Paradoxical Cerebral Perfusion in Parkinson's Disease Patients with Orthostatic Hypotension: A Dual-Phase 18F-Florbetaben Positron Emission Tomography Study.
J Parkinsons Dis
; 11(3): 1335-1344, 2021.
Article
em En
| MEDLINE
| ID: mdl-34024782
ABSTRACT
BACKGROUND:
Orthostatic hypotension (OH) may antedate Parkinson's disease (PD) or be found in early stages of the disease. OH may induce a PD brain to chronic hypotensive insults. 18F-Florbetaben (18F-FBB) tracer has a high first-pass influx rate and can be used with positron emission tomography (PET) as a surrogate marker for early- and late-phase evaluation of cerebral perfusion and cerebral amyloidosis, respectively.OBJECTIVE:
In this study, we evaluated whether 18F-FBB uptake in the early- and late-phases of PD was related to OH. This study manipulated the imaging modality to illustrate the physiology of cerebral flow with OH in PD (PDâ+âOH).METHODS:
A group of 73 early-stage PD patients was evaluated with a head-up tilt-test and 18F-FBB PET imaging. The cognitive status was assessed by a comprehensive battery of neuropsychological tests. PET images were normalized, and both early- and late-phase standardized uptake value ratios (SUVRs) of pre-specified regions were obtained. The associations between regional SUVRs and OH and cognitive status were analyzed.RESULTS:
Twenty (27.4%) participants had OH. Thirteen (17.8%) patients were interpreted as having amyloid pathology based on regional 18F-FBB uptake. Early-phase SUVRs were higher in specific brain regions of PDâ+âOH patients than those without OH. However, late-phase SUVRs did not differ between the groups. The early-phase SUVRs were not influenced by amyloid burden or by interaction between amyloid and orthostatic hypotension. Cognitive functions were not disparate when PDâ+âOH patients were contrasted with non-OH patients in this study.CONCLUSION:
Cerebral blood flow was elevated in patients with early PDâ+âOH. This finding suggests augmented cerebral perfusion in PDâ+âOH might be a compensatory regulation in response to chronic OH.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Doença de Parkinson
/
Circulação Cerebrovascular
/
Hipotensão Ortostática
Limite:
Humans
Idioma:
En
Revista:
J Parkinsons Dis
Ano de publicação:
2021
Tipo de documento:
Article