Badoud Simon, Nicastro Nicolas, Garibotto Valentina, Burkhard Pierre R, Haller Sven
Neurology Unit, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland.
Neurophysiology Unit, Department of Medicine, University of Fribourg (CH), Fribourg, Switzerland.
Eur J Nucl Med Mol Imaging. 2016 Mar;43(3):509-16. doi: 10.1007/s00259-015-3176-5. Epub 2015 Aug 29.
To assess correlations between the degree of dopaminergic depletion measured using single-photon emission computed tomography (SPECT) and different clinical parameters of disease progression in Parkinson's disease (PD).
This retrospective study included 970 consecutive patients undergoing (123)I-ioflupane SPECT scans in our institution between 2003 and 2013, from which we selected a study population of 411 patients according to their clinical diagnosis: 301 patients with PD (69.4 ± 11.0 years, of age, 163 men) and 110 patients with nondegenerative conditions included as controls (72.7 ± 8.0 years of age, 55 men). Comprehensive and operator-independent data analysis included spatial normalization into standard space, estimation of the mean uptake values in the striatum (caudate nucleus + putamen) and voxel-wise correlation between SPECT signal intensity and disease stage as well as disease duration in order to investigate the spatiotemporal pattern of the dopaminergic nigrostriatal degeneration. To compensate for potential interactions between disease stage and disease duration, one parameter was used as nonexplanatory coregressor for the other.
Increasing disease stage was associated with an exponential decrease in (123)I-ioflupane uptake (R(2) = 0.1501) particularly in the head of the ipsilateral caudate nucleus (p < 0.0001), whereas increasing disease duration was associated with a linear decrease in (123)I-ioflupane uptake (p < 0.0001; R(2) = 0.1532) particularly in the contralateral anterior putamen (p < 0.0001).
We observed two distinct spatiotemporal patterns of posterior to anterior dopaminergic depletion associated with disease stage and disease duration in patients with PD. The developed operator-independent reference database of 411 (123)I-ioflupane SPECT scans can be used for clinical and research applications.
评估使用单光子发射计算机断层扫描（SPECT）测量的多巴胺能神经元缺失程度与帕金森病（PD）疾病进展的不同临床参数之间的相关性。
这项回顾性研究纳入了2003年至2013年间在我们机构连续接受（123）I-碘氟烷SPECT扫描的970例患者，我们根据临床诊断从中选取了411例患者作为研究对象：301例PD患者（年龄69.4±11.0岁，男性163例）和110例非退行性疾病患者作为对照（年龄72.7±8.0岁，男性55例）。全面且与操作人员无关的数据分析包括空间归一化到标准空间、纹状体（尾状核+壳核）平均摄取值的估计以及SPECT信号强度与疾病分期和病程之间的体素相关性，以研究多巴胺能黑质纹状体变性的时空模式。为了补偿疾病分期和病程之间的潜在相互作用，将一个参数用作另一个参数的非解释性共回归变量。
疾病分期增加与（123）I-碘氟烷摄取呈指数下降相关（R² = 0.1501），尤其是在同侧尾状核头部（p < 0.0001），而病程延长与（123）I-碘氟烷摄取呈线性下降相关（p < 0.0001；R² = 0.1532），尤其是在对侧前壳核（p < 0.0001）。
我们观察到PD患者中与疾病分期和病程相关的从后到前多巴胺能神经元缺失的两种不同时空模式。所建立的包含411例（123）I-碘氟烷SPECT扫描的与操作人员无关的参考数据库可用于临床和研究应用。
