Positron emission tomography (PET) is a useful technique for the consecutive investigation of the relationship between changes in neurotransmission
biomarkers and behavioral signs in animal models of
Parkinson's disease (PD). In this study, we aimed to investigate the threshold of
dopamine (DA) neuron damage for the appearance of
tremor by observing the longitudinal changes of pre- and post-synaptic DA
biomarkers in awake monkeys using PET with multiple tracers. Three cynomolgus monkeys were treated with
MPTP every 3-6 weeks until
tremor was observed. Brain uptake of [
11C]PE2I, [beta-11C]
DOPA, and [11C]
raclopride for DA transporter (DAT),
DOPA utilization, and DA D2 receptor were measured using PET as a single set in awake condition. Sets of PET scans were repeated in parallel with continuous behavioral estimation. The pre-synaptic
biomarkers of DA neuron in the striatum decreased [
11C]PE2I binding and [beta-11C]
DOPA uptake in an
MPTP dose-dependent manner.
Tremor was not observed until striatal [
11C]PE2I binding was reduced to about 15% of the pretreatment level and [beta-11C]
DOPA uptake was reduced to about 34%. DA D2 receptor measured by [11C]
raclopride was not significantly changed throughout the experiment. Our results revealed that it is possible to quantitatively define the threshold of the onset of behavioral PD signs by monitoring spontaneous motor activity, and in vivo PET with DAT marker can be a
biomarker for early diagnosis at the presymptomatic stage of PD and for high-risk groups.