Differences in [99mTc]TRODAT-1 SPECT binding to dopamine transporters in patients with multiple system atrophy and Parkinson's disease.

Division of Nuclear Medicine, 110 Donner Building, H.U.P., 3400 Spruce Street, Philadelphia, PA, 19104, USA.
European journal of nuclear medicine and molecular imaging (Impact Factor: 5.11). 03/2005; 32(3):302-7. DOI: 10.1007/s00259-004-1667-x
Source: PubMed

ABSTRACT Multiple system atrophy (MSA), a disorder causing autonomic dysfunction, parkinsonism, and cerebellar dysfunction, is difficult to differentiate from other movement disorders, particularly early in the course of disease. This study evaluated whether [99mTc]TRODAT-1 binding to the dopamine transporter differentiates MSA from other movement disorders.
Single-photon emission computed tomographic brain scans were acquired in 25 MSA patients, 48 age-matched controls, and 130 PD patients, 3 h after the injection of 740 MBq (20 mCi) of [99mTc]TRODAT-1. Regions of interest (ROIs) were placed manually on subregions of both basal ganglia and distribution volume ratios (DVRs) were calculated. Regional DVRs were compared between study groups in MSA patients. Student's t tests were used to compare MSA patients with other study groups. Spearman correlations were used to compare DVRs with NP measures.
Based upon various motor scores, MSA and PD patients had comparable motor impairment, and were significantly impaired compared with controls. Mean DVRs in the basal ganglia of MSA patients were significantly less than those of controls, but generally higher (p<0.05) than in PD patients. In particular, the MSA patients had significantly increased DVRs in the posterior putamen (mean 0.49+/-0.30) compared with PD patients (0.74+/-0.25).
Movement disorder patients could be differentiated from controls, but MSA and PD patients could not be easily differentiated from each other. As a group, MSA patients had significantly higher mean [99mTc]TRODAT-1 binding, particularly in the posterior putamen, compared with PD patients and significantly lower binding compared with controls. This may reflect different pathophysiological processes of the two neurodegenerative diseases.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Recent technologic advances make it increasingly possible to image neurotransmitter systems in living human brain, The dopamine system has been most intensively studied owing to its involvement in several brain disorders such as Parkinson's disease and Huntington's disease, as well as psychiatric disorders such as schizophrenia, depression, and compulsive behavioral disorders of multiple types. A variety of aspects of dopamine receptor density, function, and dopaminergic terminal status can now be assessed using the minimally invasive neuroimaging techniques of positron emission tomography and single-photon emission computed tomography. Although these techniques are currently used most often in the context of research, clinical applications are rapidly emerging.
    Neuroimaging Clinics of North America 12/2006; 16(4):553-73, vii-viii. · 1.20 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In this article the role of molecular imaging with SPECT and PET in patients with movement disorders is reviewed. It is mentioned that SPECT and PET imaging with cocaine analogues ((123)I-beta-CIT,(123)I-FP-CIT, (18)F-DOPA), radioligands labeling the presynaptic dopamine transporters, is of value for the differentiation of patients with PD or Parkinson-plus syndromes with individuals with essential tremor. In addition the clinical impact of this procedure, the role of molecular imaging in the preclinical diagnosis and in the follow-up of patients with PD, as well as, in the differential diagnosis between Alzheimer's disease and Lewy-body dementia, is evaluated. Finally, the clinical impact of (123)I-IBZM-SPECT imaging, a radiopharmaceutical which labels the postsynaptic D(2) receptors and the discrimination between idiopathic PD and Parkinson-plus syndromes (multiple system atrophy, progressive supranuclear palsy and corticobasal ganglia degeneration), is mentioned.
    Nuclear medicine review. Central & Eastern Europe: journal of Bulgarian, Czech, Macedonian, Polish, Romanian, Russian, Slovak, Yugoslav societies of nuclear medicine and Ukrainian Society of Radiology 02/2006; 9(2):147-53.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Olfactory dysfunction is an early 'pre-clinical' sign of Parkinson's disease (PD). The present review is a comprehensive and up-to-date assessment of such dysfunction in PD and related disorders. The olfactory bulb is implicated in the dysfunction, since only those syndromes with olfactory bulb pathology exhibit significant smell loss. The role of dopamine in the production of olfactory system pathology is enigmatic, as overexpression of dopaminergic cells within the bulb's glomerular layer is a common feature of PD and most animal models of PD. Damage to cholinergic, serotonergic, and noradrenergic systems is likely involved, since such damage is most marked in those diseases with the most smell loss. When compromised, these systems, which regulate microglial activity, can influence the induction of localized brain inflammation, oxidative damage, and cytosolic disruption of cellular processes. In monogenetic forms of PD, olfactory dysfunction is rarely observed in asymptomatic gene carriers, but is present in many of those that exhibit the motor phenotype. This suggests that such gene-related influences on olfaction, when present, take time to develop and depend upon additional factors, such as those from aging, other genes, formation of α-synuclein- and tau-related pathology, or lowered thresholds to oxidative stress from toxic insults. The limited data available suggest that the physiological determinants of the early changes in PD-related olfactory function are likely multifactorial and may include the same determinants as those responsible for a number of other non-motor symptoms of PD, such as dysautonomia and sleep disturbances.
    Neurobiology of Disease 12/2011; 46(3):527-52. · 5.62 Impact Factor

Full-text (2 Sources)

Available from
May 27, 2014