Antonini A, Vontobel P, Psylla M, Günther I, Maguire P R, Missimer J, Leenders K L
PET Department, Paul Scherrer Institute, Villigen, Switzerland.
Arch Neurol. 1995 Dec;52(12):1183-90. doi: 10.1001/archneur.1995.00540360061017.
To assess the relationship between striatal dopa decarboxylase capacity, D2 dopamine receptor binding, and energy metabolism in Parkinson's disease (PD).
Positron emission tomographic (PET) studies of glucose and dopa metabolism and D2 dopamine receptor binding in the caudate nucleus and putamen of patients with PD at different Hoehn and Yahr (HY) stages using PET and the tracers 18F-fluorodeoxyglucose (FDG), 6-18F-fluoro-L-dopa (FDOPA), and 11C-raclopride (RACLO).
Positron emission tomography research program at the Paul Scherrer Institute.
Twenty patients with PD at different stages of the disease (HY stages I through IV; five patients for each stage) compared with separate groups of age-matched healthy subjects.
Influx constant (Ki) for specific FDOPA uptake; uptake index ratio for RACLO binding to D2 dopamine receptors; normalized to global FDG metabolic rate for glucose consumption; and semiquantitative score for assessment of tremor, rigidity, and bradykinesia in PD.
Patients with PD at HY stages I to II (hereafter HY-I-II PD) revealed reduced FDOPA metabolism, particularly in the putamen. The FDOPA uptake in the putamen and caudate nucleus declined with increasing HY staging and scoring for bradykinesia and rigidity. Putamen RACLO binding to D2 dopamine receptors was up-regulated in patients with HY-I-II PD but declined toward control values, with increasing disease severity. Putamen side-to-side asymmetries of FDOPA metabolism and RACLO binding revealed a significant correlation. Putamen FDG metabolism showed a relative increase in all patients with PD.
Our results show that FDOPA, RACLO, and FDG PET measurements provide complementary information to characterize metabolic and receptor changes in the striatum of PD with different degrees of motor disability. The FDOPA uptake reflects the best motor-related pathologic features, as indicated by the significant correlation between Ki values and clinical scores. The significant association between RACLO and FDOPA in the putamen suggests that D2 dopamine receptor changes are related to the reduction of presynaptic dopaminergic nerve terminals. Putamen FDG increase is probably the result of more complex feedback mechanisms that are primarily induced by striatal dopamine deficiency.
评估帕金森病（PD）患者纹状体多巴胺脱羧酶活性、D2多巴胺受体结合与能量代谢之间的关系。
采用正电子发射断层扫描（PET）及示踪剂18F-氟脱氧葡萄糖（FDG）、6-18F-氟-L-多巴（FDOPA）和11C-雷氯必利（RACLO），对处于不同Hoehn和Yahr（HY）分期的PD患者的尾状核和壳核进行葡萄糖及多巴代谢以及D2多巴胺受体结合的PET研究。
保罗·谢尔研究所正电子发射断层扫描研究项目。
20例处于疾病不同阶段（HY分期I至IV期；每个阶段5例）的PD患者，并与年龄匹配的健康受试者分组进行比较。
FDOPA特异性摄取的流入常数（Ki）；RACLO与D2多巴胺受体结合的摄取指数比；以整体FDG代谢率标准化的葡萄糖消耗量；以及用于评估PD患者震颤、强直和运动迟缓的半定量评分。
处于HY I至II期（以下简称HY-I-II期PD）的患者显示FDOPA代谢降低，尤其是在壳核。壳核和尾状核中的FDOPA摄取量随着HY分期增加以及运动迟缓与强直评分增加而下降。壳核中RACLO与D2多巴胺受体的结合在HY-I-II期PD患者中上调，但随着疾病严重程度增加而降至对照值。FDOPA代谢和RACLO结合的壳核左右不对称显示出显著相关性。所有PD患者的壳核FDG代谢均呈现相对增加。
我们的结果表明，FDOPA、RACLO和FDG的PET测量为表征不同程度运动功能障碍的PD患者纹状体中的代谢和受体变化提供了互补信息。FDOPA摄取反映了最佳的运动相关病理特征，如Ki值与临床评分之间的显著相关性所示。壳核中RACLO与FDOPA之间的显著关联表明，D2多巴胺受体变化与突触前多巴胺能神经末梢减少有关。壳核FDG增加可能是主要由纹状体多巴胺缺乏诱导的更复杂反馈机制的结果。
