Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Parkinsonism Relat Disord. 2018 Nov;56:47-51. doi: 10.1016/j.parkreldis.2018.06.022. Epub 2018 Jun 14.
Olfactory dysfunction is a sensitive biomarker of neurodegeneration and a cardinal premotor symptom of Parkinson's disease (PD). Although several non-motor symptoms of PD have been correlated with decreased dopamine transporter uptake, olfactory dysfunction and reduced dopamine transporter uptake have not been widely investigated in PD. In this study, we aimed to identify the dopamine transporter status of the corpus striatum and thalamus using a magnetic resonance imaging (MRI)-guided spatial normalization method in patients with PD according to olfactory function.
Among 87 PD patients, 50 had hyposmia and 37 had normosmia. All patients underwent positron emission tomography (PET) using F-N-(3-fluoropropyl)-2beta-carbon ethoxy-3beta-(4-iodophenyl) nortropane (F-FP-CIT) and T1-weighted MRI. PET images were normalized with simultaneously performed spatially normalized MRI and the regional standardized uptake value ratios (SUVR) with a volume of interest template were compared according to olfactory function.
The bilateral caudates and the left anterior and posterior putamen of the hyposmic group showed significantly reduced dopamine transporter uptake compared to the normosmic group. In partial correlation coefficient analysis, olfactory identification impairment was correlated with the SUVR values of the caudate nuclei.
More dopaminergic impairment of the bilateral caudate nuclei was found in hyposmic PD. This finding suggests that decreased dopamine uptake in the caudate nucleus may be an imaging trace of olfactory dysfunction in patients with PD.
嗅觉功能障碍是神经退行性变的敏感生物标志物，也是帕金森病（PD）的主要运动前期症状。尽管 PD 的几种非运动症状与多巴胺转运体摄取减少有关，但嗅觉功能障碍和多巴胺转运体摄取减少在 PD 中尚未得到广泛研究。在这项研究中，我们根据嗅觉功能，旨在通过 MRI 引导的空间归一化方法来确定 PD 患者纹状体和丘脑的多巴胺转运体状态。
在 87 名 PD 患者中，50 名患者存在嗅觉减退，37 名患者嗅觉正常。所有患者均接受 F-N-（3-氟丙基）-2β-碳乙氧基-3β-（4-碘苯基）-nortropane（F-FP-CIT）正电子发射断层扫描（PET）和 T1 加权 MRI。通过同时进行空间归一化 MRI 将 PET 图像归一化，并根据嗅觉功能比较感兴趣区模板的区域标准化摄取比值（SUVR）。
嗅觉减退组的双侧尾状核和左侧前、后壳核的多巴胺转运体摄取明显低于嗅觉正常组。在偏相关系数分析中，嗅觉识别障碍与尾状核 SUVR 值相关。
在嗅觉减退的 PD 患者中发现双侧尾状核的多巴胺能损伤更大。这一发现表明，尾状核中多巴胺摄取的减少可能是 PD 患者嗅觉功能障碍的影像学痕迹。
