ArticleMovement disorders : official journal of the Movement Disorder Society2026
Spatiotemporal Progression Patterns of Striatal Dopamine Depletion and Cerebral Hypoperfusion in Parkinson's Disease.
Article in Movement disorders : official journal of the Movement Disorder Society, 2026. 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
backgroundThe identification of Parkinson's disease (PD) subtypes is crucial for predicting the disease course and designing personalized therapeutic strategies.
objectivesThe aim of the study was to characterize the heterogeneity of the spatiotemporal evolutionary patterns of striatal dopamine depletion and cerebral hypoperfusion in PD.
methodsWe retrospectively enrolled 708 patients with newly diagnosed PD and 50 healthy controls who underwent dual-phase
resultsSubtype 1 (n = 406) initially presented with asymmetric dopamine loss in the posterior putamen, followed by dopaminergic deficits in other striatal subregions and, later, cerebral hypoperfusion. Subtype 2 (n = 205) exhibited diffuse and symmetric striatal dopamine loss in the early stages, followed by cerebral hypoperfusion in the mid-stages. Subtype 3 (n = 89) initially showed the parieto-occipital hypoperfusion, followed by cerebral hypoperfusion in other cortical areas and striatal dopamine depletion. Subtype 2 had an older age of onset, and subtype 3 had a younger age of onset and a lower prevalence of rapid eye movement sleep behavior disorder. Time-dependent Cox regression models showed that the risk of dementia conversion within a follow-up period of 4 years was higher in subtypes 2 and 3 (hazard ratios 1.772 and 2.802, respectively) than subtype 1, after the confounding effects were adjusted. The risk of developing levodopa-induced dyskinesia and freezing of gait was comparable between subtypes.
conclusionsThe spatiotemporal trajectories of striatal dopamine depletion and cerebral hypoperfusion on dual-phase
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