Department of Medicine, Imperial College London, Cyclotron Building, Hammersmith Hospital, Du Cane Road, W12 0NN, UK.
Biomark Med. 2010 Oct;4(5):651-60. doi: 10.2217/bmm.10.86.
The dopamine transporter (DAT) is responsible for clearance of dopamine from the synaptic cleft after its release. Imaging DAT availability provides a measure of dopamine terminal function and a method for detecting striatal dopamine deficiency states present in idiopathic Parkinson's disease and atypical neurodegenerative Parkinsonian disorders such as multiple system atrophy and progressive supranuclear palsy. DAT imaging with PET or single photon emission computed tomography can be used to support a diagnosis of dopamine-deficient parkinsonism in cases where this is suspected and rationalize the use of dopaminergic agents as therapy. It can also detect subclinical dopaminergic dysfunction when present in subjects at risk of Parkinson's disease, such as relatives of patients, susceptibility gene mutation carriers, and subjects with late-onset hyposmia or sleep disorders. Finally, the presence of normal DAT availability on imaging can help exclude nondopamine-deficient syndromes, such as dystonic and severe essential tremors, drug-induced and psychogenic parkinsonism that, on occasion, mimic Parkinson's disease.
多巴胺转运体（DAT）负责在多巴胺释放后从突触间隙清除多巴胺。DAT 可用性的成像提供了一种测量多巴胺末梢功能的方法，并可用于检测特发性帕金森病和非典型神经退行性帕金森病障碍（如多系统萎缩和进行性核上性麻痹）中存在的纹状体多巴胺缺乏状态。正电子发射断层扫描或单光子发射计算机断层扫描的 DAT 成像可用于支持对多巴胺缺乏性帕金森综合征的诊断，在怀疑存在这种情况且合理使用多巴胺能药物作为治疗方法的情况下。当帕金森病高危人群（如患者的亲属、易感基因突变携带者和嗅觉障碍或睡眠障碍的迟发性人群）存在亚临床多巴胺能功能障碍时，它也可以检测到。最后，成像上正常的 DAT 可用性的存在有助于排除非多巴胺缺乏综合征，如肌张力障碍性和严重特发性震颤、药物诱导和精神性帕金森病，这些疾病有时会模仿帕金森病。
