Chouker M, Tatsch K, Linke R, Pogarell O, Hahn K, Schwarz J
Department of Nuclear Medicine, Ludwig-Maximilians-University Munich, Germany.
Nucl Med Commun. 2001 Jun;22(6):721-5. doi: 10.1097/00006231-200106000-00017.
Imaging of striatal dopamine transporter binding allows differentiation between patients with Parkinson's disease and controls. We investigated the use of this technique to monitor disease progression. We used N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl) tropane (IPT) and single photon emission computed tomography (SPECT) to determine dopamine transporter function in eight patients with Parkinson's disease Hoehn and Yahr stage I to III over time. Patients were recruited from the movement disorder clinic and were studied at entry and after a follow-up period of 1 and 2 years. Specific striatal IPT binding was measured with a manual region of interest technique. At entry, all patients showed a reduction of striatal IPT uptake of approximately 50% compared to controls, with a mean striatum to background ratio of 3.61 +/- 0.72 (controls, 7.34 +/- 1.18). Putamen to background ratios were initially measured as 2.42 +/- 0.74 and caudate to background ratios as 5.00 +/- 0.73 (controls, 6.46 +/- 1.22 for putamen and 8.58 +/- 1.36 for caudate). Specific striatal IPT binding decreased by a mean of 6.6% in the first year and another 5.3% in the second year. Changes of specific IPT binding over time were similar in caudate and putamen. In patients with clinically asymmetric disease, differences between the rate of decline in the ipsilateral and contralateral sides could not be detected. The findings suggest that IPT SPECT can quantify the reduction of dopamine transporter binding over time. This technique seems to be a useful tool in monitoring the intra-individual progression of dopaminergic cell loss in patients with Parkinson's disease and may help to follow the effects of putative neuroprotective drugs in future clinical trials.
纹状体多巴胺转运体结合成像能够区分帕金森病患者与对照者。我们研究了使用该技术来监测疾病进展情况。我们使用N-(3-碘丙烯-2-基)-2β-甲氧羰基-3β-(4-氯苯基)托烷(IPT)和单光子发射计算机断层扫描(SPECT)来测定8例 Hoehn 和 Yahr 分期为 I 至 III 期的帕金森病患者不同时间的多巴胺转运体功能。患者从运动障碍门诊招募，在入组时以及随访1年和2年后进行研究。采用手动感兴趣区技术测量纹状体特异性 IPT 结合情况。入组时，与对照者相比，所有患者纹状体 IPT 摄取量均降低约50%，纹状体与本底的平均比值为3.61±0.72(对照者为7.34±1.18)。壳核与本底的比值最初测量为2.42±0.74，尾状核与本底的比值为5.00±0.73(对照者壳核为6.46±1.22，尾状核为8.58±1.36)。纹状体特异性 IPT 结合在第一年平均下降6.6%，在第二年又下降5.3%。尾状核和壳核中特异性 IPT 结合随时间的变化相似。在临床症状不对称的患者中，未检测到同侧和对侧下降速率的差异。这些发现表明，IPT SPECT 能够量化多巴胺转运体结合随时间的减少情况。该技术似乎是监测帕金森病患者多巴胺能细胞丢失个体内进展的有用工具，并且可能有助于在未来的临床试验中追踪假定的神经保护药物的效果。
