路易体痴呆和阿尔茨海默病中2型囊泡单胺转运体的体内评估

In vivo assessment of vesicular monoamine transporter type 2 in dementia with lewy bodies and Alzheimer disease.

作者信息

Villemagne Victor L, Okamura Nobuyuki, Pejoska Svetlana, Drago John, Mulligan Rachel S, Chételat Gaël, Ackermann Uwe, O'Keefe Graeme, Jones Gareth, Gong Sylvia, Tochon-Danguy Henry, Kung Hank F, Masters Colin L, Skovronsky Daniel M, Rowe Christopher C

机构信息

Department of Nuclear Medicine, Centre for Positron Emission Tomography, Austin Hospital, Austin Health, Heidelber, Australia.

出版信息

Arch Neurol. 2011 Jul;68(7):905-12. doi: 10.1001/archneurol.2011.142.

DOI:10.1001/archneurol.2011.142

PMID:21747030

Abstract

OBJECTIVE

To assess the diagnostic potential of imaging striatal monoaminergic terminal integrity with the vesicular monoamine transporter type 2 (VMAT2) radioligand (18)F 9-fluropropyl-(+)-dihydrotetrabenazine ([(18)F]AV-133) and positron emission tomography to distinguish dementia with Lewy bodies (DLB) from Alzheimer disease (AD).

DESIGN, SETTING, AND PARTICIPANTS: Nine patients with DLB, 10 patients with AD, 20 patients with Parkinson disease (PD), and 10 healthy age-matched control subjects underwent [(18)F]AV-133 positron emission tomography studies. VMAT2 density was calculated through normalized tissue uptake value ratios at 120 to 140 minutes postinjection using the primary visual cortex as the reference region.

MAIN OUTCOME MEASURE

Comparison of the tissue ratio for [(18)F]AV-133 between the different clinical diagnostic groups.

RESULTS

Lower VMAT2 densities were observed in patients with DLB when compared with patients with AD especially in the posterior putamen (caudate: mean [SD], 1.24 [0.6] vs 2.83 [0.9]; P < .001; effect size = 2.1; anterior putamen: mean [SD], 0.90 [0.5] vs 3.01 [0.9]; P < .001; effect size = 2.9; posterior putamen: mean [SD], 0.62 [0.5] vs 2.87 [0.8]; P < .001; effect size = 3.4). Compared with healthy controls, [(18)F]AV-133 tissue ratios were significantly lower by 88% and 74% in the posterior putamen, 74% and 65% in the anterior putamen, and 53% and 51% in the caudate nucleus of patients with PD and DLB, respectively. In contrast to patients with PD and DLB, no reductions were observed in patients with AD.

CONCLUSIONS

[(18)F]AV-133 allows assessment of nigrostriatal degeneration in Lewy body diseases. [(18)F]AV-133 can robustly detect reductions of dopaminergic nigrostriatal afferents in patients with DLB and assist in the differential diagnosis from AD.

摘要

目的

通过使用2型囊泡单胺转运体（VMAT2）放射性配体（18）F 9-氟丙基-（+）-二氢四苯嗪（[(18)F]AV-133）及正电子发射断层扫描评估纹状体单胺能终末完整性的诊断潜力，以区分路易体痴呆（DLB）与阿尔茨海默病（AD）。

设计、地点和参与者：9例DLB患者、10例AD患者、20例帕金森病（PD）患者及10例年龄匹配的健康对照者接受了[(18)F]AV-133正电子发射断层扫描研究。使用初级视觉皮层作为参考区域，通过注射后120至140分钟时的标准化组织摄取值比率计算VMAT2密度。

主要观察指标

比较不同临床诊断组之间[(18)F]AV-133的组织比率。

结果

与AD患者相比，DLB患者的VMAT2密度较低，尤其是在壳核后部（尾状核：均值[标准差]，1.24[0.6]对2.83[0.9]；P<.001；效应大小=2.1；壳核前部：均值[标准差]，0.90[0.5]对3.01[0.9]；P<.001；效应大小=2.9；壳核后部：均值[标准差]，0.62[0.5]对2.87[0.8]；P<.001；效应大小=3.4）。与健康对照相比，PD和DLB患者壳核后部的[(18)F]AV-133组织比率分别显著降低88%和74%，壳核前部降低74%和65%，尾状核降低53%和51%。与PD和DLB患者不同，AD患者未观察到降低。