Investigating the role of 99mTc-TRODAT-1 SPECT imaging in idiopathic Parkinson’s disease

Abstract

Abstract:Objective: To investigate the role of 99m Tc-TRODAT-1 SPECT in diagnosis and assessing severity of idiopathic Parkinson's disease (PD). Methods: Thirty-eight patients with primary, tentative diagnosis of PD and eighteen age-matched normal controls were studied with 99m Tc-TRODAT-1 SPECT imaging. The regions of interests (ROIs) were drawn manually on cerebellum (CB), occipital cortex (OC) and three transverse plane slice-views of striatums, the semiquantitative BG (background)/[(OC+CB)/2] were then calculated. Results: A lower uptake of 99m Tc-TRODAT-1 in striatums were displayed in thirty-six out of thirty-eight PD patients by visual inspection, compared to controls. In twenty-four PD cases with HYS (Hoehn and Yahr scale) stage I, a greater loss of DAT uptake was found in striatum and its subregions contralateral striatum to the affected limbs than in the same regions of the controls, although the striatal uptake was bilaterally reduced. Using Spearman correlation analysis showed that the reduction of the uptake ratios significantly correlated with the UPDRS in striatum and all its subregions in the PD group (P<0.05), a similar change was also found in the putamen by using the rating scale of Hoehn and Yahr (P<0.05). However, analysis of variance (ANOVA) did not show any relationship between the decreasing uptake of 99m Tc-TRODAT-1 and increasing severity of PD patients, although the specific uptake of 99m Tc-TRODAT-1 was continuously decreased in the striatum by visual inspection with the progress of PD from HYS stage I to III. Conclusion:99m Tc-TRODAT-1 SPECT imaging may serve as a useful method for improving the correct diagnosis of PD. In assessing the role of 99m Tc-TRODAT-1 SPECT in disease severity of PD, UPDRS can offer a comprehensive index, although the Hoehn and Yahr assessment may be available in part.

Three cases of delusional parasitosis caused by dopamine agonists

“… 5 suggested that the increased levels of extracellular dopamine found in the striatum of patients with DP is due to decreased striatal dopamine transporter (DAT) functioning and not due to increased rates of release. Their hypothesis is supported by evidence of DAT inhibitors such as cocaine and amphetamine derivatives inducing DP, and of evidence of decreased striatal DAT functioning in secondary causes of DP such as PD 6 …”

“…Their hypothesis is supported by evidence of DAT inhibitors such as cocaine and amphetamine derivatives inducing DP, and of evidence of decreased striatal DAT functioning in secondary causes of DP such as PD. 6 Dopaminergic neurones encode for the 'salience' or importance of environmental stimuli. In conditions such as PD or schizophrenia, in which dopamine is dysregulated, aberrant salience is assigned to normal stimuli, which then leads onto delusion formation.…”

Avaliação quantitativa e qualitativa da densidade de transportadores pré-sinápticos de Dopamina em pacientes saudáveis e em portadores de Doença de Parkinson: um estudo de SPECT com [99mTc]-TRODAT-1

“…Vários autores relatam que a progressão nos estádios de HYS correlaciona-se com o declínio motor e com a deterioração da qualidade de vida (BHIDAYASIRI;TARSY, 2012;SCHENKMAN et al, 2001). Por sua vez, estudos de neuroimagem frequentemente sugerem que a redução de potenciais de ligação do corpo estriado e nas subregiões significantemente se correlacionam com a gravidade da doença, representada pela HYS e pela gravidade dos sintomas motores estabelecida pela escala UPDRS (ASENBAUM et al, 1997;GENG et al, 2005;HUANG et al, 2004;…”

Parkinson’s disease in China: a forty-year growing track of bedside work

“…Besides rapid eye movement sleep behavior disorder, constipation and hyposmia, clinical biomarkers are paid attention by Chinese neurologists. Radiological methods, such as 99m Tc-TRODAT-1 single photon emission computed tomography (SPECT) [63], 18 F-fluorodeoxyglucose positron emission tomography imaging ( 18 F-FDG-PET) [64], functional magnetic resonance imaging [65] and Iodine-123-meta-iodobenzylguanidine ( 131 I-MIBG) [66] have been put into use. The combinations of several biomarkers in PD have been set up, such as the combination of ‘swallow-tail’ sign and putaminal hypointensity [67].…”