Educational level and its association with dopamine transporter loss in patients with Parkinson's disease

Merle C Hoenig; Verena Dzialas; Magdalena Banwinkler; Adrian Asendorf; Alexander Drzezga; Thilo van Eimeren

doi:10.1016/j.parkreldis.2023.105844

Educational level and its association with dopamine transporter loss in patients with Parkinson's disease

Parkinsonism Relat Disord. 2023 Oct:115:105844. doi: 10.1016/j.parkreldis.2023.105844. Epub 2023 Sep 5.

Authors

Merle C Hoenig¹, Verena Dzialas², Magdalena Banwinkler², Adrian Asendorf², Alexander Drzezga³, Thilo van Eimeren²

Affiliations

¹ Research Center Juelich, Institute of Neuroscience and Medicine II, Molecular Organization of the Brain, Juelich, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Cologne, Germany. Electronic address: m.hoenig@fz-juelich.de.
² University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Cologne, Germany.
³ Research Center Juelich, Institute of Neuroscience and Medicine II, Molecular Organization of the Brain, Juelich, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Cologne, Germany; German Center for Neurodegenerative Diseases, Bonn/Cologne, Germany.

PMID: 37690218
DOI: 10.1016/j.parkreldis.2023.105844

Abstract

Background: According to the cognitive-reserve concept, higher educated dementia patients tolerate more brain pathology than lower educated patients with similar impairment. Here, we examined whether higher education is associated with more severe dopamine terminal loss at the diagnosis of Parkinson's disease (PD).

Methods: Dopamine transporter (DaT) SPECT information of 352 de novo PD patients and 172 healthy controls (HC) were retrieved from PPMI. Correlation analyses were performed between education years and regional DaT signal (i.e., putamen, caudate, striatum), correcting for UPDRS-III, age, sex and MoCA. Second, using a median split on education (Md = 16 yrs), high and low education groups were determined, which were matched for demographic and/or clinical scores and compared based on regional DaT signals. Finally, moderation analyses were conducted in the PD cohort, assessing the effect of education on the relation between putaminal DaT capacity and UPDRS-III. All analyses were performed across the entire cohorts and separately for three age ranges (sixth, seventh and eighth life decade).

Results: Only PD patients in their eighth life decade presented a positive association between education and regional dopamine signalling. A significant moderation effect of education on the association between putaminal DaT signal loss and motor symptom severity was observed in this group (B=3.377, t=3.075, p = .003). The remaining analyses did not yield any significant results, neither in the PD nor HC cohort.

Conclusion: Higher education is not related with greater tolerance against dopamine loss in PD, but may nonetheless assert protective effects at more advanced age.