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Imaging of dopamine transporters and D2 receptors in patients with Parkinson’s disease and multiple system atrophy

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to ascertain whether combined presynaptic and postsynaptic dopaminergic single-photon emission computed tomography (SPECT) scanning is useful for differentiation between patients with idiopathic Parkinson’s disease (IPD), patients with multiple system atrophy of the striatonigral type (MSA) and healthy subjects.

Methods

SPECT measurements of the dopamine transporter (DAT) were done with 123I-β-CIT, while for determination of the dopamine D2-like receptors (D2), 123I-epidepride was used. Clinical evaluation and SPECT scans were carried out in 14 patients with IPD, eight patients with MSA and 11 healthy age-matched control subjects.

Results

Putaminal DAT binding was reduced to 32% of control values in IPD and to 19% of control values in MSA . Significantly higher striatal asymmetry in DAT binding was found in MSA than in controls, but IPD patients had significantly higher asymmetry than MSA patients. Striatal D2 binding did not differ significantly between patients and healthy controls but the ratio between caudate DAT and D2 binding was significantly higher in patients with IPD than in those with MSA, even when disease severity was taken into account.

Conclusion

Patients with reduced striatal 123I-β-CIT binding and a side-to-side difference greater than 15% are likely to suffer from IPD. Patients with reduced striatal 123I-β-CIT binding and a side-to-side difference of between 5% and 15% are more likely to have MSA. 123I-epidepride SPECT measurements may add further diagnostic information, since the ratio between DAT and D2 receptor binding is significantly higher in IPD than in MSA.

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References

  1. Osaki Y, Ben-Shlomo Y, Wenning GK, et al. Do published criteria improve clinical diagnostic accuracy in multiple system atrophy? Neurology 2002;59:1486–91.

    CAS  PubMed  Google Scholar 

  2. Schrag A, Good CD, Miszkiel K, et al. Differentiation of atypical parkinsonian syndromes with routine MRI. Neurology 2000;54:697–702.

    CAS  PubMed  Google Scholar 

  3. Yekhlef F, Ballan G, Macia F, Delmer O, Sourgen C, Tison F. Routine MRI for the differential diagnosis of Parkinson’s disease, MSA, PSP, and CBD. J Neural Transm 2003;110:151–69.

    Article  CAS  PubMed  Google Scholar 

  4. Marek K, Innis R, van Dyck C, et al. [123I]β-CIT SPECT imaging assessment of the rate of Parkinson’s disease progression. Neurology 2001;57:2089–94.

    CAS  PubMed  Google Scholar 

  5. Ghaemi M, Hilker R, Rudolf J, Sobesky J, Heiss W-D. Differentiating multiple system atrophy from Parkinson’s disease: contribution of striatal and midbrain MRI volumetry and multi-tracer PET imaging. J Neurol Neurosurg Psychiatry 2002;73:517–23.

    Article  CAS  PubMed  Google Scholar 

  6. Kim YJ, Ichise M, Ballinger JR, et al. Combination of dopamine transporter and D2 receptor SPECT in the diagnostic evaluation of PD, MSA, and PSP. Mov Disord 2002;17:303–12.

    Article  PubMed  Google Scholar 

  7. Gilman S, Low PA, Quinn N, et al. Consensus statement on the diagnosis of multiple system atrophy. J Neurol Sci 1999;163:94–8.

    Article  CAS  PubMed  Google Scholar 

  8. Jernigan TL, Archibald SL, Fennema-Notestine C, Gamst AC, Stout JC, Bonner J, Hesselink JR. Effects of age on tissues and regions of the cerebrum and cerebellum. Neurobiol Aging 2001;22:581–94.

    Article  CAS  PubMed  Google Scholar 

  9. Laruelle M, Wallace E, Seibyl JP, et al. Graphical, kinetic, and equilibrium analyses of in vivo [123I] (-CIT binding to dopamine transporters in healthy human subjects. J Cereb Blood Flow Metab 1994;14:982–94.

    CAS  PubMed  Google Scholar 

  10. Pinborg LH, Videbaek C, Knudsen GM, Swahn C-G, Halldin C, Paulson OB, Lassen NA. Dopamine D2 receptor quantification in extrastriatal brain regions using [123I]epidepride with bolus/infusion. Synapse 2000;36:322–9.

    Article  CAS  PubMed  Google Scholar 

  11. Varrone A, Marek KL, Jennings D, Innis RB, Seibyl JP. [123I]β-CIT SPECT imaging demonstrates reduced density of striatal dopamine transporters in Parkinson’s disease and multiple system atrophy. Mov Disord 2001;16:1023–32.

    Article  CAS  PubMed  Google Scholar 

  12. Brücke T, Asenbaum S, Pirker W, et al. Measurement of the dopaminergic degeneration in Parkinson’s disease with [123I]β-CIT and SPECT. J Neural Transm 1997;50(Suppl):9–24.

  13. van Dyck CH, Seibyl JP, Malison RT, et al. Age-related decline in dopamine transporters: analysis of striatal subregions, nonlinear effects, and hemispheric asymmetries. Am J Geriatr Psychiatry 2002;10:36–43.

    Article  PubMed  Google Scholar 

  14. Pirker W, Asenbaum S, Bencsits G, et al. [123I](-CIT SPECT in multiple system atrophy, progressive supranuclear palsy, and corticobasal degeneration. Mov Disord 2000;15:1158–67.

    Article  CAS  PubMed  Google Scholar 

  15. Antonini A, Schwarz J, Oertel WH, Pogarell O, Leenders KL. Long-term changes of striatal dopamine D2 receptors in patients with Parkinson’s disease: a study with positron emission tomography and [11C]raclopride. Mov Disord 1997;12:33–8.

    CAS  PubMed  Google Scholar 

  16. Ichise M, Kim YJ, Ballinger JR, et al. SPECT imaging of pre- and postsynaptic dopaminergic alterations in l-dopa-untreated PD. Neurology 1999;52:1206–14.

    CAS  PubMed  Google Scholar 

  17. Brooks DJ, Ibanez V, Sawle GV, et al. Striatal D2 receptor status in Parkinson’s disease, striatonigral degeneration, and progressive supranuclear palsy, measured with 11C-raclopride and PET. Ann Neurol 1992;31:184–92.

    CAS  PubMed  Google Scholar 

  18. Schulz JB, Klockgether T, Petersen D, et al. Multiple system atrophy: natural history, MRI morphology, and dopamine receptor imaging with 123IBZM-SPECT. J Neurol Neurosurg Psychiatry 1994;57:1047–56.

    CAS  PubMed  Google Scholar 

  19. Innis RB, Marek KL, Sheff K, et al. Effect of treatment with l-dopa/carbidopa or l-selegiline on striatal dopamine transporter SPECT imaging with [123I]β-CIT. Mov Disord 1999;14:436–42.

    Article  CAS  PubMed  Google Scholar 

  20. Guttman M, Stewart D, Hussey D, Wilson A, Houle S, Kish S. Influence of l-dopa and pramipexole on striatal dopamine transporter in early PD. Neurology 2001;56:1559–64.

    CAS  PubMed  Google Scholar 

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Acknowledgements

This study was supported by The 1991 Pharmacy Foundation, The Health Insurance Fund, The Lundbeck Foundation, the Danish Medical Union’s Research Foundation, the Danish Parkinson’s Society and the Danish Research Council.

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Authors and Affiliations

  1. Neurobiology Research Unit 9201, Department of Neurology, University Hospital Rigshospitalet, 9 Blegdamsvej, 2100, Copenhagen, Denmark

    G. M. Knudsen, G. Thomsen, T. Nygaard & C. Videbæk

  2. Department of Neurology, Bispebjerg University Hospital, Copenhagen, Denmark

    M. Karlsborg, L. Regeur & L. Werdelin

  3. Department of MR, Hvidovre University Hospital, Copenhagen, Denmark

    K. Krabbe

Authors
  1. G. M. Knudsen
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  2. M. Karlsborg
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  3. G. Thomsen
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  4. K. Krabbe
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  5. L. Regeur
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  6. T. Nygaard
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  7. C. Videbæk
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  8. L. Werdelin
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Correspondence to G. M. Knudsen.

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Knudsen, G.M., Karlsborg, M., Thomsen, G. et al. Imaging of dopamine transporters and D2 receptors in patients with Parkinson’s disease and multiple system atrophy. Eur J Nucl Med Mol Imaging 31, 1631–1638 (2004). https://doi.org/10.1007/s00259-004-1578-x

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  • DOI: https://doi.org/10.1007/s00259-004-1578-x

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