Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
Mov Disord. 2024 May;39(5):847-854. doi: 10.1002/mds.29769. Epub 2024 Mar 13.
As a biomarker targeting vesicular monoamine transporter 2 (VMAT2), F-9-fluoropropyldihydrotetrabenazine (F-FP-DTBZ) positron emission tomography (PET) is highly accurate in diagnosing Parkinson's disease (PD) and assessing its severity. However, evidence is insufficient in patients with progressive supranuclear palsy (PSP).
We evaluated the striatal and extrastriatal monoaminergic disruption of PSP and differences in patterns between patients with PSP, PD, and healthy controls (HCs) using F-FP-DTBZ PET, as well as its correlations with the clinical characteristics of PSP.
We recruited 58 patients with PSP, 23 age- and duration-matched patients with PD, as well as 17 HCs. Patients were scanned using F-FP-DTBZ PET/computed tomography, and images were spatially normalized and analyzed based on the volume of interest.
VMAT2 binding differed significantly in the striatum and substantia nigra among the groups (P < 0.001). A more severe disruption in the caudate was noted in the PSP group (P < 0.001) than in the PD group. However, no differences were found in the nucleus accumbens, hippocampus, amygdala, or raphe between the PD and PSP groups. Within the PSP group, striatal VMAT2 binding was significantly associated with the fall/postural stability subscore of the PSP Rating Scale, especially in the putamen. Furthermore, VMAT2 binding was correlated with Mini-Mental State Examination or Montreal Cognitive Assessment in the hippocampus.
Caudate disruptions showed prominent differences among the groups. VAMT2 binding in the striatum and hippocampus reflects the severity of fall/postural stability and cognition, respectively. © 2024 International Parkinson and Movement Disorder Society.
作为囊泡单胺转运体 2（VMAT2）的生物标志物，F-9-氟丙基二氢四苯并嗪（F-FP-DTBZ）正电子发射断层扫描（PET）在诊断帕金森病（PD）和评估其严重程度方面具有高度准确性。然而，在进行性核上性麻痹（PSP）患者中，证据尚不充分。
我们使用 F-FP-DTBZ PET 评估 PSP 患者纹状体和纹状体外单胺能破坏的情况，以及 PSP 患者、PD 患者和健康对照者（HCs）之间的模式差异，并探讨其与 PSP 临床特征的相关性。
我们招募了 58 例 PSP 患者、23 例年龄和病程匹配的 PD 患者以及 17 例 HCs。患者接受 F-FP-DTBZ PET/CT 扫描，根据感兴趣区进行图像空间标准化和分析。
各组间纹状体和黑质中的 VMAT2 结合存在显著差异（P < 0.001）。与 PD 组相比，PSP 组的尾状核破坏更为严重（P < 0.001）。然而，在伏隔核、海马体、杏仁核或中缝核中，PD 组和 PSP 组之间无差异。在 PSP 组内，纹状体 VMAT2 结合与 PSP 评定量表的跌倒/姿势稳定性亚评分显著相关，尤其是在壳核。此外，VMAT2 结合与海马体的简易精神状态检查或蒙特利尔认知评估相关。
尾状核的破坏在各组之间存在显著差异。纹状体和海马体中的 VAMT2 结合分别反映了跌倒/姿势稳定性和认知的严重程度。© 2024 国际帕金森病和运动障碍学会。
