[123I]β-CIT SPECT is a useful method for monitoring dopaminergic degeneration in early stage Parkinson’s disease
[123I]β-CIT SPECT is a useful method for monitoring dopaminergic degeneration in early stage Parkinson’s disease
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DOI：
10.1136/jnnp.74.3.294
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发表时间：
2003-03
期刊：
影响因子：
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通讯作者：
A. Winogrodzka;P. Bergmans;Jan Booij;E. V. Royen;J. C. Stoof;Erik Ch Wolters
中科院分区：
文献类型：
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作者：
A. Winogrodzka;P. Bergmans;Jan Booij;E. V. Royen;J. C. Stoof;Erik Ch Wolters
目的：探讨[123I]β-CIT SPECT监测帕金森病多巴胺能变性进展的有效性；探讨d2受体激动剂短期治疗对纹状体[123I]β-CIT结合的影响；并确定证明一种假定的神经保护剂的显著效果所需的SPECT成像的样本量和频率。方法：对50例早期帕金森病患者进行检查。两次SPECT成像序列，间隔12个月。以纹状体、壳核和尾状核结合特异性与非特异性[123I]β-CIT比值的平均年变化作为结局指标。结果：两幅图像之间的[123I]β-CIT结合比率在所有感兴趣的区域都有所下降。[123I]β-CIT结合率在整个纹状体中平均下降8%，在壳层区下降8%，在尾状体区下降4%。对比9名患者在两种不同条件下（关闭状态和药物治疗）的扫描结果，使用[123I]β-CIT SPECT测量纹状体多巴胺转运体的表达没有显著变化。功效分析表明，如果一种神经保护剂的功效为0.80，在两年内达到预期保护效果的30%，那么在整个壳核测量效果时，每组需要216例患者才能检测出显著（p < 0.05）的疗效。结论：[123I]β-CIT SPECT似乎是研究帕金森病多巴胺能变性进展的有用工具，并可能提供客观的方法来衡量神经保护治疗的有效性。短期使用多巴胺激动剂治疗对[123I]β-CIT与多巴胺转运体的结合没有显著影响。如果后一项发现在更大的患者群体中得到重复，则支持[123I]β-CIT SPECT用于检查接受d2受体激动剂治疗的患者神经退行性疾病进展的适用性。
Objectives:To examine the validity of [123I]β-CIT SPECT for monitoring the progression of dopaminergic degeneration in Parkinson’s disease; to investigate the influence of short term treatment with D2receptor agonists on striatal [123I]β-CIT binding; and to determine the sample size and frequency of SPECT imaging required to demonstrate a significant effect of a putative neuroprotective agent. Methods:A group of 50 early stage Parkinson’s disease patients was examined. Two SPECT imaging series were obtained, 12 months apart. The mean annual change in the ratio of specific to non-specific [123I]β-CIT binding to the striatum, putamen, and caudate nucleus was used as the outcome measure. Results:A decrease in [123I]β-CIT binding ratios between the two images was found in all regions of interest. The average decrease in [123I]β-CIT binding ratios was about 8% in the whole striatum, 8% in the putaminal region, and 4% in the caudate region. Comparison of scans done in nine patients under two different conditions—in the off state and while on drug treatment—showed no significant alterations in the expression of striatal dopamine transporters as measured using [123I]β-CIT SPECT. Power analysis indicated that to detect a significant (p < 0.05) effect of a neuroprotective agent with 0.80 power and 30% of predicted protection within two years, 216 patients are required in each group when the effects are measured in the whole putamen. Conclusions:[123I]β-CIT SPECT seems to be a useful tool to investigate the progression of dopaminergic degeneration in Parkinson’s disease and may provide an objective method of measuring the effectiveness of neuroprotective treatments. Short term treatment with a D2agonist does not have a significant influence on [123I]β-CIT binding to dopamine transporters. If the latter finding is replicated in larger groups of patients, it supports the suitability of [123I]β-CIT SPECT for examining the progression of neurodegeneration in patients being treated with D2receptor agonists.