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正电子发射断层扫描成像在快速眼动睡眠行为障碍和帕金森病早期检测中的应用——基于模型的成本效益分析。

PET imaging for a very early detection of rapid eye movement sleep behaviour disorder and Parkinson's disease - A model-based cost-effectiveness analysis.

机构信息

Brain Global, Department of Neurology & Neurological Surgery, 27659 Arabian Drive, Salisbury, MD 21801, USA.

Neuropedia for Training and Scientific Research, Amman, Jordan.

出版信息

Clin Neurol Neurosurg. 2024 Aug;243:108404. doi: 10.1016/j.clineuro.2024.108404. Epub 2024 Jun 19.

Abstract

Parkinson's disease (PD) is the second most prevalent neurodegenerative condition after Alzheimer's disease and it represents one of the fastest emerging neurological diseases worldwide. PD is usually diagnosed after the third decade of life with symptoms like tremors at rest and muscle stiffness. Rapid Eye Movement sleep behavioral disorder (RBD) is another disorder that is caused by a loss of typical muscle relaxation during sleep with a lot of motor activity. Usually, RBD is strongly associated with PD. Recent studies have demonstrated that PD reduces the life expectancy of patients to 10 and 20 years after being diagnosed. In addition, delayed diagnosis and treatment of these neurological disorders have significant socio-economic impacts on patients, their partners and on the general public. Often, it is not clear about PD associated financial burdens both in low and high-income countries. On the other hand, PD triggers neurological variations that affect differences in the dopamine transporter (DAT) and in glucose metabolism. Therefore, positron emission tomography (PET) using specific DAT radiotracers and fluorine-18 labeled desoxyglucose (FDG) has being considered a key imaging technique that could be applied clinically for the very early diagnosis of RBD and in PD. However, a few myths about PET is that it is very expensive. Here, we looked at the cost of treatment of PD and RBD in relation to early PET imaging. Our finding suggests that PET imaging might also be a cost sparing diagnostic option in the management of patients with PD and RBD, not only for first world countries as it is the case now but also for the third world countries. Therefore, PET is a cost-effective imaging technique for very early diagnostic of RBD and PD.

摘要

帕金森病(PD)是仅次于阿尔茨海默病的第二大常见神经退行性疾病,也是全球发病率增长最快的神经退行性疾病之一。PD 通常在人生的第三个十年被诊断出来,其症状包括静止性震颤和肌肉僵硬。快速眼动睡眠行为障碍(RBD)是另一种疾病,它是由于睡眠中典型的肌肉松弛丧失引起的,伴随着大量的运动活动。通常,RBD 与 PD 密切相关。最近的研究表明,PD 会使患者的预期寿命减少 10 年和 20 年。此外,这些神经障碍的诊断和治疗延迟会对患者、他们的伴侣和公众产生重大的社会经济影响。通常,在低收入和高收入国家,PD 相关的经济负担都不清楚。另一方面,PD 引发的神经变化会影响多巴胺转运体(DAT)和葡萄糖代谢的差异。因此,使用特定的 DAT 放射性示踪剂和氟-18 标记的脱氧葡萄糖(FDG)的正电子发射断层扫描(PET)已被认为是一种关键的成像技术,可以用于 RBD 和 PD 的早期诊断。然而,关于 PET 的一个误解是它非常昂贵。在这里,我们研究了 PD 和 RBD 的治疗费用与早期 PET 成像之间的关系。我们的研究结果表明,在 PD 和 RBD 患者的管理中,PET 成像也可能是一种节省成本的诊断选择,不仅适用于现在的第一世界国家,也适用于第三世界国家。因此,PET 是一种用于 RBD 和 PD 早期诊断的具有成本效益的成像技术。

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