Neishi Hiroyuki, Ikawa Masamichi, Okazawa Hidehiko, Tsujikawa Tetsuya, Arishima Hidetaka, Kikuta Ken-Ichiro, Yoneda Makoto
Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Second Department of Internal Medicine (Neurology), Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
Eur Neurol. 2017;78(3-4):161-168. doi: 10.1159/000479627. Epub 2017 Aug 24.
This study sought to precisely evaluate striatal oxidative stress and its relationship with the disease severity in Parkinson's disease (PD) using double brain imaging, 62Cu-diacetyl-bis (N4-methylthiosemicarbazone) (62Cu-ATSM) PET and 123I-FP-CIT SPECT.
Nine PD patients were studied with brain 62Cu-ATSM PET for oxidative stress and 123I-FP-CIT SPECT for the density of striatal dopamine transporter. Standardized uptake values (SUVs) were obtained from the delayed phase of dynamic 62Cu-ATSM PET, and striatum-to-cerebellum SUV ratio (SUVR) was calculated. To correct the effect of neuronal loss in the striatum, 62Cu-ATSM SUVR was corrected for striatal specific binding ratio (SBR) values of 123I-FP-CIT (SUVR/SBR).
62Cu-ATSM SUVR without correction was not significantly correlated with disease severity estimated by the Unified Parkinson's Disease Rating Scale (UPDRS) scores or 123I-FP-CIT SBR. In contrast, the SUVR/SBR showed significant correlations with the UPDRS total and motor scores, and 123I-FP-CIT SBR.
Oxidative stress in the remaining striatal dopaminergic neurons estimated by SUVR/SBR was increased with disease severity in PD patients, suggesting that oxidative stress based on mitochondrial dysfunction contributes to promoting dopaminergic neuronal degeneration in PD. 62Cu-ATSM PET with 123I-FP-CIT SPECT correction would be a promising tool to evaluate dopaminergic neuronal oxidative stress in PD.
本研究旨在通过双脑成像、62Cu-二乙酰双（N4-甲基硫代半卡巴腙）（62Cu-ATSM）正电子发射断层扫描（PET）和123I-FP-CIT单光子发射计算机断层扫描（SPECT）精确评估帕金森病（PD）纹状体氧化应激及其与疾病严重程度的关系。
对9例PD患者进行脑部62Cu-ATSM PET检查以评估氧化应激，进行123I-FP-CIT SPECT检查以评估纹状体多巴胺转运体密度。从动态62Cu-ATSM PET的延迟期获得标准化摄取值（SUV），并计算纹状体与小脑SUV比值（SUVR）。为校正纹状体神经元丢失的影响，用123I-FP-CIT的纹状体特异性结合率（SBR）值校正62Cu-ATSM SUVR（SUVR/SBR）。
未校正的62Cu-ATSM SUVR与统一帕金森病评定量表（UPDRS）评分或123I-FP-CIT SBR评估的疾病严重程度无显著相关性。相比之下，SUVR/SBR与UPDRS总分和运动评分以及123I-FP-CIT SBR显著相关。
SUVR/SBR评估的剩余纹状体多巴胺能神经元氧化应激随PD患者疾病严重程度增加，提示基于线粒体功能障碍的氧化应激促进了PD中多巴胺能神经元变性。经123I-FP-CIT SPECT校正的62Cu-ATSM PET将是评估PD中多巴胺能神经元氧化应激的一种有前景的工具。
