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The new parkinson patient in Umeå (NYPUM) project is an ongoing (started in 2004) longitudinal population-based cohort study of incident patients with idiopathic parkinsonism, including Parkinson's disease (PD). The projects ambition is to identify all new cases with idiopathic parkinsonism within the Umeå catchment area (approximately 140 000 inhabitants), and follow them in their disease progression for at least five years. The included patients repeatedly undergo extensive investigations that engage many scientists in several disciplines from both preclinical- and clinical research. An important part of the versatile project is to investigate the evolvement of cognitive functioning in PD related to brain responses. Cognitive impairment is common in PD and many patients have mild cognitive impairment (MCI). The risk of developing PD-dementia is highly increased for patients with MCI compared to patients without MCI. Repeated examinations with functional MRI and single photon emission tomography (SPECT) are used to increase understanding of the functional basis of PD-pathology and cognitive impairment.
Key imaging findings within NYPUM include:

• De novo drug-naïve patients with PD demonstrated transient under recruitment in striatum (caudate and putamen) compared to healthy controls. The reported finding demonstrated that patients with PD had impaired phasic components of executive working-memory control subserved by the striatum (Marklund et al., 2009).

• In a cross-sectional study, early-phase PD-patients demonstrated extensive cortical working-memory related under-recruitments compared to healthy controls. Within the PD-group, PD-patients with MCI demonstrated additional under-recruitments in right caudate nucleus and bilateral anterior cingulate cortex (ACC) compared to PD-patients without MCI. Furthermore, the dopaminergic presynaptic uptake (SPECT) were lower in right caudate for patients with MCI compared to patients without MCI, and the presynaptic uptake correlated with the fMRI-signal (Ekman et al., 2012).

Urban Ekman



Involved UFBI-members: Lars Nyberg, Johan Eriksson, Urban Ekman, Katrine Åhlström Riklund,
Susanna Jakobson-Mo.

Involved partners:
PI Lars Forsgren