Patterns of dopamine transporter imaging in subtypes of multiple system atrophy
Patterns of dopamine transporter imaging in subtypes of multiple system atrophy
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DOI：
10.1111/ane.12932
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发表时间：
2018-08-01
影响因子：
3.5
通讯作者：
Wang, J.
中科院分区：
文献类型：
--
作者：
Bu, L. -L.;Liu, F. -T.;Wang, J.
目的：根据帕金森亚型 (MSA-P) 和小脑亚型 (MSA-C) 的临床变异，通过 (11) C-N-2-甲甲氧基-3-(4-氟苯基)-托烷 (C-11-CFT) 正电子发射，研究多系统萎缩 (MSA) 队列中纹状体（尾状核和壳核）多巴胺转运蛋白 (DAT) 丢失模式的差异断层扫描 (PET) 成像。材料和方法：106 名受试者（41 名可能患有 MSA-P 的患者；40 名可能患有 MSA-C 的患者；25 名健康对照）接受了 C-11-CFT PET。分别计算双侧尾核、前壳核和后壳核的次区域 C-11-CFT 摄取，以测量纹状体多巴胺能功能。结果：与正常对照相比，MSA-C 和 MSA-P 患者纹状体中 DAT 结合显着减少（所有区域，MSA-C 与对照，P < .0001；MSA-P 与对照，P < .0001）。 MSA-P 患者的 DAT 减少比 MSA-C 患者更明显（所有区域，P < .0001）。 40 名 MSA-C 患者中有 11 名没有表现出 DAT 丢失，而所有 MSA-P 患者中纹状体 DAT 丢失都很明显。与 MSA-C 患者相比，MSA-P 亚型显示出更明显的 DAT 丢失前后梯度和更不对称的多巴胺能功能障碍。结论：本文研究的 MSA 亚型显示出纹状体黑质变性的显着不同的空间/解剖模式，这可能有助于深入了解其疾病病理生理学。具体来说，MSA-P 患者表现出不均匀且更明显的多巴胺神经支配丧失，而 MSA-C 患者则表现出相对均匀的模式。此外，纹状体中 DAT C-11-CFT 结合的典型减少并不存在于所有 MSA-C 患者中，少数病例显示出正常的 DAT 结合。
Objectives: To investigate the differences in the pattern of striatal (caudate and putamen) dopamine transporter (DAT) loss in a multiple system atrophy (MSA) cohort, based on the clinical variants parkinsonian subtype (MSA-P) and cerebellar subtype (MSA-C) via (11) C-N-2-carbomethoxy-3-(4-fluorophenyl)-tropane (C-11-CFT) positron emission tomography (PET) imaging.Materials and Methods: One hundred and six subjects (forty-one patients with probable MSA-P; forty patients with probable MSA-C; twenty-five healthy controls) underwent C-11-CFT PET. Subregional C-11-CFT uptake of bilateral caudate, anterior putamen, and posterior putamen was calculated respectively to measure the striatal dopaminergic function.Results: Significant decrease in DAT binding in striatum was revealed in patients with MSA-C and MSA-P compared to normal controls (all regions, MSA-C vs controls, P < .0001; MSA-P vs controls, P < .0001). DAT reduction was more pronounced in MSA-P patients than that in MSA-C patients (all regions, P < .0001). Eleven of forty MSA-C patients displayed no DAT loss, whereas striatal DAT loss was evident in all MSA-P patients. MSA-P subtype showed a more obvious anteroposterior gradient of DAT loss and more asymmetric dopaminergic dysfunction compared to MSA-C patients.Conclusion: The subtypes of MSA studied here show significantly different spatial/anatomic patterns of striatonigral degeneration which may provide insights into their disease pathophysiology. Specifically, MSA-P patients exhibit an uneven and much greater pronounced loss of dopamine innervation, while a relatively uniform pattern is revealed in patients with the MSA-C. Furthermore, the typical reduction in DAT C-11-CFT binding in striatum is not present in all MSA-C patients, with a minority of cases showing normal DAT binding.