerated decline in performance on symbol digit modality but not MoCA in Parkinson's Disease Psychosis.
Article in BMJ mental health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCognitive deficits and reduced dopamine transporter (DAT) binding ratio have been reported in Parkinson's disease psychosis (PDP). However, it remains unclear whether DAT striatal binding ratio (SBR) may contribute to worsening cognitive performance in PDP.
objectivesWe examined this using data from the Parkinson's Progression Markers Initiative.
methodsWe analysed data from 392 PD patients, from baseline to year 4 follow-up, and classified patients into PD with psychosis (PDP) and without psychosis (PDnP). DAT SBR was available from
findingsPDP patients had lower DAT SBR compared with PDnP patients (b=-0.092, p=0.035) over all time points, which remained significant after controlling for age, sex and ethnicity. PDP patients also reported worse trajectory of task performance on the Montreal Cognitive Assessment (MoCA) (b=-0.238, p=0.001) and symbol digit modality (b=-0.534, p=0.016) compared with PDnP patients. Declining performance in symbol digit modality (Group×Time×DAT SBR interaction, b=0.683, p=0.028) but not MoCA was differentially associated with the decline in DAT SBR over time. MoCA scores declined more in PDP compared with PDnP patients over all timepoints (Group×Time interaction, b=-0.284, p=0.016).
conclusionsDecline in striatal presynaptic dopamine function may specifically underlie longitudinal decline in performance in the symbol digit modality task that engages processing speed, associative learning and working memory in PD psychosis. Whether striatal presynaptic dopamine changes explain accelerated longitudinal decline in other cognitive domains in people with PDP remains to be tested.
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