Tissingh G, Bergmans P, Booij J, Winogrodzka A, van Royen E A, Stoof J C, Wolters E C
Academisch Ziekenhuis Vrije Universiteit, Department of Neurology, Amsterdam, The Netherlands.
J Neurol. 1998 Jan;245(1):14-20. doi: 10.1007/s004150050168.
Ten healthy subjects and 16 patients with early Parkinson's disease (PD) were examined with single photon emission computed tomography (SPECT) and [123I]beta-CIT, a ligand for the dopamine (DA) transporter. Only drug-naive patients were examined since the expression of and binding to DA transporters may be influenced by dopaminergic medication. The main finding was a significant reduction in [123I]beta-CIT binding in the ipsi- and contralateral striatal regions, especially in the putamen, which showed a mean reduction of 65% of the control mean. Discriminant function analysis of the putaminal [123I]beta-CIT binding measures classified 100% of the cases in the correct group. Disease severity correlated negatively and highly significantly with the binding measures. Tremor ratings did not correlate with the SPECT measures, whereas rigidity, and to a lesser extent bradykinesia, did. Patients with unilateral PD showed a bilateral loss of striatal DA transporters. Our findings indicate that with [123I]beta-CIT SPECT it is possible to diagnose PD in subjects with very mild symptoms and signs. Moreover, finding a bilateral loss of striatal DA transporters in patients with unilateral PD also suggests that it may be possible to identify subjects in the preclinical phase of the disease.
10名健康受试者和16名早期帕金森病（PD）患者接受了单光子发射计算机断层扫描（SPECT）检查，并使用了[123I]β-CIT，一种多巴胺（DA）转运体的配体。仅对未服用过药物的患者进行了检查，因为多巴胺能药物可能会影响DA转运体的表达和结合。主要发现是同侧和对侧纹状体区域的[123I]β-CIT结合显著减少，尤其是壳核，其平均减少量为对照平均值的65%。对壳核[123I]β-CIT结合测量值进行判别函数分析，将100%的病例正确分类。疾病严重程度与结合测量值呈高度显著的负相关。震颤评分与SPECT测量值无关，而僵直以及程度较轻的运动迟缓则相关。单侧PD患者表现出双侧纹状体DA转运体缺失。我们的研究结果表明，使用[123I]β-CIT SPECT能够在症状和体征非常轻微的受试者中诊断出PD。此外，在单侧PD患者中发现双侧纹状体DA转运体缺失也表明，有可能识别出处于疾病临床前期的受试者。
