Department of Human Neurosciences, Sapienza University of Rome, Italy.
Department of Human Neurosciences, Sapienza University of Rome, Italy; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Neuroimage Clin. 2023;40:103526. doi: 10.1016/j.nicl.2023.103526. Epub 2023 Oct 10.
In this research, our primary objective was to explore the correlation between basal ganglia dopaminergic neurotransmission, assessed using 123I-FP-CIT (DAT-SPECT), and finger movements abnormalities in patients with essential tremor (ET) and Parkinson's disease (PD).
We enrolled 16 patients with ET, 17 with PD, and 18 healthy controls (HC). Each participant underwent comprehensive clinical evaluations, kinematic assessments of finger tapping. ET and PD patients underwent DAT-SPECT imaging. The DAT-SPECT scans were subjected to both visual and semi-quantitative analysis using DaTQUANT®. We then investigated the correlations between the clinical, kinematic, and DAT-SPECT data, in patients.
Our findings confirm that individuals with ET exhibited slower finger tapping than HC. Visual evaluation of radiotracer uptake in both striata demonstrated normal levels within the ET patient cohort, while PD patients displayed reduced uptake. However, there was notable heterogeneity in the quantification of uptake within the striata among ET patients. Additionally, we found a correlation between the amount of radiotracer uptake in the striatum and movement velocity during finger tapping in patients. Specifically, lower radioligand uptake corresponded to decreased movement velocity (ET: coef. = 0.53, p-adj = 0.03; PD: coef. = 0.59, p-adj = 0.01).
The study's findings suggest a potential link between subtle changes in central dopaminergic tone and altered voluntary movement execution, in ET. These results provide further insights into the pathophysiology of ET. However, longitudinal studies are essential to determine whether the slight reduction in dopaminergic tone observed in ET patients represents a distinct subtype of the disease or could serve as a predictor for the clinical progression into PD.
在这项研究中，我们的主要目的是探索基底节多巴胺能神经传递与特发性震颤（ET）和帕金森病（PD）患者手指运动异常之间的相关性，使用 123I-FP-CIT（DAT-SPECT）进行评估。
我们招募了 16 名 ET 患者、17 名 PD 患者和 18 名健康对照者（HC）。每位参与者都接受了全面的临床评估和手指敲击的运动学评估。ET 和 PD 患者接受了 DAT-SPECT 成像。使用 DaTQUANT®对 DAT-SPECT 扫描进行了视觉和半定量分析。然后，我们研究了患者的临床、运动学和 DAT-SPECT 数据之间的相关性。
我们的发现证实，ET 患者的手指敲击速度比 HC 慢。在 ET 患者队列中，双侧纹状体放射性示踪剂摄取的视觉评估显示正常水平，而 PD 患者显示摄取减少。然而，在 ET 患者中，纹状体摄取的定量存在显著异质性。此外，我们发现患者纹状体中放射性示踪剂摄取量与手指敲击运动速度之间存在相关性。具体来说，较低的配体摄取与运动速度降低相关（ET：系数=0.53，p 调整=0.03；PD：系数=0.59，p 调整=0.01）。
该研究的结果表明，ET 中中枢多巴胺能张力的细微变化与自愿运动执行的改变之间可能存在联系。这些结果为 ET 的病理生理学提供了进一步的见解。然而，需要进行纵向研究来确定 ET 患者中观察到的轻微多巴胺能张力降低是否代表该疾病的一个独特亚型，或者是否可以作为向 PD 临床进展的预测指标。
