{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T01:37:47Z","timestamp":1780623467753,"version":"3.54.1"},"reference-count":40,"publisher":"SAGE Publications","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPD"],"published-print":{"date-parts":[[2021,8,2]]},"abstract":"<jats:p>Background: Orthostatic hypotension (OH) may antedate Parkinson\u2019s 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 (PD\u200a+\u200aOH). 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 PD\u200a+\u200aOH 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 PD\u200a+\u200aOH patients were contrasted with non-OH patients in this study. Conclusion: Cerebral blood flow was elevated in patients with early PD\u200a+\u200aOH. This finding suggests augmented cerebral perfusion in PD\u200a+\u200aOH might be a compensatory regulation in response to chronic OH.<\/jats:p>","DOI":"10.3233\/jpd-212596","type":"journal-article","created":{"date-parts":[[2021,5,21]],"date-time":"2021-05-21T13:23:25Z","timestamp":1621603405000},"page":"1335-1344","source":"Crossref","is-referenced-by-count":11,"title":["Paradoxical Cerebral Perfusion in Parkinson\u2019s Disease Patients with Orthostatic Hypotension: A Dual-Phase 18F-Florbetaben Positron Emission Tomography Study"],"prefix":"10.1177","volume":"11","author":[{"given":"Sang-Won","family":"Yoo","sequence":"first","affiliation":[{"name":"Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seunggyun","family":"Ha","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine, Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyukjin","family":"Yoon","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine, Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Yeon","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwang-Soo","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joong-Seok","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","reference":[{"key":"10.3233\/JPD-212596_ref1","doi-asserted-by":"crossref","first-page":"e1526","DOI":"10.1212\/WNL.0000000000008314","article-title":"Orthostatic hypotension in Parkinson disease: A 7-year prospective population-based study","volume":"93","author":"Hiorth","year":"2019","journal-title":"Neurology"},{"key":"10.3233\/JPD-212596_ref2","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/S1474-4422(14)70287-X","article-title":"Prediagnostic presentations of Parkinson\u2019s disease in primary care: A case-control study","volume":"14","author":"Schrag","year":"2015","journal-title":"Lancet Neurol"},{"key":"10.3233\/JPD-212596_ref3","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1016\/j.parkreldis.2015.10.018","article-title":"Cerebral autoregulation and white matter lesions in Parkinson\u2019s disease and multiple system atrophy","volume":"21","author":"Indelicato","year":"2015","journal-title":"Parkinsonism Relat Disord"},{"key":"10.3233\/JPD-212596_ref4","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1002\/mds.27867","article-title":"Pathological influences on clinical heterogeneity in Lewy body diseases","volume":"35","author":"Coughlin","year":"2020","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-212596_ref5","doi-asserted-by":"crossref","first-page":"1300","DOI":"10.1007\/s00259-016-3393-6","article-title":"Dual-phase amyloid PET: Hitting two birds with one stone","volume":"43","author":"Valentina","year":"2016","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"10.3233\/JPD-212596_ref6","doi-asserted-by":"crossref","first-page":"23","DOI":"10.2967\/jnumed.116.183152","article-title":"Metabolic imaging in Parkinson disease","volume":"58","author":"Meles","year":"2017","journal-title":"J Nucl Med"},{"key":"10.3233\/JPD-212596_ref7","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s40035-017-0076-6","article-title":"Imaging biomarkers in Parkinson\u2019s disease and Parkinsonian syndromes: Current and emerging concepts","volume":"6","author":"Saeed","year":"2017","journal-title":"Transl Neurodegener"},{"key":"10.3233\/JPD-212596_ref8","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.nicl.2016.10.005","article-title":"Evaluation of early-phase [(18)F]-florbetaben PET acquisition in clinical routine cases","volume":"14","author":"Daerr","year":"2017","journal-title":"Neuroimage Clin"},{"key":"10.3233\/JPD-212596_ref9","doi-asserted-by":"crossref","first-page":"e8","DOI":"10.1097\/RLU.0000000000002768","article-title":"Early-phase 18F-Florbetaben PET as an alternative modality for 18F-FDG PET","volume":"45","author":"Son","year":"2020","journal-title":"Clin Nucl Med"},{"key":"10.3233\/JPD-212596_ref10","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1136\/jnnp.51.6.745","article-title":"The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson\u2019s disease","volume":"51","author":"Gibb","year":"1988","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"10.3233\/JPD-212596_ref11","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1002\/mds.26424","article-title":"MDS clinical diagnostic criteria for Parkinson\u2019s disease","volume":"30","author":"Postuma","year":"2015","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-212596_ref12","unstructured":"Fahn S , Elton RL , Members of the UPDRS Development Committee (1987) Unified Parkinson\u2019s disease rating scale. In Fahn S, Marsden CD, Calne DB, Leiberman A, eds. Florham Park: Health Care Information, NJ, pp. 157\u2013163."},{"key":"10.3233\/JPD-212596_ref13","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1212\/WNL.17.5.427","article-title":"Parkinsonism: Onset, progression and mortality","volume":"17","author":"Hoehn","year":"1967","journal-title":"Neurology"},{"key":"10.3233\/JPD-212596_ref14","unstructured":"Kang Y , Jahng S , Na DL (2012) Seoul Neuropsychological Screening Battery, 2nd Edition (SNSB-II). Human Brain Research & Consulting Co., Seoul."},{"key":"10.3233\/JPD-212596_ref15","doi-asserted-by":"crossref","first-page":"137","DOI":"10.12779\/dnd.2015.14.4.137","article-title":"Constructing a composite score for the Seoul neuropsychological screening battery-core","volume":"14","author":"Jahng","year":"2015","journal-title":"Dement Neurocogn Disord"},{"key":"10.3233\/JPD-212596_ref16","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s10286-011-0119-5","article-title":"Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome","volume":"21","author":"Freeman","year":"2011","journal-title":"Clin Auton Res"},{"key":"10.3233\/JPD-212596_ref17","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1097\/RLU.0000000000002424","article-title":"Initial versus follow-up sequential myocardial 123I-MIBG scintigraphy to discriminate Parkinson disease from atypical Parkinsonian syndromes","volume":"44","author":"Ryu","year":"2019","journal-title":"Clin Nucl Med"},{"key":"10.3233\/JPD-212596_ref18","doi-asserted-by":"crossref","first-page":"116189","DOI":"10.1016\/j.neuroimage.2019.116189","article-title":"Automated anatomical labeling atlas 3","volume":"206","author":"Rolls","year":"2020","journal-title":"Neuroimage"},{"key":"10.3233\/JPD-212596_ref19","first-page":"B4466","article-title":"Perfusion and metabolism imaging studies in Parkinson\u2019s disease","volume":"59","author":"Borghammer","year":"2012","journal-title":"Dan Med J"},{"key":"10.3233\/JPD-212596_ref20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jalz.2014.07.003","article-title":"The Centiloid Project: Standardizing quantitative amyloid plaque estimation by PET","volume":"11","author":"Klunk","year":"2015","journal-title":"Alzheimers Dement"},{"key":"10.3233\/JPD-212596_ref21","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1016\/j.jalz.2015.02.004","article-title":"Florbetaben PET imaging to detect amyloid beta plaques in Alzheimer\u2019s disease: Phase 3 study","volume":"11","author":"Sabri","year":"2015","journal-title":"Alzheimers Dement"},{"key":"10.3233\/JPD-212596_ref22","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1093\/brain\/awv104","article-title":"Parkinson\u2019s disease dementia: A neural networks perspective","volume":"138","author":"Gratwicke","year":"2015","journal-title":"Brain"},{"key":"10.3233\/JPD-212596_ref23","doi-asserted-by":"crossref","unstructured":"Benarroch EE , Cutsforth-Gregory JK , Flemming KD (2017) Mayo clinic medical neurosciences: Organized by neurologic system and level. Oxford University Press, Oxford.","DOI":"10.1093\/med\/9780190209407.001.0001"},{"key":"10.3233\/JPD-212596_ref24","unstructured":"Mtui E , Gruener G , Dockery P (2015) Fitzgerald\u2019s Clinical Neuroanatomy and Neuroscience. Elsevier Health Sciences, New York."},{"key":"10.3233\/JPD-212596_ref25","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/j.nbd.2011.10.025","article-title":"Cardiovascular dysautonomia in Parkinson disease: From pathophysiology to pathogenesis","volume":"46","author":"Jain","year":"2012","journal-title":"Neurobiol Dis"},{"key":"10.3233\/JPD-212596_ref26","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1016\/S1474-4422(16)30079-5","article-title":"Neurogenic orthostatic hypotension and supine hypertension in Parkinson\u2019s disease and related synucleinopathies: Prioritisation of treatment targets","volume":"15","author":"Espay","year":"2016","journal-title":"Lancet Neurol"},{"key":"10.3233\/JPD-212596_ref27","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1093\/bjaceaccp\/mkt001","article-title":"Cerebral physiology","volume":"13","author":"Tameem","year":"2013","journal-title":"Cont Educ Anaesth Crit Care Pain"},{"key":"10.3233\/JPD-212596_ref28","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/S1474-4422(12)70291-0","article-title":"Tracking pathophysiological processes in Alzheimer\u2019s disease: An updated hypothetical model of dynamic biomarkers","volume":"12","author":"Jack","year":"2013","journal-title":"Lancet Neurol"},{"key":"10.3233\/JPD-212596_ref29","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.3233\/JAD-180522","article-title":"Dual Time-Point [18F]Florbetaben PET delivers dual biomarker information in mild cognitive impairment and Alzheimer\u2019s disease","volume":"66","author":"Florek","year":"2018","journal-title":"J Alzheimers Dis"},{"key":"10.3233\/JPD-212596_ref30","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/S0197-4580(00)00111-1","article-title":"Critically attained threshold of cerebral hypoperfusion: The CATCH hypothesis of Alzheimer\u2019s pathogenesis","volume":"21","author":"de la Torre","year":"2000","journal-title":"Neurobiol Aging"},{"key":"10.3233\/JPD-212596_ref31","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1001\/jamaneurol.2013.217","article-title":"Blood pressure and progression of brain atrophy: The SMART-MR Study","volume":"70","author":"Jochemsen","year":"2013","journal-title":"JAMA Neurol"},{"key":"10.3233\/JPD-212596_ref32","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1093\/brain\/awu043","article-title":"Association of brain amyloid-beta with cerebral perfusion and structure in Alzheimer\u2019s disease and mild cognitive impairment","volume":"137","author":"Mattsson","year":"2014","journal-title":"Brain"},{"key":"10.3233\/JPD-212596_ref33","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1002\/mds.25857","article-title":"The neurobiological basis of cognitive impairment in Parkinson\u2019s disease","volume":"29","author":"Halliday","year":"2014","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-212596_ref34","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/s00441-017-2649-1","article-title":"Locus coeruleus","volume":"373","author":"Benarroch","year":"2018","journal-title":"Cell Tissue Res"},{"key":"10.3233\/JPD-212596_ref35","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1093\/brain\/awx348","article-title":"Evaluation of the noradrenergic system in Parkinson\u2019s disease: An 11C-MeNER PET and neuromelanin MRI study","volume":"141","author":"Sommerauer","year":"2018","journal-title":"Brain"},{"key":"10.3233\/JPD-212596_ref36","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1038\/nrn2573","article-title":"The locus coeruleus and noradrenergic modulation of cognition","volume":"10","author":"Sara","year":"2009","journal-title":"Nat Rev Neurosci"},{"key":"10.3233\/JPD-212596_ref37","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1136\/jnnp-2015-312690","article-title":"Presence of cerebral amyloid modulates phenotype and pattern of neurodegeneration in early Parkinson\u2019s disease","volume":"87","author":"McMillan","year":"2016","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"10.3233\/JPD-212596_ref38","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1002\/mds.26510","article-title":"Nonmotor features of Parkinson\u2019s disease subtypes","volume":"31","author":"Marras","year":"2016","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-212596_ref39","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1212\/WNL.0000000000002086","article-title":"Survival in synucleinopathies: A prospective cohort study","volume":"85","author":"Goldstein","year":"2015","journal-title":"Neurology"},{"key":"10.3233\/JPD-212596_ref40","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1001\/jamaneurol.2015.0703","article-title":"New clinical subtypes of Parkinson disease and their longitudinal progression: A prospective cohort comparison with other phenotypes","volume":"72","author":"Fereshtehnejad","year":"2015","journal-title":"JAMA Neurol"}],"container-title":["Journal of Parkinson's Disease"],"original-title":[],"link":[{"URL":"https:\/\/content.iospress.com\/download?id=10.3233\/JPD-212596","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T04:49:58Z","timestamp":1777610998000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.3233\/JPD-212596"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,2]]},"references-count":40,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3233\/jpd-212596","relation":{},"ISSN":["1877-7171","1877-718X"],"issn-type":[{"value":"1877-7171","type":"print"},{"value":"1877-718X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,2]]}}}