[sup 123 I] beta-CIT/SPECT imaging demonstrates bilateral loss of dopamine transporters in hemi-Parkinson's disease

Abstract

We have used in vivo single-photon emission computed tomography (SPECT) of the dopamine transporter with 2 beta-carboxymethoxy-3 beta-(4-iodophenyl)tropane ([123I] beta-CIT) to investigate striatal dopamine transporter loss in patients with early Parkinson's disease (PD). Striatal uptake of ([123I] beta-CIT was compared in eight early-PD patients with exclusively hemi-parkinsonism and eight age- and sex-matched healthy subjects. [123I] beta-CIT striatal uptake was reduced by approximately 53% contralateral and by 38% ipsilateral to the clinically symptomatic side in the hemi-PD patients, compared with the mean striatal uptake in age- and sex-matched healthy subjects. The relative reduction in [123I] beta-CIT uptake in the hemi-PD patients was greater in the putamen than in the caudate. These data demonstrate that SPECT imaging of the dopamine transporter with [123I] beta-CIT can identify patients with PD at the onset of motor symptoms and suggest that this technique also may be useful in identifying individuals with developing dopaminergic pathology before onset of motor symptoms.

Direct comparison of FP-CIT SPECT and F-DOPA PET in patients with Parkinson’s disease and healthy controls

“…This implies that both methods can possibly also be used to identify patients in a preclinical phase of the disease. This has been confirmed by others [16,18,21].…”

“…SPECT imaging with FP-CIT produces a high target to background ratio. Several studies have demonstrated that striatal FP-CIT uptake is reduced in patients with PD compared to healthy controls [14][15][16][17][18][19][20][21][22]. It has been shown that striatal uptake values of FP-CIT SPECT and F-DOPA PET correlate well with each other in patients with different stages of PD [15,23].…”

[123I]β-CIT single-photon emission tomography in Parkinson's disease reveals a smaller decline in dopamine transporters with age than in controls

“…This aging effect was also more pronounced in the patients aged 32-45 years than in those older than 45 years. As mentioned earlier, Marek et al [7], using [ 123 I]β-CIT, found a significant decline in striatal binding with age in PD patients (n=8), while Tedroff et al [6] failed to find such a decline using 11 C-nomifensine (n=6). However, in these studies, involving a relatively small number of patients, neither the severity of PD nor the medication was taken into account, which makes it difficult to estimate reliably the contribution of age.…”

“…Using 11 C-nomifensine PET, Tedroff et al [6] did not find any significant decline in binding with age (n=6), whereas Marek et al [7], using [ 123 I]β-CIT SPET, did (n=8).…”

123-I ioflupane (Datscan®) presynaptic nigrostriatal imaging in patients with movement disorders

“…It is, therefore, important to diagnose the disease in its early stages with the help of all available diagnostic methods to rule out symptomatic parkinsonisms or parkinsonian syndromes, other than idiopathic PD, and start specific treatment. In patients with recent onset PD or hemiparkinsonism, a 50% decrease in presynaptic transporters has been observed in the putamen contralateral to the symptomatic side, and a 30% decrease in the putamen ipsilateral to symptoms (Marek et al, 1996;Tissingh et al, 1998). Evaluation of pre-synaptic dopaminergic integrity using 123-I Ioflupane in PD is a useful tool to: diagnose early stages, characterize disease severity and progression (Seibyl et al, 1995;Rinne et al, 1995), predict PD bilateralization in patients in a very early stage (when symptoms often involve only one side of the body) (Marek et al, 2001), assess the efficacy of agents slowing the course of disease and, more controversially, differentiate an idiopathic disorder from other forms of parkinsonian syndromes (Innis et al, 1993).…”