Maly Emily F, DiFilippo Frank P, Lapin Brittany, Li Yadi, Berman Sarah, Bozoki Andrea C, Fleisher Jori E, Galvin James E, Irwin David J, Lippa Carol F, Litvan Irene, Tsuang Debby W, Zabetian Cyrus P, Taylor Angela S, Bekris Lynn M, Lopez Oscar L, Galasko Douglas, Leverenz James B
Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Lou Ruvo Center for Brain Health, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Alzheimers Dement. 2025 Sep;21(9):e70596. doi: 10.1002/alz.70596.
We aimed to determine whether I-ioflupane single-photon emission computed tomography (SPECT) striatal binding ratio (SBR) correlated with parkinsonian motor symptoms in dementia with Lewy bodies (DLB) and if SBR predicts worsening of parkinsonism over time.
A retrospective cohort study of the U.S. Dementia with Lewy Bodies Consortium dataset including individuals with DLB with baseline I-ioflupane SPECT analyzed with DaTQUANT and baseline and 24-month Movement Disorder Society Unified Parkinson's Disease Rating Scale-Part III (MDS-UPDRS-III). A subset had cerebrospinal fluid α-synuclein seed amplification assay (SAA) evaluation.
Baseline mean SBRs were significant predictors of baseline and 24-month MDS-UPDRS-III scores, although they did not predict meaningful worsening over time. SAA positivity was associated with lower SBRs; Z score cut-off values are provided.
In suspected DLB, I-ioflupane SPECT, at diagnosis, could be used to confirm underlying dopamine deficiency; it does not predict meaningful worsening of motor parkinsonism. More severe dopamine deficiency increases confidence in presence of synucleinopathy.
I-ioflupane single-photon emission computed tomography (SPECT) can confirm underlying dopamine deficiency. Striatal binding ratio (SBR) Z scores predicted 24-month Unified Parkinson's Disease Rating Scale-Part III (UPDRS-III) scores. SBR Z scores are not predictive of subsequent meaningful worsening of parkinsonism. More severe dopamine dysfunction on SPECT is associated with presence of seed amplification assay (SAA). SBR Z score cut-offs that indicate cerebrospinal fluid SAA positivity are provided.
我们旨在确定123I-碘氟潘单光子发射计算机断层扫描（SPECT）纹状体结合率（SBR）是否与路易体痴呆（DLB）中的帕金森运动症状相关，以及SBR是否能预测帕金森症随时间的恶化情况。
对美国路易体痴呆协会数据集进行回顾性队列研究，纳入基线时接受DaTQUANT分析的123I-碘氟潘SPECT检查的DLB患者，以及有基线和24个月时的运动障碍协会统一帕金森病评定量表第三部分（MDS-UPDRS-III）评分。一部分患者还进行了脑脊液α-突触核蛋白种子扩增试验（SAA）评估。
基线平均SBR是基线和24个月时MDS-UPDRS-III评分的显著预测指标，尽管它们不能预测随时间的有意义的恶化情况。SAA阳性与较低的SBR相关；提供了Z评分临界值。
在疑似DLB中，诊断时的123I-碘氟潘SPECT可用于确认潜在的多巴胺缺乏；它不能预测帕金森运动症状的有意义的恶化。更严重的多巴胺缺乏增加了存在突触核蛋白病的可信度。
123I-碘氟潘单光子发射计算机断层扫描（SPECT）可确认潜在的多巴胺缺乏。纹状体结合率（SBR）Z评分可预测24个月时的统一帕金森病评定量表第三部分（UPDRS-III）评分。SBR Z评分不能预测帕金森症随后的有意义的恶化。SPECT上更严重的多巴胺功能障碍与种子扩增试验（SAA）的存在相关。提供了指示脑脊液SAA阳性的SBR Z评分临界值。
