Combination of dopamine transporter and D2 receptor SPELT in the diagnostic evaluation of PD, MSA, and PSP
Combination of dopamine transporter and D2 receptor SPELT in the diagnostic evaluation of PD, MSA, and PSP
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DOI：
10.1002/mds.10042
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发表时间：
2002-03-01
影响因子：
8.6
通讯作者：
Lang, AE
中科院分区：
文献类型：
--
作者：
Kim, YJ;Ichise, M;Lang, AE
帕金森病（PD）、多系统萎缩（MSA）和进行性核上性麻痹（PSP）在临床上往往难以区分。这项工作的目的是调查是否结合突触前和突触后多巴胺能单光子发射计算机断层扫描（SPELT）扫描可以可靠地显示黑质纹状体多巴胺能系统的变化，并帮助区分正常对照，PD，MSA和PSP患者。我们进行了多巴胺转运蛋白（DAT）和多巴胺D2受体（D2）的SPELT评价。使用[I-123] β-CIT（DAT）和[I-123]IBF（D2）对18例PD患者（12例未接受过多巴治疗，6例接受过左旋多巴和/或多巴胺激动剂治疗）、7例纹状体黑质变性型MSA患者、6例PSP患者和29例正常对照者进行了SPELT扫描。抗帕金森病药物在扫描前至少停药12小时。在最严重运动症状的同侧和对侧的尾状核、前壳核和后壳核测量DAT和D2结合电位（Rv = V-3/V-2）。所有患者的后壳核DAT结合均显著减少。然而，D2结合在后壳核显着增加多巴未处理的PD，大于正常范围的4 12（33%），并显着降低MSA，低于正常范围的5 7（71%）。没有一个PD患者的后壳核D2结合低于正常范围。DAT结合的程度不能区分患者组。与对照组相比，后壳核与尾状核百分比D2 Rv的比值在PD或PSP和MSA之间显示出相反的模式; 18例PD中有16例尾状核较大，6例PSP中有6例尾状核较大，而7例MSA中有5例尾状核较小。这些研究结果表明，DAT SPELT可能是有用的区分帕金森综合征从控制和D2 SPELT进一步区分MSA帕金森病和可能的PSP。(C)2002运动障碍协会。
It is often difficult to differentiate clinically between Parkinson's disease (PD), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP). The objective of this work was to investigate whether combined pre- and postsynaptic dopaminergic single photon emission computed tomography (SPELT) scanning can reliably demonstrate changes in the nigrostriatal dopaminergic system and help differentiate between normal controls, PD, MSA, and PSP patients. We performed SPELT evaluation of the dopamine transporter (DAT) and dopamine D2 receptors (D2). SPELT scans using [I-123]beta-CIT (for DAT) and [I-123]IBF (for D2) were performed in 18 patients with PD (12 dopa-naive and 6 on levodopa and/or dopamine agonists), 7 with MSA of the striatonigral degeneration type, 6 with PSP, and 29 normal controls. Antiparkinsonian drugs were withheld for at least 12 hours before the scans. DAT and D2 binding potentials (Rv = V-3/V-2) were measured for caudate, anterior, and posterior putamen on the sides ipsilateral and contralateral to the worst motor symptotns. DAT binding in the posterior putamen was markedly reduced in all patients. However, D2 binding in posterior putamen was significantly increased in dopa-untreated PD, being greater than the normal range in 4 of 12 (33%), and it was significantly reduced in MSA, being below the normal range in 5 of 7 (71%). None of the patients with PD showed reduced D2 binding below the normal range in posterior putamen. The degree of DAT binding could not discriminate between the patient groups. The ratio of posterior putamen to caudate percentage D2 Rv compared with the controls showed an opposite pattern between PD or PSP and MSA; the caudate was greater in 16 of 18 with PD and 6 of 6 with PSP, whereas caudate was less in 5 of 7 with MSA. These findings suggest that DAT SPELT may be useful in differentiating parkinsonism from controls and D2 SPELT in further differentiating MSA from Parkinson's disease and possibly PSP. (C) 2002 Movement Disorder Society.