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Among a number of good choices, given active interest on details of Parkinson Disease (PD) and its treatment, Labrador-Espinosa and colleagues' “Levodopa-Induced Dyskinesia in Parkinson Disease Specifically Associates With Dopaminergic Depletion in Sensorimotor-Related Functional Subregions of the Striatum" stands out. In seeking to determine to determine whether the development of levodopa-induced dyskinesia (LID) in Parkinson disease is specifically related to dopaminergic depletion in sensorimotor-related subregions of the striatum.

The investigators retrospectively analyzed 123I-FP-CIT SPECT imaging 185 patients with PD of which 73 (40%) developed LID. They quantitated the specific dopamine transporter (DAT) binding ratio within distinct functionally defined striatal subregions related to limbic, executive, and sensorimotor systems. Regional DAT level differences were compared between patients who developed LID (PD + LID) and those who did not (PD-LID) using analysis of covariance models controlled for demographic and clinical features. For validation of the findings and assessment. They compared this with serial 123I-FP-CIT SPECT data from 343 de novo PD patients enrolled in the Parkinson Progression Marker's Initiative using mixed linear model analysis.

Compared with PD-LID, DAT level reductions in PD + LID patients were greatest in the sensorimotor striatal subregion (F = 5.99, P = 0.016) and also significant in the executive-related subregion (F = 5.30, P = 0.023). In the Parkinson Progression Marker's Initiative cohort, DAT levels in PD + LID (n = 161, 47%) were only significantly reduced compared with PD-LID in the sensorimotor striatal subregion (t = −2.05, P = 0.041). This difference was already present at baseline and remained largely constant over time.

The authors concluded that measuring DAT depletion in functionally defined sensorimotor-related striatal regions of interest may be more sensitive for detecting LID-associated dopaminergic changes at an early disease stage and that this could improve individual outcomes in this common clinical complication in PD.​

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