Topography of dopamine transporter availability in progressive supranuclear palsy: a voxelwise [123I]beta-CIT SPECT analysis.

Abstract

BACKGROUND:

Dopaminergic loss can be visualized by means of iodine I 123-labeled 2beta-carbomethoxy-3beta-(4-iodophenyl)tropane ([(123)I]beta-CIT) single-photon emission computed tomography (SPECT) in several neurodegenerative parkinsonian disorders. Most previous SPECT studies have adopted region-of-interest methods for analysis, which are subjective and operator dependent.

OBJECTIVE:

To objectively localize the cerebral dopamine transporter status in the early stages of progressive supranuclear palsy (PSP).

DESIGN:

Prospective study.

SETTING:

Parkinson disease outpatient clinic.

PATIENTS:

Fourteen patients with PSP, 17 with Parkinson disease (PD), 15 with Parkinson-variant multiple-system atrophy (MSA-P), and 13 healthy control subjects, matched for age and disease duration.

INTERVENTIONS:

Statistical parametric mapping applied to [(123)I]beta-CIT SPECT.

MAIN OUTCOME MEASURES:

Differences in [(123)I]beta-CIT uptake.

RESULTS:

All patients with the different parkinsonian disorders showed a significant decrease in striatal [(123)I]beta-CIT uptake without any overlap with the control group. In patients with MSA-P and PSP, an additional reduction in brainstem [(123)I]beta-CIT signal compared with controls and patients with PD was identified with statistical parametric mapping. Midbrain [(123)I]beta-CIT uptake discriminated atypical parkinsonian disorders from PD with an overall correct classification of 91.3%. On the other hand, [(123)I]beta-CIT SPECT failed to discriminate PSP and MSA-P.

CONCLUSION:

By applying statistical parametric mapping to [(123)I]beta-CIT SPECT images of patients with PSP, a widespread decline of monoaminergic transporter availability including the striatum and brainstem was localized in PSP, discriminating patients with PSP from patients with PD, but not from those with MSA-P. Quantification of midbrain dopamine transporter signal may therefore enhance the utility of SPECT imaging in the differential diagnosis of patients with parkinsonism.

• Authors: Klaus Seppi, Christoph Scherfler, Eveline Donnemiller, Irene Virgolini, Michael F H Schocke, Georg Goebel, Katherina J Mair, Sylvia Boesch, Christian Brenneis, Gregor K Wenning, Werner Poewe
• Journal: Archives of neurology (Arch Neurol) Vol. 63 Issue 8 Pg. 1154-60 (Aug 2006) ISSN: 0003-9942 [Print] United States
• PMID: 16908744 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Dopamine Plasma Membrane Transport Proteins
• Iodine Radioisotopes
• Radiopharmaceuticals
• 2beta-carbomethoxy-3beta-(4-iodophenyl)tropane
• Cocaine

Topics

• Aged
• Brain (diagnostic imaging, metabolism)
• Cocaine (analogs & derivatives, metabolism)
• Dopamine Plasma Membrane Transport Proteins (metabolism)
• Female
• Humans
• Iodine Radioisotopes
• Male
• Middle Aged
• Prospective Studies
• Radiopharmaceuticals
• Supranuclear Palsy, Progressive (diagnostic imaging, metabolism)
• Tomography, Emission-Computed, Single-Photon (methods)