PET Center, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY.
Clin Nucl Med. 2018 Aug;43(8):562-571. doi: 10.1097/RLU.0000000000002148.
Neuroimaging indicators of Parkinson disease have been developed and applied in clinical practices. Dopaminergic imaging reflects nigrostriatal dopaminergic dysfunction, and metabolic network imaging offers disease-related metabolic changes at a system level. We aimed to elucidate the association between Parkinsonian symptoms and neuroimaging, and interactions between different imaging techniques.
We conducted a dual-tracer PET study for the combined assessments of dopaminergic binding (C-CFT) and glucose metabolism (F-FDG) in 103 participants with Parkinson disease (65 male and 38 female subjects). The detailed clinical rating scores were systematically collected in all members. The interactions among dopaminergic bindings, metabolic changes, and clinical manifestations were evaluated at voxel, regional, and network levels.
Striatal DAT binding correlated with akinesia-rigidity (P < 0.001) but not with tremor; the metabolic PET imaging, nonspecific to the dopaminergic dysfunction, disclosed a set of brain regions correlating with the cardinal symptoms, including tremor. In addition, the unilateral symptom correlated with the contralateral nigrostriatal dopamine loss, but with bilateral metabolic changes, suggesting their differences in the application of disease-related mechanistic studies. Further imaging-imaging correlation study revealed that dopaminergic dysfunction correlated with widely distributed metabolic changes in Parkinson disease, and the modest correlations supported the findings on the clinical-imaging correlation.
In this dual-tracer PET study, we demonstrated the robust interactions among dopaminergic dysfunction, metabolic brain changes and clinical manifestations at voxel, regional, and network levels. Our findings might promote the understanding in the proper application of dopaminergic and metabolic PET imaging in Parkinson disease and offer more evidence in support of Parkinsonian pathophysiological mechanisms.
帕金森病的神经影像学指标已经在临床实践中得到了发展和应用。多巴胺能成像反映了黑质纹状体多巴胺能功能障碍，代谢网络成像则提供了系统水平的疾病相关代谢变化。我们旨在阐明帕金森病症状与神经影像学之间的关联，以及不同成像技术之间的相互作用。
我们对 103 名帕金森病患者（65 名男性和 38 名女性）进行了双重示踪 PET 研究，用于联合评估多巴胺能结合（C-CFT）和葡萄糖代谢（F-FDG）。我们系统地收集了所有参与者的详细临床评分。在体素、区域和网络水平上评估了多巴胺能结合、代谢变化和临床表现之间的相互作用。
纹状体 DAT 结合与运动不能-僵硬（P < 0.001）相关，但与震颤无关；代谢 PET 成像对多巴胺能功能障碍不具有特异性，但揭示了一组与主要症状相关的脑区，包括震颤。此外，单侧症状与对侧黑质纹状体多巴胺丢失相关，但与双侧代谢变化相关，表明它们在应用疾病相关机制研究方面存在差异。进一步的成像-成像相关性研究表明，多巴胺能功能障碍与帕金森病中广泛分布的代谢变化相关，中度相关性支持了临床-成像相关性研究的发现。
在这项双重示踪 PET 研究中，我们在体素、区域和网络水平上证实了多巴胺能功能障碍、代谢性脑变化和临床表现之间的强大相互作用。我们的发现可能有助于理解多巴胺能和代谢性 PET 成像在帕金森病中的正确应用，并为帕金森病病理生理学机制提供更多证据。
