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Emerging Concepts of Motor Reserve in Parkinson’s Disease

Journal of Movement Disorders 2020년 13권 3호 p.171 ~ 184
정석종, 이재정, 이필휴, Sohn Young-H.,
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정석종 ( Chung Seok-Jong ) - Yonsei University College of Medicine Department of Neurology
이재정 ( Lee Jae-Jung ) - Inje University College of Medicine Ilsan Paik Hospital Department of Neurology
이필휴 ( Lee Phil-Hyu ) - Yonsei University College of Medicine Department of Neurology
 ( Sohn Young-H. ) - Yonsei University College of Medicine Department of Neurology

Abstract


The concept of cognitive reserve (CR) in Alzheimer’s disease (AD) explains the differences between individuals in their susceptibility to AD-related pathologies. An enhanced CR may lead to less cognitive deficits despite severe pathological lesions. Parkinson’s disease (PD) is also a common neurodegenerative disease and is mainly characterized by motor dysfunction related to striatal dopaminergic depletion. The degree of motor deficits in PD is closely correlated to the degree of dopamine depletion; however, significant individual variations still exist. Therefore, we hypothesized that the presence of motor reserve (MR) in PD explains the individual differences in motor deficits despite similar levels of striatal dopamine depletion. Since 2015, we have performed a series of studies investigating MR in de novo patients with PD using the data of initial clinical presentation and dopamine transporter PET scan. In this review, we summarized the results of these published studies. In particular, some premorbid experiences (i.e., physical activity and education) and modifiable factors (i.e., body mass index and white matter hyperintensity on brain image studies) could modulate an individual’s capacity to tolerate PD pathology, which can be maintained throughout disease progression.

키워드

Dopamine transporter; Motor reserve; Parkinson’s disease; Positron-emission tomography

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