Quantitative analysis of striatal dopamine D2 receptors with 123 I-iodolisuride SPECT in degenerative extrapyramidal diseases.

Abstract

123I-Iodolisuride has high specific affinity for binding on dopamine D2 receptors in the striatum and has been used in a few single photon emission computed tomography (SPECT) studies of extrapyramidal disorders. The diagnosis of Parkinson's disease (PD) is very difficult in the first 5 years of evolution, with 15-25% false positive diagnoses. The aim of this study was therefore to determine the value of iodolisuride SPECT in discriminating Parkinson's from the most frequent Parkinson-plus syndromes (PPS). Seventeen patients with an extrapyramidal syndrome had a SPECT examination 1 h after injection of 180-185 MBq of 123I-iodolisuride. They were followed under dopaminergic treatment for at least 2 years. After 2 years, they were separated in two groups according to specific clinical criteria and sensitivity to dopaminergic treatment: nine patients had PD (age = 59.8+/-8.8 years; Hoehn and Yahr = 1.8+/-0.7; evolution = 4.3+/-3 years) and eight had PPS (age = 71.6+/-7.3 years; Hoehn and Yahr = 2.9+/-2.0; evolution = 4.1+/-1.5 years). The binding potential of iodolisuride in the striatum was assessed by considering the striatum (S)/occipital lobe (O) ratio at the pseudo-equilibrium 1 h after injection. The S/O ratio was statistically different between PD and PPS (1.97+/-0.3 vs. 1.65+/-0.2 (P<0.02)). Iodolisuride SPECT could differentiate both groups with a sensitivity of 88.8% and a specificity of 75%. Iodolisuride is a good specific D2 receptor ligand for SPECT and complements specific clinical criteria for the diagnosis of Parkinson's disease and differentiation between different extrapyramidal disorders.

• Authors: C Prunier, F Tranquart, J P Cottier, B Giraudeau, S Chalon, D Guilloteau, B De Toffol, F Chossat, A Autret, J C Besnard, J L Baulieu
• Journal: Nuclear medicine communications (Nucl Med Commun) Vol. 22 Issue 11 Pg. 1207-14 (Nov 2001) ISSN: 0143-3636 [Print] England
• PMID: 11606886 (Publication Type: Journal Article)

Chemical References

• Iodine Radioisotopes
• Receptors, Dopamine D2
• iodolisuride
• Lisuride

Topics

• Aged
• Aged, 80 and over
• Basal Ganglia Diseases (diagnostic imaging)
• Corpus Striatum (diagnostic imaging)
• Diagnosis, Differential
• False Positive Reactions
• Female
• Humans
• Iodine Radioisotopes (pharmacokinetics)
• Lisuride (analogs & derivatives, pharmacokinetics)
• Male
• Middle Aged
• Multiple System Atrophy (diagnostic imaging)
• Neurodegenerative Diseases (diagnostic imaging)
• Parkinson Disease (diagnostic imaging)
• Parkinsonian Disorders (diagnostic imaging)
• Receptors, Dopamine D2 (analysis)
• Supranuclear Palsy, Progressive (diagnostic imaging)
• Tomography, Emission-Computed, Single-Photon