Striatal Dopamine Deficit and Motor Impairment in Idiopathic Normal Pressure Hydrocephalus
Striatal Dopamine Deficit and Motor Impairment in Idiopathic Normal Pressure Hydrocephalus
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DOI：
10.1002/mds.28366
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发表时间：
2020-11-05
影响因子：
8.6
通讯作者：
Pacchetti, Claudio
中科院分区：
文献类型：
--
作者：
Pozzi, Nicolo Gabriele;Brumberg, Joachim;Pacchetti, Claudio
背景特发性正常压力脑积水可表现为帕金森综合征。然而，纹状体多巴胺再吸收转运蛋白的异常尚不清楚。目的探讨特发性正常压力脑积水患者与帕金森病（PD）患者和健康对照者相比，纹状体多巴胺能缺陷的存在和特征。方法我们调查了50名特发性正常压力脑积水患者、25名PD患者和40名健康对照者。所有参与者均接受[I-123]-N-omega-fluoropropyl-2 beta-carbomethoxy-3 beta-（4-iodophenyl）nortropane和单光子发射计算机断层扫描，以量化纹状体多巴胺再摄取转运蛋白结合。所有患有特发性正常压力脑积水的受试者均接受左旋多巴（l-dopa）激发试验和磁共振成像，以评估脑室扩大和白色物质变化。步态，认知，平衡，并与特发性正常压力脑积水评定量表，帕金森症与运动障碍社会统一帕金森病评定量表的运动部分进行了评估。所有患者完成了为期2年的follow-up.Results的特发性正常压力脑积水患者的功能，纹状体多巴胺再摄取转运蛋白结合，这与帕金森综合征的严重程度，但不与功能的脑室扩大或白色物质的变化，共62%。不像PD，这多巴胺能赤字在特发性正常压力脑积水是更对称和突出的尾状核。结论主题与特发性正常压力脑积水可以提出一个减少纹状体多巴胺再摄取转运蛋白结合，这是一致的帕金森氏症的严重程度和定性不同，发现在PD患者。需要纵向干预研究来证明纹状体多巴胺再摄取转运蛋白缺陷在特发性正常压力脑积水的病理生理学中的作用。(c)2020国际帕金森和运动障碍协会
Background Idiopathic normal pressure hydrocephalus can present with parkinsonism. However, abnormalities of the striatal dopamine reuptake transporter are unclear.Objectives To explore presence and features of striatal dopaminergic deficit in subjects with idiopathic normal pressure hydrocephalus as compared to Parkinson's disease (PD) patients and healthy controls.Methods We investigated 50 subjects with idiopathic normal pressure hydrocephalus, 25 with PD, and 40 healthy controls. All participants underwent [I-123]-N-omega-fluoropropyl-2 beta-carbomethoxy-3 beta-(4-iodophenyl)nortropane and single-photon emission computed tomography to quantify the striatal dopamine reuptake transporter binding. All subjects with idiopathic normal pressure hydrocephalus underwent a levodopa (l-dopa) challenge test and magnetic resonance imaging to evaluate ventriculomegaly and white matter changes. Gait, cognition, balance, and continence were assessed with the Idiopathic Normal Pressure Hydrocephalus Rating Scale, and parkinsonism with the motor section of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale. All patients completed a 2-year follow-up.Results A total of 62% of patients with idiopathic normal pressure hydrocephalus featured a reduced striatal dopamine reuptake transporter binding, which correlated with the severity of parkinsonism but not with features of ventriculomegaly or white matter changes. Unlike PD, this dopaminergic deficit in idiopathic normal pressure hydrocephalus was more symmetric and prominent in the caudate nucleus.Conclusions Subjects with idiopathic normal pressure hydrocephalus can present a reduction of striatal dopamine reuptake transporter binding, which is consistent with the severity of parkinsonism and qualitatively differs from that found in PD patients. Longitudinal interventional studies are needed to prove a role for striatal dopamine reuptake transporter deficit in the pathophysiology of idiopathic normal pressure hydrocephalus. (c) 2020 International Parkinson and Movement Disorder Society