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Jakobson Mo, Susanna, Medicine Doktor
Publications (10 of 30) Show all publications
af Bjerkén, S., Axelsson, J., Larsson, A., Flygare, C., Remes, J., Strandberg, S., . . . Jakobson Mo, S. (2023). Reliability and validity of visual analysis of [18F]FE-PE2I PET/CT in early Parkinsonian disease. Nuclear medicine communications, 44(5), 397-406
Open this publication in new window or tab >>Reliability and validity of visual analysis of [18F]FE-PE2I PET/CT in early Parkinsonian disease
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2023 (English)In: Nuclear medicine communications, ISSN 0143-3636, E-ISSN 1473-5628, Vol. 44, no 5, p. 397-406Article in journal (Refereed) Published
Abstract [en]

Objective: [18F]FE-PE2I (FE-PE2I) is a new radiotracer for dopamine transporter (DAT) imaging with PET. The aim of this study was to evaluate the visual interpretation of FE-PE2I images for the diagnosis of idiopathic Parkinsonian syndrome (IPS). The inter-rater variability, sensitivity, specificity, and diagnostic accuracy for visual interpretation of striatal FE-PE2I compared to [123I]FP-CIT (FP-CIT) single-photon emission computed tomography (SPECT) was evaluated.

Methods: Thirty patients with newly onset parkinsonism and 32 healthy controls with both an FE-PE2I and FP-CIT were included in the study. Four patients had normal DAT imaging, of which three did not fulfil the IPS criteria at the clinical reassessment after 2 years. Six raters evaluated the DAT images blinded to the clinical diagnosis, interpreting the image as being ‘normal’ or ‘pathological’, and assessed the degree of DAT-reduction in the caudate and putamen. The inter-rater agreement was assessed with intra-class correlation and Cronbach’s α. For calculation of sensitivity and specificity, DAT images were defined as correctly classified if categorized as normal or pathological by ≥4/6 raters.

Results: The overall agreement in visual evaluation of the FE-PE2I- and FP-CIT images was high for the IPS patients (α = 0.960 and 0.898, respectively), but lower in healthy controls (FE-PE2I: α = 0.693, FP-CIT: α = 0.657). Visual interpretation gave high sensitivity (both 0.96) but lower specificity (FE-PE2I: 0.86, FP-CIT: 0.63) with an accuracy of 90% for FE-PE2I and 77% for FP-CIT.

Conclusion: Visual evaluation of FE-PE2I PET imaging demonstrates high reliability and diagnostic accuracy for IPS.

Place, publisher, year, edition, pages
Wolters Kluwer, 2023
Keywords
[18F]FE-PE2I PET/computed tomography, diagnostic accuracy, early disease, Parkinson’s disease, PET
National Category
Radiology, Nuclear Medicine and Medical Imaging
Research subject
Radiology; Neurology
Identifiers
urn:nbn:se:umu:diva-206635 (URN)10.1097/mnm.0000000000001679 (DOI)000970601600009 ()36862448 (PubMedID)2-s2.0-85152168200 (Scopus ID)
Funder
Region VästerbottenUmeå UniversityParkinsonfonden
Available from: 2023-04-13 Created: 2023-04-13 Last updated: 2023-09-05Bibliographically approved
Virel, A., Johansson, J., Axelsson, J., Ericsson, M., Laterveer, R., Ögren, M., . . . af Bjerkén, S. (2022). N-acetylcysteine decreases dopamine transporter availability in the non-lesioned striatum of the 6-OHDA hemiparkinsonian rat. Neuroscience Letters, 770, Article ID 136420.
Open this publication in new window or tab >>N-acetylcysteine decreases dopamine transporter availability in the non-lesioned striatum of the 6-OHDA hemiparkinsonian rat
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2022 (English)In: Neuroscience Letters, ISSN 0304-3940, E-ISSN 1872-7972, Vol. 770, article id 136420Article in journal (Refereed) Published
Abstract [en]

This study aimed to explore the beneficial effects of the antioxidant N-acetylcysteine (NAC) on the degenerated dopamine system. The short- and long-term regulatory mechanisms of NAC on the 6-OHDA hemiparkinsonian rat model were longitudinally investigated by performing positron emission tomography (PET) imaging using the specific dopamine transporter (DAT) radioligand [18F]FE-PE2I. The results demonstrate that after a unilateral dopamine insult NAC has a strong influence on the non-lesioned hemisphere by decreasing the levels of DAT in the striatum early after the lesion. We interpret this early and short-term decrease of DAT in the healthy striatum of NAC-treated animals as a beneficial compensatory effect induced by NAC.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
6-OHDA, N-acetylcysteine, Neuroimaging, Parkinson's disease, PET
National Category
Neurosciences
Identifiers
urn:nbn:se:umu:diva-191188 (URN)10.1016/j.neulet.2021.136420 (DOI)000742672900005 ()2-s2.0-85122253129 (Scopus ID)
Funder
Region VästerbottenLars Hierta Memorial Foundation
Available from: 2022-01-11 Created: 2022-01-11 Last updated: 2023-09-05Bibliographically approved
Larsson Strömvall, A. & Jakobson Mo, S. (2022). Neuroimaging in nuclear medicine (1ed.). In: Michael Ljungberg (Ed.), Handbook of nuclear medicine and molecular imaging for physicists: volume III, radiopharmaceuticals and clinical applications (pp. 173-188). New York: CRC Press
Open this publication in new window or tab >>Neuroimaging in nuclear medicine
2022 (English)In: Handbook of nuclear medicine and molecular imaging for physicists: volume III, radiopharmaceuticals and clinical applications / [ed] Michael Ljungberg, New York: CRC Press, 2022, 1, p. 173-188Chapter in book (Other academic)
Abstract [en]

Nuclear medicine neuroimaging methods have evolved from mainly being used for research, to becoming established techniques in clinical neurology. In recent years, new technologies have led to increased image quality, and new radiopharmaceuticals with high clinical impact have been developed. The field is expected to become even more important in the future due to the higher prevalence of neurological disorders and the general ageing of the population. The current chapter begins with a basic medical introduction to brain anatomy and physiology. Different pathological conditions such as neurodegenerative disorders, epilepsy, and brain tumours are outlined. The chapter also includes examples of common imaging applications, such as imaging of cerebral blood flow, imaging of brain metabolism, imaging of neurotransmitter systems, and imaging of other cerebral functions such as amyloid and brain tumour imaging. A part on technology is included, discussing neuroimaging solutions for SPECT, SPECT/CT, PET, PET/CT, and PET/MR. Special considerations for optimization of SPECT and PET acquisition and reconstruction are also discussed. Important methods for evaluation, such as visual interpretation and quantitative techniques are also described, including implications for usage of reference databases.

Place, publisher, year, edition, pages
New York: CRC Press, 2022 Edition: 1
Series
Handbook of Nuclear Medicine and Molecular Imaging for Physicists
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-192767 (URN)10.1201/9780429489501-13 (DOI)9781138593312 (ISBN)9781032059563 (ISBN)9780429489501 (ISBN)
Available from: 2022-02-26 Created: 2022-02-26 Last updated: 2022-06-22Bibliographically approved
Bäckström, D. C., Granåsen, G., Jakobson Mo, S., Riklund, K., Trupp, M., Zetterberg, H., . . . Eriksson Domellöf, M. (2022). Prediction and early biomarkers of cognitive decline in Parkinson disease and atypical parkinsonism: a population-based study. Brain Communications, 4(2)
Open this publication in new window or tab >>Prediction and early biomarkers of cognitive decline in Parkinson disease and atypical parkinsonism: a population-based study
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2022 (English)In: Brain Communications, E-ISSN 2632-1297, Vol. 4, no 2Article in journal (Refereed) Published
Abstract [en]

The progression of cognitive decline is heterogeneous in the three most common idiopathic parkinsonian diseases: Parkinson disease, multiple system atrophy and progressive supranuclear palsy. The causes for this heterogeneity are not fully understood, and there are no validated biomarkers that can accurately identify patients who will develop dementia and when. In this population-based, prospective study, comprehensive neuropsychological testing was performed repeatedly in new-onset, idiopathic parkinsonism. Dementia was diagnosed until 10 years and participants (N = 210) were deeply phenotyped by multimodal clinical, biochemical, genetic and brain imaging measures. At baseline, before the start of dopaminergic treatment, mild cognitive impairment was prevalent in 43.4% of the patients with Parkinson disease, 23.1% of the patients with multiple system atrophy and 77.8% of the patients with progressive supranuclear palsy. Longitudinally, all three diseases had a higher incidence of cognitive decline compared with healthy controls, but the types and severity of cognitive dysfunctions differed. In Parkinson disease, psychomotor speed and attention showed signs of improvement after dopaminergic treatment, while no such improvement was seen in other diseases. The 10-year cumulative probability of dementia was 54% in Parkinson disease and 71% in progressive supranuclear palsy, while there were no cases of dementia in multiple system atrophy. An easy-to-use, multivariable model that predicts the risk of dementia in Parkinson disease within 10 years with high accuracy (area under the curve: 0.86, P < 0.001) was developed. The optimized model adds CSF biomarkers to four easily measurable clinical features at baseline (mild cognitive impairment, olfactory function, motor disease severity and age). The model demonstrates a highly variable but predictable risk of dementia in Parkinson disease, e.g. a 9% risk within 10 years in a patient with normal cognition and CSF amyloid-β42 in the highest tertile, compared with an 85% risk in a patient with mild cognitive impairment and CSF amyloid-β42 in the lowest tertile. Only small or no associations with cognitive decline were found for factors that could be easily modifiable (such as thyroid dysfunction). Risk factors for cognitive decline in multiple system atrophy and progressive supranuclear palsy included signs of systemic inflammation and eye movement abnormalities. The predictive model has high accuracy in Parkinson disease and might be used for the selection of patients into clinical trials or as an aid to improve the prevention of dementia. 

Place, publisher, year, edition, pages
Oxford University Press, 2022
Keywords
cognitive decline, dementia, Parkinson disease, multiple system atrophy, progressive supranuclear palsy
National Category
Neurology
Research subject
Neurology
Identifiers
urn:nbn:se:umu:diva-196241 (URN)10.1093/braincomms/fcac040 (DOI)000773021800001 ()35350553 (PubMedID)2-s2.0-85137588604 (Scopus ID)
Funder
Umeå UniversityRegion VästerbottenKnut and Alice Wallenberg FoundationSwedish Research Council, 2018-02532Familjen Erling-Perssons Stiftelse, FO2019-0228Familjen Erling-Perssons Stiftelse, 860197
Available from: 2022-06-10 Created: 2022-06-10 Last updated: 2022-09-26Bibliographically approved
Jakobson Mo, S., Axelsson, J., Jonasson, L. S. & Riklund, K. (2022). Validation of dynamic [18F]FE-PE2I PET for estimation of relative regional cerebral blood flow: a comparison with [15O]H2O PET. EJNMMI Research, 12(1), Article ID 72.
Open this publication in new window or tab >>Validation of dynamic [18F]FE-PE2I PET for estimation of relative regional cerebral blood flow: a comparison with [15O]H2O PET
2022 (English)In: EJNMMI Research, E-ISSN 2191-219X, Vol. 12, no 1, article id 72Article in journal (Refereed) Published
Abstract [en]

Background: Dopamine transporter (DAT) imaging is used in the diagnostic work-up in suspected parkinsonian syndromes and dementia with Lewy bodies but cannot differentiate between these syndromes, and an extra brain imaging examination of the regional cerebral blood flow (rCBF) or glucose metabolism is often needed for differential diagnosis. The requirement of two different imaging examinations is resource-consuming and inconvenient for the patients. Therefore, imaging of both cortical blood flow and DAT imaging with the same radiotracer would be more convenient and cost-effective. The aim of this study was to test whether relative regional cerebral blood flow (rCBFR) can be measured with the DAT-specific positron emission tomography (PET) tracer [18F]FE-PE2I (FE-PE2I), by validation with cerebral perfusion measured with [15O]H2O PET (H2O).

Methods: The rCBFR was quantified by kinetic modeling for FE-PE2I (R1) and H2O (F). The R1 was calculated using the simplified reference tissue model, and F was calculated with a modified Koopman double-integration method. The linear relationship and intraclass correlation (ICC) between R1 and F were tested in image data derived from 29 patients with recent onset parkinsonism and 30 healthy controls.

Results: There was a strong linear correlation across all subjects between R1 and F in the frontal, parietal, temporal, cingulate and occipital cortex as well as in the striatum (r ≥ 0.731–0.905, p < 0.001) with a good-to-excellent ICC, ranging from 0.727 to 0.943 (p < 0.001).

Conclusions: Our results suggest that FE-PE2I may be used as a proxy for cerebral perfusion, thus potentially serving as a radiotracer for assessment of both DAT availability and rCBFR in one single dynamic scan. This could be valuable in the differential diagnosis of parkinsonian syndromes.

Trial registration: EUDRA-CT 2015-003045-26. Registered 23 October 2015 https://www.clinicaltrialsregister.eu/ctr-search/search?query=2015-003045-26

Place, publisher, year, edition, pages
Springer Science+Business Media B.V., 2022
Keywords
15O H2O, 18F FE-PE2, Cerebral blood flow, Cerebral perfusion, Parkinsonian syndromes, Parkinsonism, Positron emission tomography
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-201365 (URN)10.1186/s13550-022-00941-8 (DOI)000886120800001 ()2-s2.0-85142139428 (Scopus ID)
Funder
Region VästerbottenParkinsonfonden
Available from: 2022-12-01 Created: 2022-12-01 Last updated: 2023-09-05Bibliographically approved
Jakobson Mo, S., Axelsson, J., J. Stiernman, L., Larsson, A., af Bjerkén, S., Bäckström, D. C., . . . Riklund, K. (2022). VNTR polymorphism in the SLC6A3 gene does not influence dopamine transporter availability measured by [18F]FE-PE2I PET or [123I]FP-Cit SPECT. Nuclear medicine communications, 43(3), 247-255
Open this publication in new window or tab >>VNTR polymorphism in the SLC6A3 gene does not influence dopamine transporter availability measured by [18F]FE-PE2I PET or [123I]FP-Cit SPECT
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2022 (English)In: Nuclear medicine communications, ISSN 0143-3636, E-ISSN 1473-5628, Vol. 43, no 3, p. 247-255Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To investigate the potential impact of polymorphism in the 3'-untranslated region (3'UTR) of the SLC6A3 gene (DAT1) on normal variation in dopamine transporter (DAT) imaging with [18F]FE-PE2I PET and [123I]FP-Cit SPECT.

METHODS: Thirty-six individuals (mean age 70.4±5.4 years) with normal [18F]FE-PE2I PET and [123I]FP-Cit SPECT were genotyped for variable number of tandem repeats (VNTR) in the 3′UTR of the DAT1 gene. The DAT-availability in the caudate and putamen as measured with [18F]FE-PE2I PET and [123I]FP-Cit SPECT, as well as in the substantia nigra with [18F]FE-PE2I PET were compared between the participants carrying one or two 9-repeat alleles (i.e. 9R+10R or 9R+9R; 47%) and the participants without a 9R allele (i.e. 10R+10R or 10R+11R; 53%). Nonparametric tests, linear regression analysis and mixed model analysis were used to assess any statistical difference in measured DAT availability between the two allele groups.

RESULTS: The measured DAT-availability in PET- and SPECT-imaging tended to be slightly higher in the 9R-group; however, the difference did not reach statistical significance in either the caudate or the putamen or the substantia nigra. Instead, age did have a significant effect on the DAT level (P < 0.05) notwithstanding the genotype.

CONCLUSION: No significant effect of DAT1-genotype was detectable in imaging with [18F]FE-PE2I PET or [123I]FP-Cit, instead, age accounted for the normal variation in DAT-PET and DAT-SPECT.

Place, publisher, year, edition, pages
Wolters Kluwer, 2022
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-192638 (URN)10.1097/MNM.0000000000001514 (DOI)000753310600001 ()34908018 (PubMedID)2-s2.0-85124443503 (Scopus ID)
Funder
Region VästerbottenParkinsonfonden
Available from: 2022-02-22 Created: 2022-02-22 Last updated: 2023-05-24Bibliographically approved
Flygare, L., Al-Ubaedi, A., Öhman, W. & Jakobson Mo, S. (2020). Distant metastases and synchronous malignancies on FDG-PET/CT in patients with head and neck cancer: a retrospective study. Acta Radiologica, 61(9), 1196-1204
Open this publication in new window or tab >>Distant metastases and synchronous malignancies on FDG-PET/CT in patients with head and neck cancer: a retrospective study
2020 (English)In: Acta Radiologica, ISSN 0284-1851, E-ISSN 1600-0455, Vol. 61, no 9, p. 1196-1204Article in journal (Refereed) Published
Abstract [en]

Background: Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) has been proven to be a good method to detect distant spread of head and neck cancer (HNC). However, most prior studies are based on Asian populations and may not be directly transferable to western populations.

Purpose: To investigate the frequency and distribution of distant metastases and synchronous malignancies detected by PET/CT in HNC in a northern Swedish population.

Material and Methods: All primary whole-body FDG-PET/CT examinations performed on the suspicion of HNC (n = 524 patients) between 1 January 2013 and 31 December 2016 at Umeå University Hospital in Sweden were retrospectively reviewed . After the exclusion of 189 examinations without evidence of primary HNC, 335 examinations were analyzed.

Results: Distant metastases were detected in 10 (3%) patients, all with advanced primary tumors corresponding to TNM stage 3–4, most frequently in salivary gland adenocarcinoma, where 50% of patients had distant spread. Four patients had metastases below the diaphragm, representing 20% of the salivary gland malignancies. In the remaining six patients, metastases were supraphrenic, of which all but one were identified by CT alone. Synchronous malignancies were discovered in 14 (4.2%) patients, of which five were below the diaphragm.

Conclusion: The overall frequency of distant spread and synchronous malignancy in primary HNC was generally low. However, the risk for distant metastases below the diaphragm was relatively higher in salivary gland adenocarcinoma, supporting whole-body FDG-PET/CT in the primary diagnostic work-up in these patients.

Place, publisher, year, edition, pages
Sage Publications, 2020
Keywords
Head and neck cancer, metastases, synchronous neoplasms, PET-CT, 18F-FDG
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-167605 (URN)10.1177/0284185119896344 (DOI)000507208700001 ()31902218 (PubMedID)2-s2.0-85077542542 (Scopus ID)
Available from: 2020-02-25 Created: 2020-02-25 Last updated: 2023-03-24Bibliographically approved
Bäckström, D. C., Linder, J., Jakobson Mo, S., Riklund, K., Zetterberg, H., Blennow, K., . . . Lenfeldt, N. (2020). NfL as a biomarker for neurodegeneration and survival in Parkinson disease. Neurology, 95(7), e827-e838
Open this publication in new window or tab >>NfL as a biomarker for neurodegeneration and survival in Parkinson disease
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2020 (English)In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 95, no 7, p. e827-e838Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To determine whether neurofilament light chain protein in CSF (cNfL), a sensitive biomarker of neuroaxonal damage, reflects disease severity or can predict survival in Parkinson disease (PD).

METHODS: We investigated whether disease severity, phenotype, or survival in patients with new-onset PD correlates with cNfL concentrations around the time of diagnosis in the population-based New Parkinsonism in Umeå (NYPUM) study cohort (n = 99). A second, larger new-onset PD cohort (n = 194) was used for independent validation. Association of brain pathology with the cNfL concentration was examined with striatal dopamine transporter imaging and repeated diffusion tensor imaging at baseline and 1 and 3 years.

RESULTS: Higher cNfL in the early phase of PD was associated with greater severity of all cardinal motor symptoms except tremor in both cohorts and with shorter survival and impaired olfaction. cNfL concentrations above the median of 903 ng/L conferred an overall 5.8 times increased hazard of death during follow-up. After adjustment for age and sex, higher cNfL correlated with striatal dopamine transporter uptake deficits and lower fractional anisotropy in diffusion tensor imaging of several axonal tracts.

CONCLUSIONS: cNfL shows usefulness as a biomarker of disease severity and to predict survival in PD. The present results indicate that the cNfL concentration reflects the intensity of the neurodegenerative process, which could be important in future clinical trials.

CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that in patients with PD, cNfL concentrations are associated with more severe disease and shorter survival.

Place, publisher, year, edition, pages
Wolters Kluwer, 2020
National Category
Neurology
Research subject
Neurology
Identifiers
urn:nbn:se:umu:diva-178856 (URN)10.1212/WNL.0000000000010084 (DOI)000619277100005 ()32680941 (PubMedID)2-s2.0-85089787234 (Scopus ID)
Available from: 2021-02-09 Created: 2021-02-09 Last updated: 2023-09-05Bibliographically approved
Jakobson Mo, S., Axelsson, J., Jonasson, L., Larsson, A., Ögren, M. J., Ögren, M., . . . Riklund, K. (2018). Dopamine transporter imaging with [18F]FE-PE2I PET and [123I]FP-CIT SPECT – a clinical comparison. EJNMMI Research, 8, Article ID 100.
Open this publication in new window or tab >>Dopamine transporter imaging with [18F]FE-PE2I PET and [123I]FP-CIT SPECT – a clinical comparison
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2018 (English)In: EJNMMI Research, E-ISSN 2191-219X, Vol. 8, article id 100Article in journal (Refereed) Published
Abstract [en]

Background: Dopamine transporter (DAT) imaging may be of diagnostic value in patients with clinically suspected parkinsonian disease. The purpose of this study was to compare the diagnostic performance of DAT imaging with positron emission computed tomography (PET), using the recently developed, highly DAT-selective radiopharmaceutical [18F]FE-PE2I (FE-PE2I), to the commercially available and frequently used method with [123I]FP-CIT (FP-CIT) single-photon emission computed tomography (SPECT) in early-stage idiopathic parkinsonian syndrome (PS).

Methods: Twenty-two patients with a clinical de novo diagnosis of PS and 28 healthy controls (HC) participating in an on-going clinical trial of FE-PE2I were analyzed in this study. Within the trial protocol, participants are clinically reassessed 2 years after inclusion. A commercially available software was used for automatic calculation of FP-CIT-specific uptake ratio (SUR). MRI-based volumes of interest combined with threshold PET segmentation were used for FE-PE2I binding potential relative to non-displaceable binding (BPND) quantification and specific uptake value ratios (SUVR).

Results: PET with FE-PE2I revealed significant differences between patients with a clinical de novo diagnosis of PS and healthy controls in striatal DAT availability (p < 0.001), with excellent accuracy of predicting dopaminergic deficit in early-stage PS. The effect sizes were calculated for FE-PE2I BPND (Glass’s Δ = 2.95), FE-PE2I SUVR (Glass’s Δ = 2.57), and FP-CIT SUR (Glass’s Δ = 2.29). The intraclass correlation (ICC) between FE-PE2I BPND FP-CIT SUR was high in the caudate (ICC = 0.923), putamen (ICC = 0.922), and striatum (ICC = 0.946), p < 0.001. Five of the 22 patients displayed preserved striatal DAT availability in the striatum with both methods. At follow-up, a non-PS clinical diagnosis was confirmed in three of these, while one was clinically diagnosed with corticobasal syndrome. In these patients, FE-PE2I binding was also normal in the substantia nigra (SN), while significantly reduced in the remaining patients. FE-PE2I measurement of the mean DAT availability in the putamen was strongly correlated with BPND in the SN (R = 0.816, p < 0.001). Olfaction and mean putamen DAT availability was correlated using both FE-PE2I BPND and FP-CIT SUR (R ≥ 0.616, p < 0.001).

Conclusion: DAT imaging with FE-PE2I PET yields excellent basic diagnostic differentiation in early-stage PS, at least as good as FP-CIT SPECT.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Parkinson's disease, PET, SPECT, Dopamine transporter (DAT), [F-18]FE-PE2I
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-154944 (URN)10.1186/s13550-018-0450-0 (DOI)000450488800002 ()30443684 (PubMedID)2-s2.0-85056664892 (Scopus ID)
Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2023-03-24Bibliographically approved
Bäckström, D., Granåsen, G., Eriksson Domellöf, M., Linder, J., Jakobson Mo, S., Riklund, K., . . . Forsgren, L. (2018). Early predictors of mortality in parkinsonism and Parkinson disease: A population-based study. Neurology, 91(22), E2045-E2056
Open this publication in new window or tab >>Early predictors of mortality in parkinsonism and Parkinson disease: A population-based study
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2018 (English)In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 91, no 22, p. E2045-E2056Article in journal (Refereed) Published
Abstract [en]

Objective To examine mortality and associated risk factors, including possible effects of mild cognitive impairment, imaging, and CSF abnormalities, in a community-based population with incident parkinsonism and Parkinson disease. Methods One hundred eighty-two patients with new-onset, idiopathic parkinsonism were diagnosed from January 2004 through April 2009, in a catchment area of 142,000 inhabitants in Sweden. Patients were comprehensively investigated according to a multimodal research protocol and followed prospectively for up to 13.5 years. A total of 109 patients died. Mortality rates in the general Swedish population were used to calculate standardized mortality ratio and expected survival, and Cox proportional hazard models were used to investigate independent predictors of mortality. Results The standardized mortality ratio for all patients was 1.84 (95% confidence interval 1.50-2.22, p < 0.001). Patients with atypical parkinsonism (multiple system atrophy or progressive supranuclear palsy) had the highest mortality. In early Parkinson disease, a mild cognitive impairment diagnosis, freezing of gait, hyposmia, reduced dopamine transporter activity in the caudate, and elevated leukocytes in the CSF were significantly associated with shorter survival. Conclusion Although patients presenting with idiopathic parkinsonism have reduced survival, the survival is highly dependent on the type and characteristics of the parkinsonian disorder. Patients with Parkinson disease presenting with normal cognitive function seem to have a largely normal life expectancy. The finding of a subtle CSF leukocytosis in patients with Parkinson disease with short survival may have clinical implications.

Place, publisher, year, edition, pages
Wolters Kluwer, 2018
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-154849 (URN)10.1212/WNL.0000000000006576 (DOI)000452519500002 ()30381367 (PubMedID)2-s2.0-85057199126 (Scopus ID)
Available from: 2019-01-04 Created: 2019-01-04 Last updated: 2023-03-24Bibliographically approved
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