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帕金森病中外纹状体6-[18F]氟间酪氨酸和6-[18F]氟-L-多巴摄取的双示踪剂研究。

A dual-tracer study of extrastriatal 6-[18F]fluoro-m-tyrosine and 6-[18F]-fluoro-L-dopa uptake in Parkinson's disease.

作者信息

Li Clarence T, Palotti Matthew, Holden James E, Oh Jen, Okonkwo Ozioma, Christian Bradley T, Bendlin Barbara B, Buyan-Dent Laura, Harding Sandra J, Stone Charles K, DeJesus Onofre T, Nickles Robert J, Gallagher Catherine L

机构信息

William S. Middleton Veterans Hospital and Geriatric Research Education and Clinical Center, Madison, Wisconsin; Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

出版信息

Synapse. 2014 Aug;68(8):325-31. doi: 10.1002/syn.21745. Epub 2014 Apr 22.

Abstract

6-[(18)F]-Fluoro-L-dopa (FDOPA) has been widely used as a biomarker for catecholamine synthesis, storage, and metabolism--its intense uptake in the striatum, and fainter uptake in other brain regions, is correlated with the symptoms and pathophysiology of Parkinson's disease (PD). 6-[(18)F]fluoro-m-tyrosine (FMT), which also targets L-amino acid decarboxylase, has potential advantages over FDOPA as a radiotracer because it does not form catechol-O-methyltransferase (COMT) metabolites. The purpose of the present study was to compare the regional distribution of these radiotracers in the brains of PD patients. Fifteen Parkinson's patients were studied with FMT and FDOPA positron emission tomography (PET) as well as high-resolution structural magnetic resonance imaging (MRI). MRI's were automatically parcellated into neuroanatomical regions of interest (ROIs) in Freesurfer (http://surfer.nmr.mgh.harvard.edu); region-specific uptake rate constants (Kocc) were generated from coregistered PET using a Patlak graphical approach. The essential findings were as follows: (1) regional Kocc were highly correlated between the radiotracers and in agreement with a previous FDOPA studies that used different ROI selection techniques; (2) FMT Kocc were higher in extrastriatal regions of relatively large uptake such as amygdala, pallidum, brainstem, hippocampus, entorhinal cortex, and thalamus, whereas cortical Kocc were similar between radiotracers; (3) while subcortical uptake of both radiotracers was related to disease duration and severity, cortical uptake was not. These results suggest that FMT may have advantages for examining pathologic changes within allocortical loop structures, which may contribute to cognitive and emotional symptoms of PD.

摘要

6-[(18)F]-氟-L-多巴(FDOPA)已被广泛用作儿茶酚胺合成、储存和代谢的生物标志物——其在纹状体中的强烈摄取以及在其他脑区的较弱摄取与帕金森病(PD)的症状和病理生理学相关。6-[(18)F]氟-m-酪氨酸(FMT)同样靶向L-氨基酸脱羧酶,作为一种放射性示踪剂,它相对于FDOPA具有潜在优势,因为它不会形成儿茶酚-O-甲基转移酶(COMT)代谢产物。本研究的目的是比较这些放射性示踪剂在PD患者大脑中的区域分布。对15名帕金森病患者进行了FMT和FDOPA正电子发射断层扫描(PET)以及高分辨率结构磁共振成像(MRI)研究。MRI在Freesurfer(http://surfer.nmr.mgh.harvard.edu)中自动分割为感兴趣的神经解剖区域(ROI);使用Patlak图形法从配准后的PET生成区域特异性摄取速率常数(Kocc)。主要发现如下:(1)放射性示踪剂之间的区域Kocc高度相关,并且与先前使用不同ROI选择技术的FDOPA研究结果一致;(2)FMT的Kocc在摄取相对较大的纹外区域如杏仁核、苍白球、脑干、海马体、内嗅皮质和丘脑中较高,而放射性示踪剂之间的皮质Kocc相似;(3)虽然两种放射性示踪剂的皮质下摄取与疾病持续时间和严重程度相关,但皮质摄取与疾病持续时间和严重程度无关。这些结果表明,FMT在检查allocortical环结构内的病理变化方面可能具有优势,这可能有助于PD的认知和情感症状。

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