Sasannezhad Payam, Juibary Ali Ghabeli, Sadri Kayvan, Sadeghi Ramin, Sabour Mahsa, Kakhki Vahid Reza Dabbagh, Alizadeh Hesam
Department of Neurology, Mashhad University of Medical Sciences, Mashhad, Iran.
Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Asia Ocean J Nucl Med Biol. 2017 Spring;5(2):114-119. doi: 10.22038/aojnmb.2017.8844.
Tc-TRODAT-1, which binds to the dopamine transporter, could be used to image the dopaminergic system in diagnosis of Parkinson's disease (PD). PD can be classified into two groups: late onset Parkinson's disease (LOPD) and early onset Parkinson's disease (EOPD). In this study we tried to determine the TRODAT SPECT findings in EOPD as compared to LOPD.
Fifteen patients were studied. The diagnosis of PD was defined by clinical criteria based on UK Parkinson's Disease Society Brain Bank criteria. Six patients whose age at onset of PD were younger than 50 were defined as patients with EOPD and 9 patients with older than 50 years were defined as patients with LOPD. All patients underwent Tc-TRODAT Brain SPECT.
There was a significant decrease of striatal Tc-TRODAT-1 (TRODAT) binding in PD patients in both EOPD and LOPD. No significant difference was noticed between EOPD and LOPD in disease stage and symptoms. In visual analysis, 20 (66.67%) caudate nucleuses had decreased tracer uptake while all 30 (100%) putamens had decreased or absent tracer uptake. No significant difference between EOPD and LOPD was noticed in visual analysis. Striatum, Caudate and Putamen uptake ratio to background were calculated. No significant difference was noticed between EOPD and LOPD in these ratios. However there was significant difference in visual analysis (tracer uptake) as well as in uptake ratio between putamen and caudate nucleuses in both groups (P=0.001). On the other word, we found more diminished uptake in putamen as compared the caudate. Frequency and severity of putamen involvement were much more than caudate.
Tc-TRODAT-1 SPECT imaging showed lower presynaptical dopami-nergical terminals density in both EOPD and LOPD. There was no difference between EOPD and LOPD in TRODAT uptake. Putamen showed more involvement and more diminished TRODAT uptake.
与多巴胺转运体结合的锝 - TRODAT - 1可用于成像多巴胺能系统，以辅助帕金森病（PD）的诊断。帕金森病可分为两组：晚发型帕金森病（LOPD）和早发型帕金森病（EOPD）。在本研究中，我们试图确定早发型帕金森病与晚发型帕金森病相比，锝 - TRODAT单光子发射计算机断层扫描（SPECT）的结果。
对15例患者进行了研究。帕金森病的诊断依据基于英国帕金森病协会脑库标准的临床标准。6例帕金森病发病年龄小于50岁的患者被定义为早发型帕金森病患者，9例年龄大于50岁的患者被定义为晚发型帕金森病患者。所有患者均接受了锝 - TRODAT脑SPECT检查。
早发型帕金森病和晚发型帕金森病患者纹状体的锝 - TRODAT - 1（TRODAT）结合均显著降低。早发型帕金森病和晚发型帕金森病在疾病阶段和症状方面未发现显著差异。在视觉分析中，20个（66.67%）尾状核的示踪剂摄取减少，而所有30个（100%）壳核的示踪剂摄取减少或缺失。在视觉分析中，早发型帕金森病和晚发型帕金森病之间未发现显著差异。计算了纹状体、尾状核和壳核与背景的摄取比值。早发型帕金森病和晚发型帕金森病在这些比值上未发现显著差异。然而，两组在视觉分析（示踪剂摄取）以及壳核与尾状核的摄取比值方面均存在显著差异（P = 0.001）。换句话说，我们发现壳核的摄取减少比尾状核更明显。壳核受累的频率和严重程度远高于尾状核。
锝 - TRODAT - 1 SPECT成像显示早发型帕金森病和晚发型帕金森病的突触前多巴胺能终末密度均较低。早发型帕金森病和晚发型帕金森病在TRODAT摄取方面无差异。壳核受累更明显，TRODAT摄取减少更显著。
