Nurmi Elina, Bergman Jörgen, Eskola Olli, Solin Olof, Vahlberg Tero, Sonninen Pirkko, Rinne Juha O
Department of Neurology, University of Turku, FIN-20521, Turku, Finland.
Synapse. 2003 Jun 1;48(3):109-15. doi: 10.1002/syn.10192.
The aim of this study was to investigate the progression of dopaminergic hypofunction in striatal subregions in Parkinson's disease (PD). We studied 12 patients with early PD and 11 healthy controls with a dopamine transporter ligand 2beta-carbomethoxy-3beta-(4-[(18)F]-fluorophenyl)tropane ([(18)F]CFT) positron emission tomography (PET). The PET scan was carried out twice with an average interval of 2.2 years. The regions of interest (anterior and posterior putamen, caudate nucleus, and cerebellum) were drawn on individual magnetic resonance imaging (MRI) images, matched with the PET images, and copied onto the PET images. At the first PET scan in PD patients, the [(18)F]CFT uptake in the anterior putamen was 1.92 +/- 0.67, which was 45% of the control mean, and in the posterior putamen 1.02 +/- 0.55, being only 27% of the control mean. For the caudate nucleus the corresponding figure was 2.55 +/- 0.58 (71% of the control mean). The uptake ratios had declined significantly by the time of the second PET scan and the absolute annual rate of decline of the tracer uptake was 0.23 +/- 0.14 (P < 0.001) in the anterior putamen, 0.13 +/- 0.13 (P = 0.005) in the posterior putamen, and 0.20 +/- 0.15 (P < 0.001) in the caudate nucleus. There was a statistically significant difference of the decline in the tracer uptake between the anterior and posterior putamen (P = 0.033). When the rate of progression was calculated compared to the normal control mean, the rate of annual decline was 5.3% in the anterior putamen, 3.3% in the posterior putamen, and 5.6% in the caudate nucleus, without significant changes among striatal subregions (P = 0.10). When ipsi- and contralateral sides were analyzed separately, the absolute decline of [(18)F]CFT uptake in the putamen was higher in the side ipsilateral to the predominant symptoms than in the contralateral side (P = 0.035 for anterior putamen and P = 0.026 for posterior putamen). In the caudate nucleus the absolute decline was not different between ipsi- and contralateral sides (P = 0.76). In healthy controls, no significant decline of [(18)F]CFT uptake was detected. The results are suggestive of slower progression in the posterior putamen, where the disease is more advanced, but studies to follow up the same patient at several time points are needed to resolve this question. Synapse 48:109-115, 2003.
本研究旨在调查帕金森病（PD）纹状体亚区域多巴胺能功能减退的进展情况。我们使用多巴胺转运体配体2β-甲氧羰基-3β-（4-[(18)F]-氟苯基）托烷（[(18)F]CFT）正电子发射断层扫描（PET）对12例早期PD患者和11名健康对照者进行了研究。PET扫描进行了两次，平均间隔时间为2.2年。在个体磁共振成像（MRI）图像上绘制感兴趣区域（前、后壳核、尾状核和小脑），将其与PET图像匹配，然后复制到PET图像上。在PD患者的首次PET扫描中，前壳核的[(18)F]CFT摄取量为1.92±0.67，为对照平均值的45%，后壳核为1.02±0.55，仅为对照平均值的27%。尾状核的相应数值为2.55±0.58（对照平均值的71%）。到第二次PET扫描时，摄取率显著下降，在前壳核中示踪剂摄取的绝对年下降率为0.23±0.14（P<0.001），后壳核为0.13±0.13（P = 0.005），尾状核为0.20±0.15（P<0.001）。前、后壳核之间示踪剂摄取下降存在统计学显著差异（P = 0.033）。与正常对照平均值相比计算进展率时，前壳核的年下降率为5.3%，后壳核为3.3%，尾状核为5.6%，纹状体亚区域之间无显著变化（P = 0.10）。分别分析同侧和对侧时，壳核中[(18)F]CFT摄取的绝对下降在主要症状同侧高于对侧（前壳核P = 0.035，后壳核P = 0.026）。尾状核中同侧和对侧之间的绝对下降无差异（P = 0.76）。在健康对照者中，未检测到[(18)F]CFT摄取有显著下降。结果提示疾病更严重的后壳核进展较慢，但需要对同一患者在多个时间点进行随访研究以解决这个问题。《突触》48:109 - 115，2003年。
