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. 2014 May 20;82(20):1791-7.
doi: 10.1212/WNL.0000000000000424. Epub 2014 Apr 23.

Longitudinal follow-up of SWEDD subjects in the PRECEPT Study

Kenneth Marek  1 , John Seibyl  2 , Shirley Eberly  2 , David Oakes  2 , Ira Shoulson  2 , Anthony E Lang  2 , Chris Hyson  2 , Danna Jennings  2 ; Parkinson Study Group PRECEPT Investigators
Affiliations

Longitudinal follow-up of SWEDD subjects in the PRECEPT Study

Kenneth Marek et al. Neurology. .

Abstract

Objective: To compare the clinical and imaging characteristics of those PRECEPT (Parkinson Research Examination of CEP-1347 Trial) subjects with a scan without evidence of dopaminergic deficit (SWEDD) to those with dopamine transporter (DAT) deficit scans at study baseline and during a 22-month follow-up.

Methods: Baseline (n = 799) and 22-month follow-up (n = 701) [(123)I] β-CIT SPECT scans were acquired. The percent change in [(123)I] β-CIT striatal binding ratio, the percentage of subjects requiring dopaminergic therapy, the change in Unified Parkinson's Disease Rating Scale (UPDRS) score, and the PRECEPT Study investigators' diagnosis at study termination were compared between SWEDD and DAT deficit subjects.

Results: SWEDD subjects (n = 91) compared with DAT deficit subjects (n = 708) showed reduced UPDRS score at baseline (18.7 [SD 8.5] vs 25.5 [SD 10.5], p < 0.05) and minimal change in both [(123)I] β-CIT striatal binding ratio (-0.2% [SD 12.2] vs -8.5% [SD 11.9], p < 0.0001) and UPDRS score (0.5 [SD 6.9] vs 10.5 [SD 8.9], p < 0.0001) at follow-up assessments. At PRECEPT termination, the diagnosis by study investigators was changed from Parkinson disease (PD) to other disorders not associated with DAT deficit in 44% (95% confidence interval 34.2, 54.7) of SWEDD subjects compared with 3.6% (95% confidence interval 2.3, 5.1) of DAT deficit subjects.

Conclusion: These results indicate that subjects identified as having a SWEDD, with DAT imaging within the normal range, have minimal evidence of clinical or imaging PD progression. These data strongly suggest that SWEDD subjects are unlikely to have idiopathic PD.

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Figures

Figure
Figure. Need for dopaminergic therapy in SWEDD and DAT deficit subjects
Kaplan-Meier curve showing the probability of disability requiring dopaminergic therapy in SWEDD and DAT deficit subjects during the PRECEPT Study. DAT = dopamine transporter; PRECEPT = Parkinson Research Examination of CEP-1347 Trial; SWEDD = scan without evidence of dopaminergic deficit.
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References

    1. Parkinson Study Group. Dopamine transporter brain imaging to assess the effects of pramipexole vs levodopa on Parkinson disease progression. JAMA 2002;287:1653–1661 - PubMed
    1. Parkinson Study Group. Levodopa and the progression of Parkinson's disease. N Engl J Med 2004;351:2498–2508 - PubMed
    1. Parkinson Study Group. Mixed lineage kinase inhibitor CEP-1347 fails to delay disability in early Parkinson disease. Neurology 2007;69:1480–1490 - PubMed
    1. Whone AL, Watts RL, Stoessl AJ, et al. Slower progression of Parkinson's disease with ropinirole versus levodopa: the REAL-PET Study. Ann Neurol 2003;54:93–101 - PubMed
    1. Marek K, Seibyl J; Parkinson Study Group. β-CIT scans without evidence of dopaminergic deficit (SWEDD) in the ELLDOPA-CIT and CALM-CIT Study: long-term imaging assessment. Neurology 2003;60(suppl 1):A298

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