Objective: To compare the metabolism of the putamen and the cerebral cortex between the akinesia-dominant group and the tremor-dominant group of Parkinson’s disease (PD) patients.

Background: Cognitive dysfunction is more likely to occur in patients with rigid-akinetic PD than in tremor-dominant PD patients. Furthermore, dopamine transporter (DAT) imaging has been reported as a biomarker of cognitive dysfunction in PD patients.

Method: We surveyed the data pertaining to cases with PD reported in our hospital in 2017. We determined the main symptom of the PD patients via inquiring the patients and their caregivers and their neurological findings. For the analysis of the DAT scan data, ROI setting, SBR (Specific Binding Ratio) evaluation, and QSPECT package were used. Blood flow in the cerebral cortex of both the groups was measured with 131I-IMP SPECT, which was compared using 2tZ software.

Results: There were 125 patients with Parkinson’s disease, among which 67 patients were taking DAT scan. Among the 38 PD patients who were selected, there were 26 tremor-dominant PD patients and 12 akinesia-dominant patients. There was no significant difference in the disease duration between the two groups. However, the incidence of cognitive dysfunction was slightly higher in the akinesia-dominant group. But it was no significant difference between the two groups. The akinesia-dominant group showed a significantly lower value of average SBR in DAT imaging than that of the tremor-dominant group (1.56 versus 2.38). In 131I-IMP SPECT, the akinesia group showed a decrease in blood flow around the pre-supplementary motor cortex compared to the tremor-dominant group.

Conclusion: In the akinesia-dominant group, the decline in the putamen function was severer than that in the tremor-dominant group, as shown by DAP imaging. We believe that the decrease in blood flow in the pre-supplementary motor cortex is related to the putamen condition that may vary between the tremor-dominant and the akinesia-dominant groups. This further suggests a difference in the range of dysfunction between the two groups, which may be related to the difference in progression of PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/neuroradiological-differences-between-patients-with-akinesia-dominant-and-tremor-dominant-parkinsons-disease/