Dopaminergic dysfunction and psychiatric symptoms in movement disorders: a 123I-FP-CIT SPECT study.

Abstract

PURPOSE:

Psychiatric symptoms frequently occur in patients with movement disorders. They are not a mere reaction to chronic disability, but most likely due to a combination of psychosocial factors and biochemical dysfunction underlying the movement disorder. We assessed dopamine transporter (DAT) availability by means of (123)I-FP-CIT SPECT, and motor and psychiatric features in patients with Parkinson's disease, primary dystonia and essential tremor, exploring the association between SPECT findings and symptom severity.

METHODS:

Enrolled in the study were 21 patients with Parkinson's disease, 14 patients with primary dystonia and 15 patients with essential tremor. The severity of depression symptoms was assessed using the Hamilton depression rating scale, anxiety levels using the Hamilton anxiety rating scale and hedonic tone impairment using the Snaith-Hamilton pleasure scale. Specific (123)I-FP-CIT binding in the caudate and putamen was calculated based on ROI analysis. The control group included 17 healthy subjects.

RESULTS:

As expected, DAT availability was significantly decreased in patients with Parkinson's disease, whereas in essential tremor and dystonia patients it did not differ from that observed in the control group. In Parkinson's disease patients, an inverse correlation between severity of depression symptoms and DAT availability in the left caudate was found (r = -0.63, p = 0.002). In essential tremor patients, levels of anxiety symptoms were inversely correlated with DAT availability in the left caudate (r = -0.69, p = 0.004). In dystonia patients, the severities of both anxiety and depression symptoms were inversely associated with DAT availability in the left putamen (r = -0.71, p = 0.004, and r = -0.75, p = 0.002, respectively). There were no correlations between psychometric scores and (123)I-FP-CIT uptake ratios in healthy subjects.

CONCLUSION:

We found association between presynaptic dopaminergic function and affective symptoms in different movement disorders. Interestingly, the inverse correlation was present in each group of patients, supporting the fascinating perspective that common subcortical substrates may be involved in both anxiety and depression dimensions and movement disorders.

• Authors: Daniela Di Giuda, Giovanni Camardese, Anna Rita Bentivoglio, Fabrizio Cocciolillo, Arianna Guidubaldi, Lorella Pucci, Isabella Bruno, Luigi Janiri, Alessandro Giordano, Alfonso Fasano
• Journal: European journal of nuclear medicine and molecular imaging (Eur J Nucl Med Mol Imaging) Vol. 39 Issue 12 Pg. 1937-48 (Dec 2012) ISSN: 1619-7089 [Electronic] Germany
• PMID: 22976499 (Publication Type: Journal Article)

Chemical References

• Dopamine Plasma Membrane Transport Proteins
• Radiopharmaceuticals
• Tropanes
• 2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane

Topics

• Adult
• Aged
• Behavioral Symptoms (diagnostic imaging)
• Brain (diagnostic imaging)
• Case-Control Studies
• Dopamine Plasma Membrane Transport Proteins (analysis)
• Dystonia (diagnostic imaging)
• Female
• Humans
• Male
• Middle Aged
• Parkinson Disease (diagnostic imaging)
• Radiopharmaceuticals
• Tomography, Emission-Computed, Single-Photon
• Tremor (diagnostic imaging)
• Tropanes