Song Yujin, Lee Jae-Hyeok, Kim Han-Kyeol, Lee Jae Hoon, Ryu Young Hoon, Yoo Han Soo, Lyoo Chul Hyoung
Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Department of Neurology, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea.
J Nucl Med. 2025 Feb 3;66(2):286-292. doi: 10.2967/jnumed.124.268365.
Parkinson disease (PD) is a multisystem disorder marked by progressive dopaminergic neuronal degeneration in the substantia nigra, as well as nondopaminergic systems. Our aim was to investigate longitudinal changes in -(3-[F]fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane (F-FP-CIT) binding at the putamen, substantia nigra, and raphe nuclei in PD. This retrospective cohort study enrolled 127 patients with PD, who underwent F-FP-CIT PET scans twice or more, and 71 age- and sex-matched healthy controls. A temporal trajectory model was created to estimate the longitudinal trajectories of F-FP-CIT PET specific binding ratios (SBRs) of the putamen, substantia nigra, and raphe nuclei from the prodromal to advanced stages. Associations between SBRs and age and motor severity were evaluated. At baseline, the PD group showed significantly lower F-FP-CIT SBR of the putamen and substantia nigra and higher F-FP-CIT SBR of the median raphe than did the control group. Longitudinally, F-FP-CIT decline of the putamen and substantia nigra began 11.3 and 3.4 y, respectively, before clinical onset on the more affected side. F-FP-CIT decline of the raphe nuclei remained constant for up to 20 y of disease duration. Topographically, F-FP-CIT SBR of the substantia nigra progressed from the caudal and anterolateral to the rostral and posteromedial regions. These results provide in vivo evidence of decreased striatal synaptic dopamine transporter availability approximately 8 y before decreased nigral neuronal dopamine transporter availability, which is strongly correlated with motor deficit. Serotonin transporter availability in the raphe nuclei was elevated in and remained largely unchanged during the disease span.
帕金森病（PD）是一种多系统疾病，其特征是黑质以及非多巴胺能系统中多巴胺能神经元进行性退化。我们的目的是研究帕金森病患者壳核、黑质和中缝核中-（3-[F]氟丙基-2β-甲氧基羰基-3β-（4-碘苯基）降冰片烷（F-FP-CIT）结合的纵向变化。这项回顾性队列研究纳入了127例帕金森病患者，他们接受了两次或更多次F-FP-CIT正电子发射断层扫描（PET），以及71名年龄和性别匹配的健康对照者。建立了一个时间轨迹模型，以估计从前驱期到晚期壳核、黑质和中缝核的F-FP-CIT PET特异性结合率（SBR）的纵向轨迹。评估了SBR与年龄和运动严重程度之间的关联。在基线时，帕金森病组壳核和黑质的F-FP-CIT SBR显著低于对照组，而中缝核的F-FP-CIT SBR高于对照组。纵向来看，壳核和黑质的F-FP-CIT下降分别在临床发病前11.3年和3.4年开始，在受影响更严重的一侧。中缝核的F-FP-CIT下降在疾病持续长达20年的时间里保持不变。在地形学上，黑质的F-FP-CIT SBR从尾侧和前外侧向头侧和后内侧区域进展。这些结果提供了体内证据，表明纹状体突触多巴胺转运体可用性在黑质神经元多巴胺转运体可用性下降前约8年就已降低，这与运动缺陷密切相关。中缝核中5-羟色胺转运体可用性在疾病期间升高且基本保持不变。
