Dopamine transporter imaging in progressive supranuclear palsy: Severe but nonspecific to subtypes

Abstract

Background Previous studies with a limited sample size suggested more severe dopaminergic transporter (DAT) lesions in the striatum of progressive supranuclear palsy (PSP) than those in Parkinson's disease (PD) and multiple system atrophy–parkinsonism (MSA‐P). However, few studies had taken various subtypes of PSP into consideration, making the reanalysis of DAT imaging in larger PSP cohort with various subtypes in need. Objectives To compare the dopaminergic lesion patterns of PSP with MSA‐P and PD, and to explore the specific striatal subregional patterns of different PSP subtypes. Methods 11C‐CFT positron emission tomography (PET) imaging was conducted in 83 PSP patients consisting of different subtypes, 61 patients with PD, 41 patients with MSA‐P, and 43 healthy volunteers. Demographic and clinical data were compared by the chi‐squared test or one‐way analysis of variance. A generalized linear model was used to examine intergroup differences in tracer uptake values after adjusting for age, disease duration, and disease severity. Areas under the receiver operating characteristic curve were calculated to assess the diagnostic accuracy of subregional DAT binding patterns. Results The patients with PSP presented more severe DAT loss in the striatum than in PD and MSA‐P, especially in caudate. In PSP, the subregional lesion was still more severe in putamen than in caudate, similar to that in PD and MSA‐P. Among detailed subtypes, no significant difference was detected. Conclusion The dopaminergic lesions were more severe in PSP, and no difference was detected among subtypes.

Striatal dopaminergic lesions contributed to the disease severity in progressive supranuclear palsy

“…Severe dopaminergic lesions in the striatum were common in PSP, as shown in the DAT PET imaging ( Yoo et al, 2018 ; Chen et al, 2022 ). For the first time, we reported the striatal dopaminergic dysfunctions in caudate and anterior putamen contributed to the disease severity in PSP, but not in posterior putamen.…”

“…For the first time, we reported the striatal dopaminergic dysfunctions in caudate and anterior putamen contributed to the disease severity in PSP, but not in posterior putamen. We previously reported that the lesions in posterior putamen were more prominent than caudate in PSP, reflecting specific degenerative patterns in Parkinsonism ( Chen et al, 2022 ). Pathologically, dopaminergic projections to the striatum were from different parts of substantial nigra, with putamen from ventral part and caudate from dorsal part ( Fearnley and Lees, 1991 ).…”

“…As an atypical Parkinsonism, the dopaminergic lesions in striatum have been widely reported in PSP ( Jin et al, 2013 ; Whitwell et al, 2017 ; Yoo et al, 2018 ; Chen et al, 2022 ). Compared with other tracers, the dopamine transporter (DAT) tracer represents the functional state of the dopaminergic system.…”

“…It’s widely accepted that dopaminergic dysfunction correlates closely with disease severity in Parkinson’s disease ( Liu et al, 2018 ) and atypical Parkinsonism like Multiple System Atrophy ( Lee et al, 2021 ). Given that severely decreased DAT bindings were found in both PSP-RS and PSP-non-RS subtypes ( Chen et al, 2022 ) and the contribution of the dopaminergic lesions to the disease severity in PSP has never been explored before, we conducted this cross-sectional study aiming to explore the contribution of dopaminergic lesions to the disease severity in PSP, with the DAT positron emission tomography (PET) imaging in a relatively large PSP cohort with various subtypes.…”

Correlations between cerebrospinal fluid homovanillic acid and dopamine transporter SPECT in degenerative parkinsonian syndromes

“…Moreover, the Southampton method, which we used in this study for the analysis of the striatal DAT binding, does not allow the analysis by separation of striatal subregions. It has been reported that the striatal DAT binding is lower in patients with PSP than in those with PD or MSA-P, especially in the caudate (Chen et al 2022 ; Kaasinen et al 2019 ). Future studies should consider evaluating the striatal DAT binding of each subregion separately and comparing the differences among each diagnosis.…”