Taylor John-Paul, Colloby Sean J, McKeith Ian G, Burn David J, Williams David, Patterson Jim, O'Brien John T
Institute for Ageing and Health, Wolfson Research Centre, Newcastle General Hospital, Westgate Road, Newcastle upon Tyne NE4 6BE, UK.
J Neurol Neurosurg Psychiatry. 2007 Oct;78(10):1069-71. doi: 10.1136/jnnp.2006.111666. Epub 2007 Feb 13.
123I-labelled 2beta-carbomethoxy-3beta-(4-iodophenyl)-N-(3-fluoropropyl) nortropane (123I-FP-CIT) imaging is a diagnostic tool to help differentiate dementia with Lewy bodies (DLB) from Alzheimer's disease (AD). However, in animals, cholinesterase inhibitors (ChEi) have been reported to reduce radioligand binding to the striatal dopamine transporter. As ChEi are frequently used in people with dementia, it is important to determine whether their use affects 123I-FP-CIT uptake in the striatum.
To clarify whether chronic ChEi therapy modulates striatal dopamine transporter binding measured by 123I-FP-CIT in patients with AD, DLB and Parkinson's disease with dementia (PDD).
Cross sectional study in 99 patients with AD (nine on ChEi, 25 not on ChEi), DLB (nine on ChEi, 19 not on ChEi) and PDD (six on ChEi, 31 not on ChEi) comparing 123I-FP-CIT striatal binding (caudate, anterior and posterior putamen) in patients receiving compared with those not receiving ChEi, correcting for key clinical variables including diagnosis, age, sex, Mini-Mental State Examination score, severity of parkinsonism and concurrent antidepressant use.
As previously described, 123I-FP-CIT striatal uptake was lower in DLB and PDD subjects compared with those with AD. Median duration of ChEi use was 180 days. 123I-FP-CIT uptake was not significantly reduced in subjects receiving ChEi compared those not receiving ChEi (mean percentage reduction: AD 4.3%; DLB 0.7%; PDD 6.1%; p = 0.40). ChEi use did not differentially affect striatal 123FP-CIT uptake between patient groups (p = 0.83).
Use of ChEi does not significantly influence the ability of 123I-FP-CIT imaging to distinguish AD from DLB.
123I标记的2β-甲氧羰基-3β-（4-碘苯基）-N-（3-氟丙基）去甲托烷（123I-FP-CIT）成像有助于鉴别路易体痴呆（DLB）和阿尔茨海默病（AD），是一种诊断工具。然而，据报道，在动物中，胆碱酯酶抑制剂（ChEi）会降低放射性配体与纹状体多巴胺转运体的结合。由于ChEi常用于痴呆患者，因此确定其使用是否会影响纹状体中123I-FP-CIT的摄取非常重要。
明确慢性ChEi治疗是否会调节AD、DLB和帕金森病痴呆（PDD）患者通过123I-FP-CIT测量的纹状体多巴胺转运体结合。
对99例AD患者（9例使用ChEi，25例未使用ChEi）、DLB患者（9例使用ChEi，19例未使用ChEi）和PDD患者（6例使用ChEi，31例未使用ChEi）进行横断面研究，比较使用ChEi与未使用ChEi患者的123I-FP-CIT纹状体结合（尾状核、前壳核和后壳核）情况，并对包括诊断、年龄、性别、简易精神状态检查表评分、帕金森病严重程度和同时使用抗抑郁药等关键临床变量进行校正。
如前所述，与AD患者相比，DLB和PDD患者的123I-FP-CIT纹状体摄取较低。ChEi的使用中位数为180天。与未使用ChEi的患者相比，使用ChEi的患者123I-FP-CIT摄取没有显著降低（平均降低百分比：AD为4.3%；DLB为0.7%；PDD为6.1%；p = 0.40）。ChEi的使用对不同患者组之间纹状体123FP-CIT摄取没有差异影响（p = 0.83）。
ChEi的使用不会显著影响123I-FP-CIT成像区分AD和DLB的能力。
