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症状对照者和健康志愿者的多巴胺转运体结合:神经影像学试验的考虑因素。

Dopamine transporter binding in symptomatic controls and healthy volunteers: Considerations for neuroimaging trials.

机构信息

Clinical Neurosciences, University of Turku and Turku University Hospital, Turku, Finland; Department of Neurology, Satasairaala Central Hospital, Pori, Finland; Turku PET Centre, Turku University Hospital, Turku, Finland.

Clinical Neurosciences, University of Turku and Turku University Hospital, Turku, Finland; Turku PET Centre, Turku University Hospital, Turku, Finland.

出版信息

Neuroimage Clin. 2021;32:102807. doi: 10.1016/j.nicl.2021.102807. Epub 2021 Aug 30.

Abstract

OBJECTIVE

To evaluate possible differences between brain dopamine transporter (DAT) binding in a group of symptomatic parkinsonism patients without dopaminergic degeneration and healthy individuals.

BACKGROUND

Dopaminergic neuroimaging studies of Parkinson's disease (PD) have often used control groups formed from symptomatic patients with apparently normal striatal dopamine function. We sought to investigate whether symptomatic patients can be used to represent dopaminergically normal healthy controls.

METHODS

Forty healthy elderly individuals were scanned with DAT [I]FP-CIT SPECT and compared to 69 age- and sex-matched symptomatic patients with nondegenerative conditions (including essential tremor, drug-induced parkinsonism and vascular parkinsonism). An automated region-of-interest based analysis of the caudate nucleus and the anterior/posterior putamen was performed. Specific binding ratios (SBR = [ROI-occ]/occ) were compared between the groups.

RESULTS

DAT binding in symptomatic patients was 8.6% higher in the posterior putamen than in healthy controls (p = 0.03). Binding correlated negatively with age in both groups but not with motor symptom severity, cognitive function or depression ratings.

CONCLUSIONS

Putaminal DAT binding, as measured with [I]FP-CIT SPECT, was higher in symptomatic controls than in healthy individuals. The reason for the difference is unclear but can include selection bias when DAT binding is used to aid clinical diagnosis and possible self-selection bias in healthy volunteerism. This effect should be taken into consideration when designing and interpreting neuroimaging trials investigating the dopamine system with [I]FP-CIT SPECT.

摘要

目的

评估一组无多巴胺能退变的症状性帕金森病患者与健康个体之间大脑多巴胺转运体(DAT)结合的可能差异。

背景

帕金森病(PD)的多巴胺能神经影像学研究通常使用由多巴胺功能明显正常的症状性患者组成的对照组。我们试图研究症状性患者是否可用于代表多巴胺能正常的健康对照者。

方法

40 名健康老年人接受了 DAT[I]FP-CIT SPECT 扫描,并与 69 名年龄和性别匹配的非退行性疾病(包括特发性震颤、药物诱导性帕金森病和血管性帕金森病)的症状性患者进行了比较。对尾状核和前/后壳核进行了基于自动感兴趣区的分析。比较了两组之间的特定结合比(SBR=[ROI- occ]/occ)。

结果

与健康对照组相比,症状性患者的后壳核 DAT 结合在后壳核中高 8.6%(p=0.03)。两组的结合均与年龄呈负相关,但与运动症状严重程度、认知功能或抑郁评分无关。

结论

与健康个体相比,使用[I]FP-CIT SPECT 测量的症状性对照者的壳核 DAT 结合更高。造成这种差异的原因尚不清楚,但可能包括 DAT 结合用于辅助临床诊断时的选择偏倚以及健康志愿者中的自我选择偏倚。在使用[I]FP-CIT SPECT 研究多巴胺系统的神经影像学试验设计和解释时,应考虑到这种影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5770/8416950/b80544e66fea/gr1.jpg

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