PET Center, Department of Nuclear Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Department of Nuclear Medicine, Affiliated Kunshan Hospital, Jiangsu University, Kunshan, Jiangsu, China.
J Cereb Blood Flow Metab. 2020 Mar;40(3):552-562. doi: 10.1177/0271678X19828916. Epub 2019 Feb 10.
Striatal dopamine transporter (DAT) deficiency and abnormal expression of Parkinson's disease (PD)-related pattern (PDRP) have been observed in patients with idiopathic REM sleep behavior disorder (IRBD). This study aimed to investigate the correlations between these two measures with comparison to PD using a dual tracer imaging design. Age-matched 37 IRBD patients, 86 PD patients, and 15 control subjects underwent concurrent PET scans with C-CFT to quantify dopaminergic dysfunction and F-FDG to quantify PDRP expression. IRBD patients were divided into two subgroups: those with relatively normal (IRBD-RN) or abnormal (IRBD-AB) striatal DAT binding. Significantly decreased DAT binding and increased PDRP scores were present in all patient groups, except for IRBD-RN, relative to the controls. There was a significant effect of hemisphere and hemisphere × group interaction for DAT binding but not for PDRP expression. Significant correlations were observed between DAT binding and PDRP expression in the IRBD-AB and PD groups but not in the IRBD-RN group. IRBD patients present with an intermediate state in striatal DAT distribution and PDRP activity between PD and normal controls. The modest correlations between the two measures in both IRBD and PD suggest that differences in network activity cannot be fully explained by nigrostriatal dopaminergic denervation.
纹状体多巴胺转运体 (DAT) 缺乏和帕金森病 (PD) 相关模式 (PDRP) 的异常表达已在特发性 REM 睡眠行为障碍 (IRBD) 患者中观察到。本研究旨在使用双示踪剂成像设计，通过比较 PD 患者，探讨这两种测量方法之间的相关性。37 名年龄匹配的 IRBD 患者、86 名 PD 患者和 15 名对照受试者接受了 C-CFT 以定量评估多巴胺能功能和 F-FDG 以定量评估 PDRP 表达的同时 PET 扫描。将 IRBD 患者分为两组：纹状体 DAT 结合相对正常（IRBD-RN）或异常（IRBD-AB）的患者。除了 IRBD-RN 组外，所有患者组的 DAT 结合均显著降低，而 PDRP 评分均升高，与对照组相比。DAT 结合存在显著的半球效应和半球×组交互作用，但 PDRP 表达不存在这种效应。在 IRBD-AB 和 PD 组中观察到 DAT 结合与 PDRP 表达之间存在显著相关性，但在 IRBD-RN 组中没有。IRBD 患者在纹状体 DAT 分布和 PDRP 活性方面呈现出介于 PD 和正常对照之间的中间状态。在 IRBD 和 PD 中，这两种测量方法之间的适度相关性表明，网络活动的差异不能完全用黑质纹状体多巴胺能神经支配丧失来解释。
