Department of Neurology, Gunma University Graduate School of Medicine, Maebashi, Japan.
Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan.
J Neurol Sci. 2023 Aug 15;451:120713. doi: 10.1016/j.jns.2023.120713. Epub 2023 Jun 15.
I-ioflupane single-photon emission computed tomography (SPECT) is a highly sensitive and established neuroimaging technique for parkinsonian syndromes (PS). However, differentiating PS by visual inspection or analysis of regions of interest is challenging. To date, image analysis has not been able to differentiate dementia with Lewy bodies (DLB) from Parkinson's disease with dementia (PDD). This study aimed to differentiate PS based on the characteristics of striatal dopamine transporter (DAT) binding using voxel-based analysis. We acquired I-ioflupane SPECT data from patients with DLB (n = 30), Parkinson's disease (PD; n = 122), PDD (n = 19), multiple system atrophy with predominant parkinsonism (MSA-P; n = 18), and progressive supranuclear palsy (PSP; n = 45). DAT binding was reduced in the posterior striatum of patients with PD and PDD, whereas it was similar in MSA-P, PSP, and DLB. Hippocampal atrophy, visually evaluated by cerebral magnetic resonance imaging, did not affect striatal DAT binding in DLB. DAT binding in the anterior striatum was inversely correlated with the severity of parkinsonism in PD and PDD but not in DLB. Thus, the appearance of striatal DAT binding might indicate different pathological processes in DLB and PDD.
碘[123I]-β-单环哌啶托烷（I-ioflupane）单光子发射计算机断层扫描（SPECT）是一种高度敏感且成熟的帕金森综合征（PS）神经影像学技术。然而，通过视觉检查或分析感兴趣区域来区分 PS 具有挑战性。迄今为止，图像分析还无法区分路易体痴呆（DLB）与帕金森病痴呆（PDD）。本研究旨在使用基于体素的分析方法，根据纹状体多巴胺转运体（DAT）结合的特征来区分 PS。我们从 DLB 患者（n=30）、帕金森病（PD；n=122）、PDD（n=19）、以帕金森病为主的多系统萎缩（MSA-P；n=18）和进行性核上性麻痹（PSP；n=45）中获取 I-ioflupane SPECT 数据。PD 和 PDD 患者的后纹状体 DAT 结合减少，而 MSA-P、PSP 和 DLB 则相似。脑磁共振成像视觉评估的海马萎缩并未影响 DLB 中的纹状体 DAT 结合。PD 和 PDD 中前纹状体的 DAT 结合与帕金森病的严重程度呈负相关，但在 DLB 中则不然。因此，纹状体 DAT 结合的出现可能表明 DLB 和 PDD 中存在不同的病理过程。
