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Salin P, Melon C, Chassain C, Gubellini P, Pages G, Pereira B, Le Fur Y, Durif F, Kerkerian-Le Goff L. Interhemispheric reactivity of the subthalamic nucleus sustains progressive dopamine neuron loss in asymmetrical parkinsonism. Neurobiol Dis 2024; 191:106398. [PMID: 38182075 DOI: 10.1016/j.nbd.2023.106398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/21/2023] [Accepted: 12/30/2023] [Indexed: 01/07/2024] Open
Abstract
Parkinson's disease (PD) is characterized by the progressive and asymmetrical degeneration of the nigrostriatal dopamine neurons and the unilateral presentation of the motor symptoms at onset, contralateral to the most impaired hemisphere. We previously developed a rat PD model that mimics these typical features, based on unilateral injection of a substrate inhibitor of excitatory amino acid transporters, L-trans-pyrrolidine-2,4-dicarboxylate (PDC), in the substantia nigra (SN). Here, we used this progressive model in a multilevel study (behavioral testing, in vivo 1H-magnetic resonance spectroscopy, slice electrophysiology, immunocytochemistry and in situ hybridization) to characterize the functional changes occurring in the cortico-basal ganglia-cortical network in an evolving asymmetrical neurodegeneration context and their possible contribution to the cell death progression. We focused on the corticostriatal input and the subthalamic nucleus (STN), two glutamate components with major implications in PD pathophysiology. In the striatum, glutamate and glutamine levels increased from presymptomatic stages in the PDC-injected hemisphere only, which also showed enhanced glutamatergic transmission and loss of plasticity at corticostriatal synapses assessed at symptomatic stage. Surprisingly, the contralateral STN showed earlier and stronger reactivity than the ipsilateral side (increased intraneuronal cytochrome oxidase subunit I mRNA levels; enhanced glutamate and glutamine concentrations). Moreover, its lesion at early presymptomatic stage halted the ongoing neurodegeneration in the PDC-injected SN and prevented the expression of motor asymmetry. These findings reveal the existence of endogenous interhemispheric processes linking the primary injured SN and the contralateral STN that could sustain progressive dopamine neuron loss, opening new perspectives for disease-modifying treatment of PD.
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Affiliation(s)
- Pascal Salin
- Aix-Marseille Univ, CNRS, IBDM, Marseille, France
| | | | - Carine Chassain
- University of Clermont Auvergne, CHU, CNRS, Clermont Auvergne INP, Institut Pascal, F-63000 Clermont-Ferrand, France; INRAE, AgroResonance Facility, F-63122 Saint-Genès-Champanelle, France
| | | | - Guilhem Pages
- INRAE, AgroResonance Facility, F-63122 Saint-Genès-Champanelle, France; INRAE, UR QuaPA, F-63122 Saint-Genès-Champanelle, France
| | - Bruno Pereira
- University Hospital Clermont-Ferrand, Biostatisticis Unit (DRCI), Clermont-Ferrand, France
| | - Yann Le Fur
- Aix-Marseille Univ, CNRS, CRMBM, Marseille, France
| | - Franck Durif
- University of Clermont Auvergne, CHU, CNRS, Clermont Auvergne INP, Institut Pascal, F-63000 Clermont-Ferrand, France.
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Seibyl JP, Kuo P. What Is the Role of Dopamine Transporter Imaging in Parkinson Prevention Clinical Trials? Neurology 2022; 99:61-67. [PMID: 35970589 DOI: 10.1212/wnl.0000000000200786] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 04/11/2022] [Indexed: 12/17/2022] Open
Affiliation(s)
- John Peter Seibyl
- From the Institute for Neurodegenerative Disorders (J.P.S.), New Haven, CT; Department of Radiology (P.K.), University of Arizona, Tucson; and Invicro, LLC (P.K.), New Haven, CT.
| | - Phillip Kuo
- From the Institute for Neurodegenerative Disorders (J.P.S.), New Haven, CT; Department of Radiology (P.K.), University of Arizona, Tucson; and Invicro, LLC (P.K.), New Haven, CT
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3
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A Review of Diagnostic Imaging Approaches to Assessing Parkinson's Disease. BRAIN DISORDERS 2022. [DOI: 10.1016/j.dscb.2022.100037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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4
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Yeh SHH, Tsai CJ, Yu TH, Chiang YH, Lin SZ, Peng NJ, Huang WS. 99mTc-TRODAT-1 SPECT Revealed That Striatal Dopamine Transport Availability Significantly Decreases in Late Mid-Aged Healthy Taiwanese and Then Remains Stable. Clin Nucl Med 2022; 47:201-208. [PMID: 35081059 PMCID: PMC8820763 DOI: 10.1097/rlu.0000000000004063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/12/2021] [Accepted: 11/12/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Neuroimaging studies in the past 20 years have documented an age-related decline in striatal dopamine transporters (DATs), which is a marker of dopaminergic neurodegeneration; however, concerns about ethnic variations in the decline in DAT with age have not been addressed. The purpose of this study was to assess the rate of striatal DAT loss in healthy Taiwanese adults using kit-based 99mTc-TRODAT-1, a radioligand for DAT SPECT. PATIENTS AND METHODS Fifty healthy subjects (mean age ± SD, 63 ± 12 years; range, 30-80 years) were studied. 99mTc-TRODAT-1 was prepared from a lyophilized kit. Brain DAT SPECT imaging was acquired between 165 and 195 minutes postinjection (~740 MBq or 20 mCi) using a dual-head camera equipped with fan-beam collimators (Helix SPX; GE). Specific uptake in the striatum (ST), caudate nucleus (CA), and putamen (PU) were calculated from reconstructed transaxial slices at the level of maximal striatal activity. Occipital cortices were used as reference areas. Data were presented as specific binding ratios. RESULTS Age had a significant moderate to large negative effect on striatal DAT, which declined by -25.7% ± 6.10% between the ages of 30 and 80 years, equivalent to 6.4% loss per decade. The rates of decline in the CA and PU were 6.9% and 7.3% per decade, respectively. CONCLUSIONS This study suggests ethnic variations may not significantly affect the age-related decline in DAT. The data generated in this study could also be used as a reference to estimate DAT loss/occupancy in patients with DAT-related diseases.
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Affiliation(s)
- Skye Hsin-Hsien Yeh
- From the Brain Research Center, National Yang Ming Chaio Tung University
- School of Medicine, National Defense Medical Center
| | - Chi-Jung Tsai
- Department of Nuclear Medicine, Taipei Medical University Hospital
- Department of Nuclear Medicine, Tri-Service General Hospital
| | - Tsung-Hsun Yu
- From the Brain Research Center, National Yang Ming Chaio Tung University
| | | | | | - Nan-Jing Peng
- Department of Nuclear Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wen-Sheng Huang
- Department of Nuclear Medicine, Taipei Medical University Hospital
- Department of Nuclear Medicine, Tri-Service General Hospital
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Brücke T, Brücke C. Dopamine transporter (DAT) imaging in Parkinson's disease and related disorders. J Neural Transm (Vienna) 2021; 129:581-594. [PMID: 34910248 DOI: 10.1007/s00702-021-02452-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/30/2021] [Indexed: 11/27/2022]
Abstract
This review gives an insight into the beginnings of dopamine transporter (DAT) imaging in the early 1990s, focussing on single photon emission tomography (SPECT). The development of the method and its consolidation as a now widely used clinical tool is described. The role of DAT-SPECT in the diagnosis and differential diagnosis of PD, atypical parkinsonian syndromes and several other different neurological disorders is reviewed. Finally the clinical research using DAT-SPECT as a biomarker for the progression of PD, for the detection of a preclinical dopaminergic lesion and its correlation with neuropathological findings is outlined.
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Affiliation(s)
- Thomas Brücke
- Ottakring Clinic, Neurological Department, Verein zur Förderung der Wissenschaftlichen Forschung am Wilhelminenspital (FWFW), Montleartstrasse 37, 1160, Vienna, Austria.
- , Linke Wienzeile 12, 1060, Vienna, Austria.
| | - Christof Brücke
- Department for Neurology, Medical University Vienna, Währingergürtel 18-20, 1090, Vienna, Austria
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Li KR, Avecillas-Chasin J, Nguyen TD, Gillen KM, Dimov A, Chang E, Skudin C, Kopell BH, Wang Y, Shtilbans A. Quantitative evaluation of brain iron accumulation in different stages of Parkinson's disease. J Neuroimaging 2021; 32:363-371. [PMID: 34904328 DOI: 10.1111/jon.12957] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/23/2021] [Accepted: 11/23/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND AND PURPOSE Excessive brain iron deposition is involved in Parkinson's disease (PD) pathogenesis. However, the correlation of iron accumulation in various brain nuclei is not well-established in different stages of the disease. This cross-sectional study aims to evaluate quantitative susceptibility mapping (QSM) as an imaging technique to measure brain iron accumulation in PD patients in different stages compared to healthy controls. METHODS Ninety-six PD patients grouped by their Hoehn and Yahr (H&Y) stages and 31 healthy controls were included in this analysis. The magnetic susceptibility values of the substantia nigra (SN), red nucleus (RN), caudate, putamen, and globus pallidus were obtained and compared. RESULTS Iron level was increased in the SN of PD patients in all stages versus controls (p < .001), with no significant difference within stages. Iron in the RN was significantly increased in stage II versus controls (p = .013) and combined stages III and IV versus controls (p < .001). The iron levels in caudate, putamen, and globus pallidus were not different between any groups. CONCLUSIONS Our data suggest iron accumulation occurs early in the disease course and only in the SN and RN of these patients. This is a large cross-sectional study of brain iron deposition in PD patients according to H&Y staging. Prospective studies are warranted to further validate QSM as a method to follow brain iron, which could serve as a disease biomarker and a therapeutic target.
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Affiliation(s)
- Kailyn R Li
- Department of Radiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York, USA.,MD Program, Weill Cornell Medicine, New York, New York, USA
| | | | - Thanh D Nguyen
- Department of Radiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York, USA
| | - Kelly M Gillen
- Department of Radiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York, USA
| | - Alexey Dimov
- Department of Radiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York, USA
| | - Eileen Chang
- Department of Radiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York, USA
| | - Carly Skudin
- Department of Radiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York, USA
| | - Brian H Kopell
- Department of Neurosurgery, Mount Sinai Hospital, New York, New York, USA
| | - Yi Wang
- Department of Radiology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York, USA
| | - Alexander Shtilbans
- Department of Neurology, Weill Cornell Medicine, NewYork-Presbyterian Hospital, New York, New York, USA.,Department of Neurology, Hospital for Special Surgery, New York, New York, USA
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Hutchison RM, Evans KC, Fox T, Yang M, Barakos J, Bedell BJ, Cedarbaum JM, Brys M, Siderowf A, Lang AE. Evaluating dopamine transporter imaging as an enrichment biomarker in a phase 2 Parkinson's disease trial. BMC Neurol 2021; 21:459. [PMID: 34814867 PMCID: PMC8609885 DOI: 10.1186/s12883-021-02470-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 10/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dopamine transporter single-photon emission computed tomography (DaT-SPECT) can quantify the functional integrity of the dopaminergic nerve terminals and has been suggested as an imaging modality to verify the clinical diagnosis of Parkinson's disease (PD). Depending on the stage of progression, approximately 5-15% of participants clinically diagnosed with idiopathic PD have been observed in previous studies to have normal DaT-SPECT patterns. However, the utility of DaT-SPECT in enhancing early PD participant selection in a global, multicenter clinical trial of a potentially disease-modifying therapy is not well understood. METHODS The SPARK clinical trial was a phase 2 trial of cinpanemab, a monoclonal antibody against alpha-synuclein, in participants with early PD. DaT-SPECT was performed at screening to select participants with DaT-SPECT patterns consistent with degenerative parkinsonism. Acquisition was harmonised across 82 sites. Images were reconstructed and qualitatively read at a central laboratory by blinded neuroradiologists for inclusion prior to automated quantitative analysis. RESULTS In total, 482 unique participants were screened between January 2018 and May 2019; 3.8% (15/398) of imaged participants were excluded owing to negative DaT-SPECT findings (i.e., scans without evidence of dopaminergic deficit [SWEDD]). CONCLUSION A smaller proportion of SPARK participants were excluded owing to SWEDD status upon DaT-SPECT screening than has been reported in prior studies. Further research is needed to understand the reasons for the low SWEDD rate in this study and whether these results are generalisable to future studies. If supported, the radiation risks, imaging costs, and operational burden of DaT-SPECT for enrichment may be mitigated by clinical assessment and other study design aspects. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03318523 . Date submitted: October 19, 2017. First Posted: October 24, 2017.
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Affiliation(s)
| | | | | | - Minhua Yang
- Biogen, 300 Binney Street, Cambridge, MA, 02142, USA
| | | | | | | | | | | | - Anthony E Lang
- Morton and Gloria Shulman Movement Disorders Clinic, Toronto, ON, Canada.,Edmond J. Safra Program in Parkinson's Disease, Toronto, ON, Canada
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8
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Palermo G, Giannoni S, Bellini G, Siciliano G, Ceravolo R. Dopamine Transporter Imaging, Current Status of a Potential Biomarker: A Comprehensive Review. Int J Mol Sci 2021; 22:11234. [PMID: 34681899 PMCID: PMC8538800 DOI: 10.3390/ijms222011234] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 11/16/2022] Open
Abstract
A major goal of current clinical research in Parkinson's disease (PD) is the validation and standardization of biomarkers enabling early diagnosis, predicting outcomes, understanding PD pathophysiology, and demonstrating target engagement in clinical trials. Molecular imaging with specific dopamine-related tracers offers a practical indirect imaging biomarker of PD, serving as a powerful tool to assess the status of presynaptic nigrostriatal terminals. In this review we provide an update on the dopamine transporter (DAT) imaging in PD and translate recent findings to potentially valuable clinical practice applications. The role of DAT imaging as diagnostic, preclinical and predictive biomarker is discussed, especially in view of recent evidence questioning the incontrovertible correlation between striatal DAT binding and nigral cell or axon counts.
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Affiliation(s)
- Giovanni Palermo
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.P.); (S.G.); (G.B.); (G.S.)
| | - Sara Giannoni
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.P.); (S.G.); (G.B.); (G.S.)
- Unit of Neurology, San Giuseppe Hospital, 50053 Empoli, Italy
| | - Gabriele Bellini
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.P.); (S.G.); (G.B.); (G.S.)
| | - Gabriele Siciliano
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.P.); (S.G.); (G.B.); (G.S.)
| | - Roberto Ceravolo
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.P.); (S.G.); (G.B.); (G.S.)
- Center for Neurodegenerative Diseases, Unit of Neurology, Parkinson’s Disease and Movement Disorders, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
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9
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Fan HC, Chang YK, Tsai JD, Chiang KL, Shih JH, Yeh KY, Ma KH, Li IH. The Association Between Parkinson's Disease and Attention-Deficit Hyperactivity Disorder. Cell Transplant 2021; 29:963689720947416. [PMID: 33028106 PMCID: PMC7784516 DOI: 10.1177/0963689720947416] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
While Parkinson’s disease (PD) and attention-deficit hyperactivity disorder (ADHD) are two distinct conditions, it has been hypothesized that they share several overlapping anatomical and neurochemical changes. In order to investigate that hypothesis, this study used claims data from Taiwan’s Longitudinal Health Insurance Database 2000 to provide the significant nationwide population-based evidence of an increased risk of PD among ADHD patients, and the connection between the two conditions was not the result of other comorbidities. Moreover, this study showed that the patients with PD were 2.8 times more likely to have a prior ADHD diagnosis compared with those without a prior history of ADHD. Furthermore, an animal model of ADHD was generated by neonatally injecting rats with 6-hydroxydopamine (6-OHDA). These rats were subjected to behavior tests and the 99mTc-TRODAT-1 brain imaging at the juvenile stage. Compared to control group rats, the 6-OHDA rats showed a significantly reduced specific uptake ratio in the striatum, indicating an underlying PD-linked pathology in the brains of these ADHD phenotype-expressing rats. Overall, these results support that ADHD shares a number of anatomical and neurochemical changes with PD. As such, improved knowledge of the neurochemical mechanisms underlying ADHD could result in improved treatments for various debilitating neurological disorders, including PD.
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Affiliation(s)
- Hueng-Chuen Fan
- Department of Pediatrics, 59084Tungs' Taichung Metroharbor Hospital, Wuchi, Taichung.,Department of Medical research, 68866Tungs' Taichung Metroharbor Hospital, Wuchi, Taichung.,Department of Life Sciences, 59084National Chung Hsing University, Taichung.,Department of Rehabilitation, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli
| | - Yu-Kang Chang
- Department of Medical research, 68866Tungs' Taichung Metroharbor Hospital, Wuchi, Taichung.,Department of Life Sciences, 59084National Chung Hsing University, Taichung.,Department of Rehabilitation, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli
| | - Jeng-Dau Tsai
- School of Medicine, 34899Chung Shan Medical University, Taichung.,Department of Pediatrics, 34899Chung Shan Medical University Hospital, Taichung
| | - Kuo-Liang Chiang
- Department of Pediatric Neurology, 38009Kuang-Tien General Hospital, Taichung.,Department of Nutrition, Hungkuang University, Taichung
| | - Jui-Hu Shih
- Department of Pharmacy Practice, 63452Tri-Service General Hospital, Taipei.,School of Pharmacy, 71548National Defense Medical Center, Taipei
| | - Kuan-Yi Yeh
- Department of Biology and Anatomy, 71548National Defense Medical Center, Taipei
| | - Kuo-Hsing Ma
- Department of Biology and Anatomy, 71548National Defense Medical Center, Taipei
| | - I-Hsun Li
- Department of Pharmacy Practice, 63452Tri-Service General Hospital, Taipei.,School of Pharmacy, 71548National Defense Medical Center, Taipei
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10
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Implication of metabolic and dopamine transporter PET in dementia with Lewy bodies. Sci Rep 2021; 11:14394. [PMID: 34257349 PMCID: PMC8277897 DOI: 10.1038/s41598-021-93442-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 06/24/2021] [Indexed: 11/08/2022] Open
Abstract
To evaluate the implication of 18F-fluorodeoxyglucose (FDG)- and dopamine transporter (DAT)-positron emission tomography (PET) in the diagnosis and clinical symptoms of dementia with Lewy bodies (DLB), 55 DLB patients and 49 controls underwent neuropsychological evaluation and FDG-, DAT-, and 18F-Florbetaben (FBB) PET. DAT- and FDG-uptake and FDG/DAT ratio were measured in the anterior and posterior striatum. The first principal component (PC1) of FDG subject residual profiles was identified for each subject. Receiver operating characteristic curve analyses for the diagnosis of DLB were performed using FDG- and DAT-PET biomarkers as predictors, and general linear models for motor severity and cognitive scores were performed adding FBB standardized uptake value ratio as a predictor. Increased metabolism in the bilateral putamen, vermis, and somato-motor cortices, which characterized PC1, was observed in the DLB group, compared to the control group. A combination of posterior putamen FDG/DAT ratio and PC1 showed the highest diagnostic accuracy (91.8% sensitivity and 96.4% specificity), which was significantly greater than that obtained by DAT uptake alone. Striatal DAT uptake and PC1 independently contributed to motor severity and language, memory, frontal/executive, and general cognitive dysfunction in DLB patients, while only PC1 contributed to attention and visuospatial dysfunction.
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11
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Kerstens VS, Varrone A. Dopamine transporter imaging in neurodegenerative movement disorders: PET vs. SPECT. Clin Transl Imaging 2020. [DOI: 10.1007/s40336-020-00386-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Abstract
Purpose
The dopamine transporter (DAT) serves as biomarker for parkinsonian syndromes. DAT can be measured in vivo with single-photon emission computed tomography (SPECT) and positron emission tomography (PET). DAT-SPECT is the current clinical molecular imaging standard. However, PET has advantages over SPECT measurements, and PET radioligands with the necessary properties for clinical applications are on the rise. Therefore, it is time to review the role of DAT imaging with SPECT compared to PET.
Methods
PubMed and Web of Science were searched for relevant literature of the previous 10 years. Four topics for comparison were used: diagnostic accuracy, quantitative accuracy, logistics, and flexibility.
Results
There are a few studies directly comparing DAT-PET and DAT-SPECT. PET and SPECT both perform well in discriminating neurodegenerative from non-neurodegenerative parkinsonism. Clinical DAT-PET imaging seems feasible only recently, thanks to simplified DAT assessments and better availability of PET radioligands and systems. The higher resolution of PET makes more comprehensive assessments of disease progression in the basal ganglia possible. Additionally, it has the possibility of multimodal target assessment.
Conclusion
DAT-SPECT is established for differentiating degenerative from non-degenerative parkinsonism. For further differentiation within neurodegenerative Parkinsonian syndromes, DAT-PET has essential benefits. Nowadays, because of wider availability of PET systems and radioligand production centers, and the possibility to use simplified quantification methods, DAT-PET imaging is feasible for clinical use. Therefore, DAT-PET needs to be considered for a more active role in the clinic to take a step forward to a more comprehensive understanding and assessment of Parkinson’s disease.
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Hossein‐Tehrani MR, Ghaedian T, Hooshmandi E, Kalhor L, Foroughi AA, Ostovan VR. Brain TRODAT‐SPECT Versus MRI Morphometry in Distinguishing Early Mild Parkinson's Disease from Other Extrapyramidal Syndromes. J Neuroimaging 2020; 30:683-689. [DOI: 10.1111/jon.12740] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 05/18/2020] [Accepted: 05/21/2020] [Indexed: 01/26/2023] Open
Affiliation(s)
| | - Tahereh Ghaedian
- Nuclear Medicine and Molecular Imaging Research Center, Namazi Teaching Hospital Shiraz University of Medical Sciences Shiraz Iran
| | - Etrat Hooshmandi
- Clinical Neurology Research Center Shiraz University of Medical Sciences Shiraz Iran
| | - Leila Kalhor
- Nuclear Medicine and Molecular Imaging Research Center, Namazi Teaching Hospital Shiraz University of Medical Sciences Shiraz Iran
| | - Amin Abolhasani Foroughi
- Medical Imaging Research Center Shiraz University of Medical Sciences Shiraz Iran
- Epilepsy Research Center Shiraz University of Medical Sciences Shiraz Iran
| | - Vahid Reza Ostovan
- Clinical Neurology Research Center Shiraz University of Medical Sciences Shiraz Iran
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Uchida Y, Kan H, Sakurai K, Inui S, Kobayashi S, Akagawa Y, Shibuya K, Ueki Y, Matsukawa N. Magnetic Susceptibility Associates With Dopaminergic Deficits and Cognition in Parkinson's Disease. Mov Disord 2020; 35:1396-1405. [DOI: 10.1002/mds.28077] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/06/2020] [Accepted: 04/06/2020] [Indexed: 12/24/2022] Open
Affiliation(s)
- Yuto Uchida
- Department of Neurology and Neuroscience Nagoya City University Graduate School of Medical Sciences Nagoya Japan
- Department of Neurology Toyokawa City Hospital Aichi Japan
| | - Hirohito Kan
- Radiological and Medical Laboratory Sciences Nagoya University Graduate School of Medicine Nagoya Japan
| | - Keita Sakurai
- Department of Radiology Teikyo University School of Medicine Tokyo Japan
| | - Shohei Inui
- Department of Radiology, Graduate School of Medicine The University of Tokyo Tokyo Japan
| | | | | | | | - Yoshino Ueki
- Department of Rehabilitation Medicine Nagoya City University Graduate School of Medical Sciences Nagoya Japan
| | - Noriyuki Matsukawa
- Department of Neurology and Neuroscience Nagoya City University Graduate School of Medical Sciences Nagoya Japan
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Shin JH, Lee WW, Lee JY, Kim HJ, Jeon B. GCH-1 genetic variant may cause Parkinsonism by unmasking the subclinical nigral pathology. J Neurol 2020; 267:1952-1959. [PMID: 32170445 DOI: 10.1007/s00415-020-09788-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 03/05/2020] [Accepted: 03/06/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Recent studies suggest that GTP cyclohydrolase 1 (GCH-1) variant may be a risk factor for nigral degeneration causing PD. METHODS A 49-year-old Korean woman visited our movement disorder clinic with the initial presentation of Parkinsonism starting at age 47. We monitored the degree of nigral degeneration with serial FP-CIT PET throughout the course of her disease (2, 8 and 11 years from disease onset). RESULTS The initial clinical presentation was consistent with intrinsic dopamine deficiency caused by GCH-1 variant. However, her follow-up disease course was consistent with Parkinsonism caused by nigral neurodegeneration. We found a novel GCH-1 variant in the current case. The disease course of the patient was overall benign in motor and non-motor aspects, corresponding to previously reported GCH-1 cases with PD. Serial FP-CIT PET scans showed normal initial FP-CIT binding followed by a continuous decline of the putaminal binding ratio. However, the decreased binding ratio could not sufficiently explain the corresponding clinical duration of the patient. Therefore, dopamine deficiency by GCH-1 genetic variant contributed to Parkinsonism in the current case with subclinical nigral degeneration. CONCLUSION Our case suggests that GCH-1 variant causes Parkinsonism by unmasking the subclinical nigral pathology, not by causing the nigral neurodegeneration.
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Affiliation(s)
- Jung Hwan Shin
- Department of Neurology, College of Medicine, Seoul National University Hospital, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 110-774, South Korea
| | - Woong-Woo Lee
- Department of Neurology, Nowon Eulji Medical Center, Seoul, South Korea
| | - Jee-Young Lee
- Department of Neurology, Seoul National University Boramae Hospital, Seoul, South Korea
| | - Han-Joon Kim
- Department of Neurology, College of Medicine, Seoul National University Hospital, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 110-774, South Korea
| | - Beomseok Jeon
- Department of Neurology, College of Medicine, Seoul National University Hospital, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 110-774, South Korea.
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Garrido A, Iranzo A, Stefani A, Serradell M, Muñoz-Lopetegi A, Marrero P, Högl B, Gaig C, Santamaria J, Tolosa E, Poewe W. Lack of Asymmetry of Nigrostriatal Dopaminergic Function in Healthy Subjects. Mov Disord 2020; 35:1072-1076. [PMID: 32141653 DOI: 10.1002/mds.28019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/07/2020] [Accepted: 02/10/2020] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE In right-handed patients with Parkinson's disease (PD) or isolated rapid eye movement sleep behavior disorder, dopamine transporter (DAT) [(123)I]β-carboxymethyoxy-3-β-(4-iodophenyl) tropane single photon emission computed tomography (SPECT) shows predominant nigrostriatal deficit in the left striatum. This suggests that in PD patients, the nigrostriatal system of the dominant hemisphere is more susceptible to disease-related dysfunction. To confirm this hypothesis, we investigated whether the nigrostriatal function is symmetric in healthy controls and in patients with PD. METHODS In 113 right-handed healthy controls and 279 right-handed early-PD patients, we examined the striatal dopaminergic terminals function in each hemisphere using DAT-SPECT. RESULTS In the controls, DAT-SPECT showed symmetric specific binding ratios in the putamen and caudate nucleus of each hemisphere. In patients with PD, the specific binding ratio was lower in the left than in the right putamen. CONCLUSIONS Right-handed healthy controls have symmetric nigrostriatal dopaminergic function. The left hemispheric predominance of nigrostriatal deficit seen in right-handed premotor and manifest PD represents an early pathological feature of the disease. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Alicia Garrido
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clinic de Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Alex Iranzo
- Center for Sleep Disorders, Neurology Service, Hospital Clinic de Barcelona, IDIBAPS, CIBERNED, Barcelona, Spain
| | - Ambra Stefani
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Mònica Serradell
- Center for Sleep Disorders, Neurology Service, Hospital Clinic de Barcelona, IDIBAPS, CIBERNED, Barcelona, Spain
| | - Amaia Muñoz-Lopetegi
- Center for Sleep Disorders, Neurology Service, Hospital Clinic de Barcelona, IDIBAPS, CIBERNED, Barcelona, Spain
| | - Paula Marrero
- Center for Sleep Disorders, Neurology Service, Hospital Clinic de Barcelona, IDIBAPS, CIBERNED, Barcelona, Spain
| | - Birgit Högl
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Carles Gaig
- Center for Sleep Disorders, Neurology Service, Hospital Clinic de Barcelona, IDIBAPS, CIBERNED, Barcelona, Spain
| | - Joan Santamaria
- Center for Sleep Disorders, Neurology Service, Hospital Clinic de Barcelona, IDIBAPS, CIBERNED, Barcelona, Spain
| | - Eduard Tolosa
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clinic de Barcelona, Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - Werner Poewe
- Center for Sleep Disorders, Neurology Service, Hospital Clinic de Barcelona, IDIBAPS, CIBERNED, Barcelona, Spain
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16
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Salazar RD, Moon KLM, Neargarder S, Cronin-Golomb A. Spatial judgment in Parkinson's disease: Contributions of attentional and executive dysfunction. Behav Neurosci 2020; 133:350-360. [PMID: 31294590 DOI: 10.1037/bne0000329] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Spatial judgment is impaired in Parkinson's disease (PD), with previous research suggesting that disruptions in attention and executive function are likely contributors. If judgment of center places demands on frontal systems, performance on tests of attention/executive function may correlate with extent of bias in PD, and attentional disturbance may predict inconsistency in spatial judgment. The relation of spatial judgment to attention/executive function may differ for those with left-side versus right-side motor onset (LPD, RPD), reflecting effects of attentional lateralization. We assessed 42 RPD, 37 LPD, and 67 healthy control participants with a Landmark task (LM) in which a cursor moved horizontally from the right (right-LM) or left (left-LM). The task was to judge the center of the line. Participants also performed neuropsychological tests of attention and executive function. LM group differences were found on left-LM only, with both PD subgroups biased leftward of the control group (RPD p < .05; LPD p < .01; no RPD-LPD difference). For left-LM trials, extent of bias significantly correlated with performance on the cognitive tasks for PD but not for the control group. PD showed greater variability in perceived center than the control group; this variability correlated with performance on the cognitive tasks. The correlations between performance on the test of spatial judgment and the tests of attention/executive function suggest that frontal-based attentional dysfunction affects dynamic spatial judgment, both in extent of spatial bias and in consistency of response as indexed by intertrial variability. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Robert D Salazar
- Department of Psychological and Brain Sciences, Boston University
| | - Kathryn L M Moon
- Department of Psychological and Brain Sciences, Boston University
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17
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Rajpoot K. Nanotechnology-based Targeting of Neurodegenerative Disorders: A Promising Tool for Efficient Delivery of Neuromedicines. Curr Drug Targets 2020; 21:819-836. [PMID: 31906836 DOI: 10.2174/1389450121666200106105633] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/18/2019] [Accepted: 12/18/2019] [Indexed: 12/13/2022]
Abstract
Traditional drug delivery approaches remained ineffective in offering better treatment to various neurodegenerative disorders (NDs). In this context, diverse types of nanocarriers have shown their great potential to cross the blood-brain barrier (BBB) and have emerged as a prominent carrier system in drug delivery. Moreover, nanotechnology-based methods usually involve numerous nanosized carrier platforms, which potentiate the effect of the therapeutic agents in the therapy of NDs especially in diagnosis and drug delivery with negligible side effects. In addition, nanotechnology-based techniques have offered several strategies to cross BBB to intensify the bioavailability of drug moieties in the brain. In the last few years, diverse kinds of nanoparticles (NPs) have been developed by incorporating various biocompatible components (e.g., polysaccharide-based NPs, polymeric NPs, selenium NPs, AuNPs, protein-based NPs, gadolinium NPs, etc.), that showed great therapeutic benefits against NDs. Eventually, this review provides deep insights to explore recent applications of some innovative nanocarriers enclosing active molecules for the efficient treatment of NDs.
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Affiliation(s)
- Kuldeep Rajpoot
- Institute of Pharmaceutical Sciences, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur, 495 009, Chhattisgarh, India
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18
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Kim M, Won JH, Youn J, Park H. Joint-Connectivity-Based Sparse Canonical Correlation Analysis of Imaging Genetics for Detecting Biomarkers of Parkinson's Disease. IEEE TRANSACTIONS ON MEDICAL IMAGING 2020; 39:23-34. [PMID: 31144631 DOI: 10.1109/tmi.2019.2918839] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Imaging genetics is a method used to detect associations between imaging and genetic variables. Some researchers have used sparse canonical correlation analysis (SCCA) for imaging genetics. This study was conducted to improve the efficiency and interpretability of SCCA. We propose a connectivity-based penalty for incorporating biological prior information. Our proposed approach, named joint connectivity-based SCCA (JCB-SCCA), includes the proposed penalty and can handle multi-modal neuroimaging datasets. Different neuroimaging techniques provide distinct information on the brain and have been used to investigate various neurological disorders, including Parkinson's disease (PD). We applied our algorithm to simulated and real imaging genetics datasets for performance evaluation. Our algorithm was able to select important features in a more robust manner compared with other multivariate methods. The algorithm revealed promising features of single-nucleotide polymorphisms and brain regions related to PD by using a real imaging genetic dataset. The proposed imaging genetics model can be used to improve clinical diagnosis in the form of novel potential biomarkers. We hope to apply our algorithm to cohorts such as Alzheimer's patients or healthy subjects to determine the generalizability of our algorithm.
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19
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SPECT and PET of the Brain. Clin Nucl Med 2020. [DOI: 10.1007/978-3-030-39457-8_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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20
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Di Caprio V, Modugno N, Mancini C, Olivola E, Mirabella G. Early‐Stage Parkinson's Patients Show Selective Impairment in Reactive But Not Proactive Inhibition. Mov Disord 2019; 35:409-418. [DOI: 10.1002/mds.27920] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/27/2019] [Accepted: 10/23/2019] [Indexed: 11/08/2022] Open
Affiliation(s)
- Veronica Di Caprio
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli (IS) Italy
| | - Nicola Modugno
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli (IS) Italy
| | - Christian Mancini
- Department of Anatomy, Histology, Forensic Medicine & OrthopedicsSapienza University Rome Italy
| | - Enrica Olivola
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli (IS) Italy
| | - Giovanni Mirabella
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Neuromed, Pozzilli (IS) Italy
- Department of Anatomy, Histology, Forensic Medicine & OrthopedicsSapienza University Rome Italy
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21
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Yamada G, Ueki Y, Oishi N, Oguri T, Fukui A, Nakayama M, Sano Y, Kandori A, Kan H, Arai N, Sakurai K, Wada I, Matsukawa N. Nigrostriatal Dopaminergic Dysfunction and Altered Functional Connectivity in REM Sleep Behavior Disorder With Mild Motor Impairment. Front Neurol 2019; 10:802. [PMID: 31404164 PMCID: PMC6677031 DOI: 10.3389/fneur.2019.00802] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 07/11/2019] [Indexed: 11/13/2022] Open
Abstract
Rapid eye movement sleep behavior disorder is parasomnia characterized by symptoms of dream enactment and loss of muscle atonia during rapid eye movement sleep. Mild motor impairment is present in some patients with rapid eye movement sleep behavior disorder and presumed to be a risk factor for conversion to synucleinopathies. The purpose of this study is to identify patients with mild motor impairment by evaluating finger tapping and to investigate its pathophysiology. Twenty-three patients with rapid eye movement sleep behavior disorder and 20 healthy control subjects were recruited in the present study. We accurately evaluated finger tapping including amplitude, peak open, and close speed with a magnetic sensing device and identified patients with mild motor impairment. Moreover, we performed 123I-2β-carbomethoxy-3β-(4-iodophenyl) nortropane SPECT and resting state functional MRI. 123I-2β-carbomethoxy-3β-(4-iodophenyl) nortropane uptake for each bilateral caudate, anterior putamen, and posterior putamen was calculated and the resting state functional connectivity of sensorimotor network was analyzed. Using finger tapping parameters, we identified eight patients with mild motor impairment. In patients with mild motor impairment, all finger tapping parameters were significantly impaired when compared to patients with normal motor function, while they exhibited no significant differences in Unified Parkinson's Disease Rating Scale part III score. 123I-2β-carbomethoxy-3β-(4-iodophenyl) nortropane uptake in the right posterior putamen, bilateral anterior putamen, and caudate was significantly lower when compared to healthy controls or patients with rapid eye movement sleep behavior disorder with normal motor function. These patients also exhibited decreased cortico-striatal functional connectivity and increased cortico-cerebellar functional connectivity when compared to healthy controls or patients with normal motor function. Our results show that mild motor impairment in rapid eye movement sleep behavior disorder evaluated by finger tapping task presented mild nigrostriatal dopaminergic dysfunction as well as alterations in resting state sensorimotor network. Although longitudinal follow up is necessary, such patients may have higher risk of short-term conversion to synucleinopathies.
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Affiliation(s)
- Gohei Yamada
- Department of Neurology, Nagoya City University Graduate School of Medical Science, Aichi, Japan
| | - Yoshino Ueki
- Department of Rehabilitation Medicine, Nagoya City University Graduate School of Medical Science, Aichi, Japan
| | - Naoya Oishi
- Medical Innovation Centre, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takuya Oguri
- Department of Neurology, Nagoya City University Graduate School of Medical Science, Aichi, Japan.,Department of Neurology, Tosei General Hospital, Aichi, Japan
| | - Ayako Fukui
- Department of Otolaryngology and Good Sleep Centre, Nagoya City University Graduate School of Medicine, Aichi, Japan
| | - Meiho Nakayama
- Department of Otolaryngology and Good Sleep Centre, Nagoya City University Graduate School of Medicine, Aichi, Japan
| | - Yuko Sano
- Research & Development Group, Centre for Technology Innovation - Healthcare, Hitachi Ltd, Saitama, Japan
| | - Akihiko Kandori
- Research & Development Group, Centre for Technology Innovation - Healthcare, Hitachi Ltd, Saitama, Japan
| | - Hirohito Kan
- Department of Radiology, Nagoya City University Hospital, Aichi, Japan
| | - Nobuyuki Arai
- Department of Radiology, Nagoya City University Hospital, Aichi, Japan
| | - Keita Sakurai
- Department of Radiology, Teikyo University, Tokyo, Japan
| | - Ikuo Wada
- Department of Rehabilitation Medicine, Nagoya City University Graduate School of Medical Science, Aichi, Japan
| | - Noriyuki Matsukawa
- Department of Neurology, Nagoya City University Graduate School of Medical Science, Aichi, Japan
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22
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Takahashi H, Watanabe Y, Tanaka H, Mochizuki H, Kato H, Hatazawa J, Tomiyama N. Quantifying the Severity of Parkinson Disease by Use of Dopaminergic Neuroimaging. AJR Am J Roentgenol 2019; 213:163-168. [DOI: 10.2214/ajr.18.20655] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Hiroto Takahashi
- Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yoshiyuki Watanabe
- Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hisashi Tanaka
- Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hideki Mochizuki
- Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hiroki Kato
- Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Jun Hatazawa
- Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Noriyuki Tomiyama
- Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
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23
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Jenkins PO, De Simoni S, Bourke NJ, Fleminger J, Scott G, Towey DJ, Svensson W, Khan S, Patel M, Greenwood R, Cole JH, Sharp DJ. Dopaminergic abnormalities following traumatic brain injury. Brain 2019; 141:797-810. [PMID: 29360949 DOI: 10.1093/brain/awx357] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 11/12/2017] [Indexed: 01/19/2023] Open
Abstract
Traumatic brain injury can reduce striatal dopamine levels. The cause of this is uncertain, but is likely to be related to damage to the nigrostriatal system. We investigated the pattern of striatal dopamine abnormalities using 123I-Ioflupane single-photon emission computed tomography (SPECT) scans and their relationship to nigrostriatal damage and clinical features. We studied 42 moderate-severe traumatic brain injury patients with cognitive impairments but no motor parkinsonism signs and 20 healthy controls. 123I-Ioflupane scanning was used to assess dopamine transporter levels. Clinical scan reports were compared to quantitative dopamine transporter results. Advanced MRI methods were used to assess the nigrostriatal system, including the area through which the nigrostriatal projections pass as defined from high-resolution Human Connectome data. Detailed clinical and neuropsychological assessments were performed. Around 20% of our moderate-severe patients had clear evidence of reduced specific binding ratios for the dopamine transporter in the striatum measured using 123I-Ioflupane SPECT. The caudate was affected more consistently than other striatal regions. Dopamine transporter abnormalities were associated with reduced substantia nigra volume. In addition, diffusion MRI provided evidence of damage to the regions through which the nigrostriatal tract passes, particularly the area traversed by dopaminergic projections to the caudate. Only a small percentage of patients had evidence of macroscopic lesions in the striatum and there was no relationship between presence of lesions and dopamine transporter specific binding ratio abnormalities. There was also no relationship between reduced volume in the striatal subregions and reduced dopamine transporter specific binding ratios. Patients with low caudate dopamine transporter specific binding ratios show impaired processing speed and executive dysfunction compared to patients with normal levels. Taken together, our results suggest that the dopaminergic system is affected by a moderate-severe traumatic brain injury in a significant proportion of patients, even in the absence of clinical motor parkinsonism. Reduced dopamine transporter levels are most commonly seen in the caudate and this is likely to reflect the pattern of nigrostriatal tract damage produced by axonal injury and associated midbrain damage.
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Affiliation(s)
- Peter O Jenkins
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Imperial College London, Division of Brain Sciences, Hammersmith Hospital, London, UK
| | - Sara De Simoni
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Imperial College London, Division of Brain Sciences, Hammersmith Hospital, London, UK
| | - Niall J Bourke
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Imperial College London, Division of Brain Sciences, Hammersmith Hospital, London, UK
| | - Jessica Fleminger
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Imperial College London, Division of Brain Sciences, Hammersmith Hospital, London, UK
| | - Gregory Scott
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Imperial College London, Division of Brain Sciences, Hammersmith Hospital, London, UK
| | - David J Towey
- Department of Nuclear Medicine, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - William Svensson
- Department of Nuclear Medicine, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Sameer Khan
- Department of Nuclear Medicine, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Maneesh Patel
- Imaging Department, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Richard Greenwood
- Institute of Neurology, Division of Clinical Neurology, University College London, London, UK
| | - James H Cole
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Imperial College London, Division of Brain Sciences, Hammersmith Hospital, London, UK
| | - David J Sharp
- Computational, Cognitive and Clinical Neuroimaging Laboratory, Imperial College London, Division of Brain Sciences, Hammersmith Hospital, London, UK
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24
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Smith CT, San Juan MD, Dang LC, Katz DT, Perkins SF, Burgess LL, Cowan RL, Manning HC, Nickels ML, Claassen DO, Samanez-Larkin GR, Zald DH. Ventral striatal dopamine transporter availability is associated with lower trait motor impulsivity in healthy adults. Transl Psychiatry 2018; 8:269. [PMID: 30531858 PMCID: PMC6286354 DOI: 10.1038/s41398-018-0328-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 11/13/2018] [Accepted: 11/15/2018] [Indexed: 12/18/2022] Open
Abstract
Impulsivity is a transdiagnostic feature of a range of externalizing psychiatric disorders. Preclinical work links reduced ventral striatal dopamine transporter (DAT) availability with heightened impulsivity and novelty seeking. However, there is a lack of human data investigating the relationship between DAT availability, particularly in subregions of the striatum, and the personality traits of impulsivity and novelty seeking. Here we collected PET measures of DAT availability (BPND) using the tracer 18F-FE-PE2I in 47 healthy adult subjects and examined relations between BPND in striatum, including its subregions: caudate, putamen, and ventral striatum (VS), and trait impulsivity (Barratt Impulsiveness Scale: BIS-11) and novelty seeking (Tridimensional Personality Questionnaire: TPQ-NS), controlling for age and sex. DAT BPND in each striatal subregion showed nominal negative associations with total BIS-11 but not TPQ-NS. At the subscale level, VS DAT BPND was significantly associated with BIS-11 motor impulsivity (e.g., taking actions without thinking) after correction for multiple comparisons. VS DAT BPND explained 13.2% of the variance in motor impulsivity. Our data demonstrate that DAT availability in VS is negatively related to impulsivity and suggest a particular influence of DAT regulation of dopamine signaling in VS on acting without deliberation (BIS motor impulsivity). While needing replication, these data converge with models of ventral striatal functions that emphasize its role as a key interface linking motivation to action.
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Affiliation(s)
- Christopher T. Smith
- 0000 0001 2264 7217grid.152326.1Department of Psychology, PMB 407817, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37240-7817 USA
| | - M. Danica San Juan
- 0000 0001 2264 7217grid.152326.1Department of Psychology, PMB 407817, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37240-7817 USA
| | - Linh C. Dang
- 0000 0001 2264 7217grid.152326.1Department of Psychology, PMB 407817, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37240-7817 USA
| | - Daniel T. Katz
- 0000 0001 2264 7217grid.152326.1Department of Psychology, PMB 407817, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37240-7817 USA
| | - Scott F. Perkins
- 0000 0001 2264 7217grid.152326.1Department of Psychology, PMB 407817, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37240-7817 USA
| | - Leah L. Burgess
- 0000 0001 2264 7217grid.152326.1Department of Psychology, PMB 407817, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37240-7817 USA
| | - Ronald L. Cowan
- 0000 0001 2264 7217grid.152326.1Department of Psychology, PMB 407817, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37240-7817 USA ,0000 0004 1936 9916grid.412807.8Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Avenue South, Suite 3057, Nashville, TN 37212 USA ,0000 0004 1936 9916grid.412807.8Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Medical Center North, 1161 21st Avenue South, Nashville, TN 37232 USA
| | - H. Charles Manning
- 0000 0004 1936 9916grid.412807.8Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Medical Center North, 1161 21st Avenue South, Nashville, TN 37232 USA ,0000 0001 2264 7217grid.152326.1Department of Chemistry, Vanderbilt University, 7330 Stevenson Center, Station B 351822, Nashville, TN 37235 USA ,0000 0001 2264 7217grid.152326.1Department of Biomedical Engineering, PMB 351826, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37235-1826 USA ,0000 0004 1936 9916grid.412807.8Department of Neurological Surgery, Vanderbilt University Medical Center, 1161 21st Avenue South, T4224 Medical Center North, Nashville, TN 37232-2380 USA
| | - Michael L. Nickels
- 0000 0004 1936 9916grid.412807.8Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Medical Center North, 1161 21st Avenue South, Nashville, TN 37232 USA
| | - Daniel O. Claassen
- 0000 0004 1936 9916grid.412807.8Department of Neurology, Vanderbilt University Medical Center, 1161 21st Avenue South, A-0118, Nashville, TN 37232-2551 USA
| | - Gregory R. Samanez-Larkin
- 0000 0004 1936 7961grid.26009.3dDepartment of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC 27708 USA
| | - David H. Zald
- 0000 0001 2264 7217grid.152326.1Department of Psychology, PMB 407817, Vanderbilt University, 2301 Vanderbilt Place, Nashville, TN 37240-7817 USA ,0000 0004 1936 9916grid.412807.8Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Avenue South, Suite 3057, Nashville, TN 37212 USA
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Abstract
OBJECTIVE To evaluate the value of I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane (I-FP-CIT) dopamine transporter single photon emission computed tomography (DAT-SPECT) to change management strategies of patients suspected of parkinsonism. METHOD This was an institutional review board-approved, retrospective study. DAT-SPECT scans ordered by movement disorder specialist and neurologists from 2011-2014 were reviewed. Clinical data and radiological reports of 173 patients suspected of parkinsonism were reviewed. The DAT-SPECT scan results were correlated with clinical assessment and treatment changes. RESULTS A total of 173 patients (104 male and 69 female subjects; age, 64.4 ± 12.6 years) suspected of parkinsonism were included. Median duration of symptoms was 36 months (range, 1-480 months). Scans were most often requested when there was diagnostic uncertainty in clinical features (59.6%, 103/173) or to differentiate one other disease from parkinsonism such as Parkinson disease (PD) versus essential tremor (23.7%, 41/173), PD versus drug-induced parkinsonism (8.7%, 15/173), or PD versus psychogenic (6.4%, 11/173) or vascular (1.7%, 3/173) disorders. Patients were classified, according to the DAT-SPECT scanning results, as those with abnormal DAT-SPECT findings (59%, 102/173) and those with normal DAT-SPECT findings (41%, 71/173). In patients with normal DAT-SPECT findings, follow-up management data were available in 76.1% (54/71). The management changed in 39.4% (28/54) after DAT scan with starting a new appropriate medications or supportive therapy in 4.2% (3/28), withholding inappropriate dopaminergic treatment in 11.3% (8/28), or continuing observation in 23.9% (17/28). In patients with abnormal DAT-SPECT findings, follow-up management data were available in 78.4% (80/102). There was change in management of 37.3% (38/80), a new PD treatment was started in 89.5% (34/38). The dose of medication was adjusted in 5.3% (2/38), although the original treatment was not changed. Parkinson disease treatment was stopped in 2.6% (1/38) and discontinued in 2.6% (1/38) based on clinical decision of neurologists despite abnormal DAT-SPECT findings. CONCLUSIONS DAT-SPECT findings impacted treatment decisions in 44.7% of patients suspected of Parkinsonism.
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Anidi C, O'Day JJ, Anderson RW, Afzal MF, Syrkin-Nikolau J, Velisar A, Bronte-Stewart HM. Neuromodulation targets pathological not physiological beta bursts during gait in Parkinson's disease. Neurobiol Dis 2018; 120:107-117. [PMID: 30196050 DOI: 10.1016/j.nbd.2018.09.004] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/18/2018] [Accepted: 09/04/2018] [Indexed: 11/25/2022] Open
Abstract
Freezing of gait (FOG) is a devastating axial motor symptom in Parkinson's disease (PD) leading to falls, institutionalization, and even death. The response of FOG to dopaminergic medication and deep brain stimulation (DBS) is complex, variable, and yet to be optimized. Fundamental gaps in the knowledge of the underlying neurobiomechanical mechanisms of FOG render this symptom one of the unsolved challenges in the treatment of PD. Subcortical neural mechanisms of gait impairment and FOG in PD are largely unknown due to the challenge of accessing deep brain circuitry and measuring neural signals in real time in freely-moving subjects. Additionally, there is a lack of gait tasks that reliably elicit FOG. Since FOG is episodic, we hypothesized that dynamic features of subthalamic (STN) beta oscillations, or beta bursts, may contribute to the Freezer phenotype in PD during gait tasks that elicit FOG. We also investigated whether STN DBS at 60 Hz or 140 Hz affected beta burst dynamics and gait impairment differently in Freezers and Non-Freezers. Synchronized STN local field potentials, from an implanted, sensing neurostimulator (Activa® PC + S, Medtronic, Inc.), and gait kinematics were recorded in 12 PD subjects, off-medication during forward walking and stepping-in-place tasks under the following randomly presented conditions: NO, 60 Hz, and 140 Hz DBS. Prolonged movement band beta burst durations differentiated Freezers from Non-Freezers, were a pathological neural feature of FOG and were shortened during DBS which improved gait. Normal gait parameters, accompanied by shorter bursts in Non-Freezers, were unchanged during DBS. The difference between the mean burst duration between hemispheres (STNs) of all individuals strongly correlated with the difference in stride time between their legs but there was no correlation between mean burst duration of each STN and stride time of the contralateral leg, suggesting an interaction between hemispheres influences gait. These results suggest that prolonged STN beta burst durations measured during gait is an important biomarker for FOG and that STN DBS modulated long not short burst durations, thereby acting to restore physiological sensorimotor information processing, while improving gait.
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Affiliation(s)
- Chioma Anidi
- Stanford University, Department of Neurology and Neurological Sciences, Rm H3136, SUMC, 300 Pasteur Drive, Stanford, CA 94305, USA.
| | - Johanna J O'Day
- Stanford University, Department of Neurology and Neurological Sciences, Rm H3136, SUMC, 300 Pasteur Drive, Stanford, CA 94305, USA.
| | - Ross W Anderson
- Stanford University, Department of Neurology and Neurological Sciences, Rm H3136, SUMC, 300 Pasteur Drive, Stanford, CA 94305, USA.
| | - Muhammad Furqan Afzal
- Stanford University, Department of Neurology and Neurological Sciences, Rm H3136, SUMC, 300 Pasteur Drive, Stanford, CA 94305, USA.
| | - Judy Syrkin-Nikolau
- Stanford University, Department of Neurology and Neurological Sciences, Rm H3136, SUMC, 300 Pasteur Drive, Stanford, CA 94305, USA.
| | - Anca Velisar
- Stanford University, Department of Neurology and Neurological Sciences, Rm H3136, SUMC, 300 Pasteur Drive, Stanford, CA 94305, USA.
| | - Helen M Bronte-Stewart
- Stanford University, Department of Neurology and Neurological Sciences, Rm H3136, SUMC, 300 Pasteur Drive, Stanford, CA 94305, USA; Stanford University, Department of Neurosurgery, 300 Pasteur Drive, Stanford, CA 94305, USA.
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Can early dopamine transporter imaging serve as a predictor of Parkinson's disease progression and late motor complications? J Neurol Sci 2018; 390:255-260. [DOI: 10.1016/j.jns.2018.05.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 04/11/2018] [Accepted: 05/06/2018] [Indexed: 11/17/2022]
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Yu KJ, Lee BJ, Han J, Park D. Usefulness of F-18 FP-CIT PET to predict dopamine-responsive hand tremor in patients other than Parkinson's disease: Two case reports. Medicine (Baltimore) 2018; 97:e10983. [PMID: 29851853 PMCID: PMC6392691 DOI: 10.1097/md.0000000000010983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
RATIONALE Treating the patients with hand tremors is clinically difficult, because a wide range of disorders can result in hand tremors. Therefore, when treatment for hand tremors begins, various pharmacological options have to be considered. In clinical practice, a practical approach is to initially check hand tremor patients for signs of Parkinson's disease (PD), because patients with PD can benefit from dopamine treatment. However, only part of patients with PD tends to show a meaningful improvement in hand tremors for dopamine treatment. On the other hand, dopamine treatment may help with hand tremors of patients with other disorders, but dopamine responsiveness can't be predicted by clinical assessment alone. PATIENTS CONCERNS Hand tremors. DIAGNOSES Hemiplegic patients (A 78-year-old man with cerebral infarction and a 65-year-old woman with traumatic brain injury) with hemi-sided hand tremor. INTERVENTIONS Fluorinated N-3-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl) nortropane (F-18 FP-CIT) positron emission tomography (PET) and dopamine agonist. OUTCOMES After the medication, hemi-side hand tremor dramatically improved. LESSONS Collectively, a dysfunction of the dopaminergic nigro-striatal pathway may lead to abnormal findings of F-18 FP-CIT PET, and these abnormal findings in brain-lesion patients with hand tremor may help predict dopamine responsiveness of hand tremor. We believe that our report may be helpful in the diagnosis and treatment of hand tremor in patients with brain-lesion.
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Affiliation(s)
- Kwang Jae Yu
- Department of Rehabilitation medicine, Daegu Fatima Hospital, Daegu
| | - Byung Joo Lee
- Department of Rehabilitation medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - Jin Han
- Deparment of Phamacology, Kyungpook National University School of Medicine, Daegu, South Korea
| | - Donghwi Park
- Department of Rehabilitation medicine, Daegu Fatima Hospital, Daegu
- Deparment of Phamacology, Kyungpook National University School of Medicine, Daegu, South Korea
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Yomtoob J, Koloms K, Bega D. DAT-SPECT imaging in cases of drug-induced parkinsonism in a specialty movement disorders practice. Parkinsonism Relat Disord 2018; 53:37-41. [PMID: 29748111 DOI: 10.1016/j.parkreldis.2018.04.037] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 04/12/2018] [Accepted: 04/28/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Compare clinical characteristics and outcomes in cases where DAT-SPECT imaging is used to distinguish Parkinson's disease from Drug-Induced Parkinsonsim. BACKGROUND Clinical uncertainty in diagnosing Parkinson's disease is common when patients are on dopamine-blocking medications. DAT-SPECT imaging can improve diagnostic certainty but little data are available on clinical characteristics and outcomes associated with normal and abnormal scan results. METHODS Retrospective chart review of patients seen at a movement disorders center between 2011 and 2017 where DAT-SPECT was ordered to distinguish Parkinson's disease from Drug-induced Parkinsonism. Descriptive statistics were calculated for variables of interest and compared by scan result. Chi-squared analyses was carried out for categorical variables and students' t-tests for continuous values. RESULTS 51 patients met inclusion criteria with 36 normal scans and 15 abnormal scans. Those with greater than 2 cardinal manifestations (tremor, rigidity, akinesia, postural instability) were more likely to have an abnormal scan (63.89% vs 93.33%, p = 0.04). No other clinical characteristics assessed were associated with scan results. Atypical antipsychotics (aripiprazole 39.21%, olanzapine 31.37%) and mood stabilizers (valproic acid 33.33%, lithium 17.65%) were most commonly associated with suspected Drug-induced Parkinsonism cases. A post-scan change in management occurred in 41.18% of patients. 55.56% of patients with normal scans responded to changes in the offending medication, with 16.66% taking over 3 months to show improvement. CONCLUSIONS Many DAT-SPECT scans at our institution are ordered to distinguish Parkinson's disease from Drug-induced Parkinsonism because clinical characteristics alone are unreliable. DAT-SPECT results lead to changes in management and the outcomes of these changes are consistent with scan results.
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Affiliation(s)
- Jacob Yomtoob
- Northwestern University Feinberg School of Medicine, United States
| | - Kimberly Koloms
- Northwestern University Feinberg School of Medicine, Department of Preventative Medicine, United States
| | - Danny Bega
- Northwestern University Feinberg School of Medicine, Department of Neurology, United States.
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Farde L, Plavén-Sigray P, Borg J, Cervenka S. Brain neuroreceptor density and personality traits: towards dimensional biomarkers for psychiatric disorders. Philos Trans R Soc Lond B Biol Sci 2018; 373:20170156. [PMID: 29483342 PMCID: PMC5832682 DOI: 10.1098/rstb.2017.0156] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2017] [Indexed: 02/06/2023] Open
Abstract
Positron emission tomography has, for 30 years, been used in numerous case-control studies searching for hypothesized differences in the density of neuroreceptor or transporter proteins in psychiatric disorders such as schizophrenia and depression. In most cases, the results have not been conclusive. One reason could be the sizeable interindividual variability in biochemical markers, which in twin studies have shown to emanate from both environmental and genetic factors, leading to low statistical power for the detection of group effects. On the other hand, the same interindividual variability has served as an opportunity for correlative studies on the biological underpinning of behaviour. Using this approach, a series of studies has linked markers for the dopamine and serotonin system to personality traits associated with psychiatric conditions. Based on increasing evidence for the view that many psychopathological states represent extremes of a continuum rather than distinct categories, this research strategy may lead to new biological insights about the vulnerability to and pathophysiology of major psychiatric disorders.This article is part of the theme issue 'Diverse perspectives on diversity: multi-disciplinary approaches to taxonomies of individual differences'.
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Affiliation(s)
- Lars Farde
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm County Council, 17176 Stockholm, Sweden
- Precision Medicine and Genomics, AstraZeneca, PET Science Centre, Karolinska Institutet, 17176 Stockholm, Sweden
| | - Pontus Plavén-Sigray
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm County Council, 17176 Stockholm, Sweden
| | - Jacqueline Borg
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm County Council, 17176 Stockholm, Sweden
| | - Simon Cervenka
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm County Council, 17176 Stockholm, Sweden
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Riederer P, Jellinger KA, Kolber P, Hipp G, Sian-Hülsmann J, Krüger R. Lateralisation in Parkinson disease. Cell Tissue Res 2018; 373:297-312. [PMID: 29656343 DOI: 10.1007/s00441-018-2832-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 03/21/2018] [Indexed: 01/11/2023]
Abstract
Asymmetry of dopaminergic neurodegeneration and subsequent lateralisation of motor symptoms are distinctive features of Parkinson's disease compared to other forms of neurodegenerative or symptomatic parkinsonism. Even 200 years after the first description of the disease, the underlying causes for this striking clinicopathological feature are not yet fully understood. There is increasing evidence that lateralisation of disease is due to a complex interplay of hereditary and environmental factors that are reflected not only in the concept of dominant hemispheres and handedness but also in specific susceptibilities of neuronal subpopulations within the substantia nigra. As a consequence, not only the obvious lateralisation of motor symptoms occurs but also patterns of associated non-motor signs are defined, which include cognitive functions, sleep behaviour or olfaction. Better understanding of the mechanisms contributing to lateralisation of neurodegeneration and the resulting patterns of clinical phenotypes based on bilateral post-mortem brain analyses and clinical studies focusing on right/left hemispheric symptom origin will help to develop more targeted therapeutic approaches, taking into account subtypes of PD as a heterogeneous disorder.
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Affiliation(s)
- P Riederer
- Center of Mental Health, Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany. .,Psychiatry Department of Clinical Research, University of Southern Denmark, Odense University Hospital, J.B. Winsløws Vej 18, Indgang 220 A, DK-5000, Odense C, Denmark.
| | - K A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, A-1150, Vienna, Austria
| | - P Kolber
- Parkinson Research Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - G Hipp
- Parkinson Research Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - J Sian-Hülsmann
- Department of Medical Physiology, University of Nairobi, PO Box 30197, Nairobi, 00100, Kenya
| | - R Krüger
- Parkinson Research Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
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32
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Bae YJ, Kim JM, Kim KJ, Kim E, Park HS, Kang SY, Yoon IY, Lee JY, Jeon B, Kim SE. Loss of Substantia Nigra Hyperintensity at 3.0-T MR Imaging in Idiopathic REM Sleep Behavior Disorder: Comparison with 123I-FP-CIT SPECT. Radiology 2018; 287:285-293. [DOI: 10.1148/radiol.2017162486] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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de Natale ER, Niccolini F, Wilson H, Politis M. Molecular Imaging of the Dopaminergic System in Idiopathic Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 141:131-172. [DOI: 10.1016/bs.irn.2018.08.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Beyer C, Cappetta K, Johnson JA, Bloch MH. Meta-analysis: Risk of hyperhidrosis with second-generation antidepressants. Depress Anxiety 2017; 34:1134-1146. [PMID: 28881483 DOI: 10.1002/da.22680] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 05/23/2017] [Accepted: 05/26/2017] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Our goal was to quantify the risk of hyperhidrosis associated with commonly used antidepressant agents and examine the impact of medication class, pharmacodynamics, and dose on risk of hyperhidrosis. METHODS We conducted a PubMed search to identify all double-blind, randomized, placebo-controlled trials examining the efficacy of second-generation antidepressant medications in the treatment of adults with a depressive disorder, anxiety disorders, or obsessive-compulsive disorder. We used a random-effects meta-analysis to examine the pooled risk ratio of hyperhidrosis reported as a side effect in adults treated with second-generation antidepressants compared to placebo. We used stratified subgroup analysis and metaregression to examine the effects of medication type, class, dosage, indication, and receptor affinity profile on the measured risk of hyperhidrosis. RESULTS We identified 76 trials involving 28,544 subjects. There was no significant difference in the risk of hyperhidrosis between serotonin-norepinephrine reuptake inhibitors (SNRI) [risk ratio (RR) = 3.17, 95% CI: 2.63-3.82] and selective serotonin reuptake inhibitors (SSRI) (RR = 2.93, 95% CI: 2.46-3.47) medications compared to placebo. All antidepressant medications were associated with a significantly increased risk of hyperhidrosis except fluvoxamine (RR = 0.56, 95% CI: 0.12-2.53), bupropion (RR = 1.23, 95% CI: 0.57-2.67), and vortioxetine (RR = 1.35, 95% CI: 0.79-2.33). The dose of SSRI/SNRI medications was not significantly associated with the risk of hyperhidrosis. Increased risk of hyperhidrosis was associated with increased affinity of SSRI/SNRI medications to the dopamine transporter. CONCLUSION Risk of hyperhidrosis was significantly increased with most antidepressant medications but was associated with dopamine transporter affinity.
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Affiliation(s)
- Chad Beyer
- Department of Psychiatry, Stellenbosch University, Stellenbosch, Western Cape, South Africa
| | | | - Jessica A Johnson
- Child Study Centre, Yale University School of Medicine, New Haven, CT, USA
| | - Michael H Bloch
- Department of Psychiatry, Yale University, New Haven, CT, USA
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Takaya S, Sawamoto N, Okada T, Okubo G, Nishida S, Togashi K, Fukuyama H, Takahashi R. Differential diagnosis of parkinsonian syndromes using dopamine transporter and perfusion SPECT. Parkinsonism Relat Disord 2017; 47:15-21. [PMID: 29157745 DOI: 10.1016/j.parkreldis.2017.11.333] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/09/2017] [Accepted: 11/13/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE We aimed to assess whether a combined analysis of dopamine transporter (DAT)- and perfusion-SPECT images (or either) could: (1) distinguish atypical parkinsonian syndromes (APS) from Lewy body diseases (LBD; majority Parkinson disease [PD]), and (2) differentiate among APS subgroups (progressive supranuclear palsy [PSP], corticobasal syndrome [CBS], and multiple system atrophy [MSA]). METHODS We recruited consecutive patients with neurodegenerative parkinsonian syndromes (LBD, n = 46; APS, n = 33). Individual [123I]FP-CIT- and [123I]iodoamphetamine-SPECT images were coregistered onto anatomical MRI segmented into brain regions. Striatal DAT activity and regional perfusion were extracted from each brain region for each patient and submitted to logistic regression analyses. Stepwise procedures were used to select predictors that should be included in the models to distinguish APS from LBD, and differentiate among the APS subgroups. Receiver-operating characteristic (ROC) analyses were performed to measure diagnostic power. Leave-one-out cross-validation (LOOCV) was performed to evaluate the diagnostic accuracy. RESULTS The model to discriminate APS from LBD showed that the area under the ROC curve (AUC) was 0.923, while the total diagnostic accuracy (TDA) was 86.1% in LOOCV. In the model to distinguish PSP, CBS, and MSA from LBD, the AUC/TDA values were 0.978/94.6%, 0.978/87.0%, and 0.880/80.3%, respectively. In the model to differentiate between CBS and MSA, MSA and PSP, and PSP and CBS, the AUC/TDA values were 0.967/91.3%, 0.920/88.0%, 0.875/77.8%, respectively. CONCLUSION An image-based automated classification using striatal DAT activity and regional perfusion patterns provided a good performance in the differential diagnosis of neurodegenerative parkinsonian syndromes without clinical information.
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Affiliation(s)
- Shigetoshi Takaya
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan; Currently Senri Rehabilitation Hospital, Osaka, Japan.
| | - Nobukatsu Sawamoto
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Human Health Science, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomohisa Okada
- Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Gosuke Okubo
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sei Nishida
- Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hidenao Fukuyama
- Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan; Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Jagadeesan AJ, Murugesan R, Vimala Devi S, Meera M, Madhumala G, Vishwanathan Padmaja M, Ramesh A, Banerjee A, Sushmitha S, Khokhlov AN, Marotta F, Pathak S. Current trends in etiology, prognosis and therapeutic aspects of Parkinson's disease: a review. ACTA BIO-MEDICA : ATENEI PARMENSIS 2017; 88:249-262. [PMID: 29083328 PMCID: PMC6142835 DOI: 10.23750/abm.v88i3.6063] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 02/01/2017] [Accepted: 02/06/2017] [Indexed: 02/07/2023]
Abstract
Parkinson's disease (PD) is a movement disorder, mainly affecting population consisting of the aged. PD occurs chiefly due to progressive loss of dopaminergic neurons in nigrostriatal pathway. Largely, PD patients suffer from non-motor symptoms, such as depression, anxiety, fatigue, and sleep disorders, that needs further investigation and addressing during PD research. Depression in PD is a predominant and complex symptom, and its pathology exists extrinsic to the nigrostriatal system. This disease can ultimately be managed by a combination of regular physiotherapy and proper medication. Taking together the present scenario of PD, including the nature of disease, characteristics, treatment, diagnosis of the patients with PD, these outcomes were reviewed to be explored along with many speech-based solutions to PD in this study. This neurodegenerative disorder needs advancement in research and development which can help patients with PD to lead a normal life.
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Mäkinen E, Joutsa J, Vahlberg T, Kaasinen V. Survival in Parkinson's disease in relation to striatal dopamine transporter binding. Parkinsonism Relat Disord 2017; 42:66-72. [DOI: 10.1016/j.parkreldis.2017.06.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 05/02/2017] [Accepted: 06/21/2017] [Indexed: 11/29/2022]
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38
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Neishi H, Ikawa M, Okazawa H, Tsujikawa T, Arishima H, Kikuta KI, Yoneda M. Precise Evaluation of Striatal Oxidative Stress Corrected for Severity of Dopaminergic Neuronal Degeneration in Patients with Parkinson’s Disease: A Study with 62Cu-ATSM PET and 123I-FP-CIT SPECT. Eur Neurol 2017; 78:161-168. [DOI: 10.1159/000479627] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 07/20/2017] [Indexed: 11/19/2022]
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Mirabella G, Fragola M, Giannini G, Modugno N, Lakens D. Inhibitory control is not lateralized in Parkinson's patients. Neuropsychologia 2017. [DOI: 10.1016/j.neuropsychologia.2017.06.025] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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40
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Iannilli E, Stephan L, Hummel T, Reichmann H, Haehner A. Olfactory impairment in Parkinson's disease is a consequence of central nervous system decline. J Neurol 2017; 264:1236-1246. [PMID: 28550478 DOI: 10.1007/s00415-017-8521-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 05/15/2017] [Accepted: 05/16/2017] [Indexed: 11/30/2022]
Abstract
Early diagnosis and timely treatment of Parkinson's disease are essential factors to provide these patients with a longer period of a better quality of life. Olfactory loss is among the first non-motor symptoms of the disease; however, in light of the many causes of smell loss, it is a very unspecific biomarker and should only be used as part of a diagnostic test battery. In this study, we investigated the olfactory response in 71 subjects, consisting of Parkinson's disease patients, hyposmic and anosmic patients of other causes, and normosmic individuals searching for sensitive, distinct biomarkers for which we used scalp event-related 64-channel electroencephalography and psychophysical tests. The analysis of the global field power indicated significant measurable differences between patients with Parkinson's disease and otherwise olfactory dysfunctional and normosmic individuals. The localization of brain sources, in particular, provides evidence for differences in mainly late EEG-components suggesting a decline of central brain networks as a causal factor for olfactory loss in Parkinson's disease. The findings indicate a different pattern of olfactory processing in patients with Parkinson's disease compared to olfactory dysfunctions of other origin, which provide further insights into the mechanisms behind olfactory dysfunction in Parkinson's.
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Affiliation(s)
- Emilia Iannilli
- Department of Otorhinolaryngology, Interdisciplinary Center "Smell and Taste", TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
| | - Lars Stephan
- Department of Otorhinolaryngology, Interdisciplinary Center "Smell and Taste", TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Thomas Hummel
- Department of Otorhinolaryngology, Interdisciplinary Center "Smell and Taste", TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Heinz Reichmann
- Department of Neurology, TU Dresden, Fetscherstraße 74, Dresden, Germany
| | - Antje Haehner
- Department of Otorhinolaryngology, Interdisciplinary Center "Smell and Taste", TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany
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Kostoglou K, Michmizos KP, Stathis P, Sakas D, Nikita KS, Mitsis GD. Classification and Prediction of Clinical Improvement in Deep Brain Stimulation From Intraoperative Microelectrode Recordings. IEEE Trans Biomed Eng 2017; 64:1123-1130. [DOI: 10.1109/tbme.2016.2591827] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Lenfeldt N, Eriksson J, Åström B, Forsgren L, Mo SJ. Fractional Anisotropy and Mean Diffusion as Measures of Dopaminergic Function in Parkinson’s Disease: Challenging Results. JOURNAL OF PARKINSONS DISEASE 2017; 7:129-142. [DOI: 10.3233/jpd-161011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Niklas Lenfeldt
- Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden
| | - Johan Eriksson
- Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden
| | - Björn Åström
- Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden
| | - Lars Forsgren
- Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden
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T2-relaxometry predicts outcome of DBS in idiopathic Parkinson's disease. NEUROIMAGE-CLINICAL 2016; 12:832-837. [PMID: 27843765 PMCID: PMC5097958 DOI: 10.1016/j.nicl.2016.09.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/26/2016] [Accepted: 09/28/2016] [Indexed: 12/25/2022]
Abstract
Introduction Deep brain stimulation (DBS) nowadays is a well-established treatment of motor symptoms in Parkinson's disease. The subthalamic nucleus (STN) is a common target for DBS, because motor improvements have been shown to be superior to best medical therapy, if DBS electrodes have been appropriately positioned. DBS target identification can be assisted by MRI beyond structural imaging by spatially resolved measurement of T2-relaxation times (T2r). Aim We pose the question, whether T2r of the STN is linked to the severity of the disease and whether outcome of DBS may be correlated to an asymmetric manifestation of the disease. Further, we investigated if abnormal T2r in the STN may be predictive for outcome of DBS. Methods Twelve patients underwent preoperative MR imaging including a multi echo relaxometry sequence (3 Tesla, Siemens Medical Systems, Erlangen, Germany) ahead of DBS. T2r were determined for STN, substantia nigra (SN), red nucleus (RN) and centrum semiovale (CSO). Unified Parkinson's disease Rating Scale (UPDRS) scores were tested before and after DBS. Patients' T2r and deduced values representing left-right asymmetry of measurements were correlated with UPDRS scores and measures for outcome of DBS. Furthermore, patients' T2r were compared with T2r measurements in 12 healthy controls (HC). Results Patients' T2r for SN (mean 45.4 ms ± 4.4 ms) and STN (mean 56.4 ms ± 3.8 ms) were significantly shorter than T2r in HCs for SN (mean 60.7 ± 4.6) and STN (mean 66.1 ms ± 4.0 ms). While no mean T2r asymmetry was found in the SN, patients' mean T2r for STN showed a weakened left-right correlation (Pearson correlation coefficient 0.19 versus 0.72 in HC) indicating asymmetric degeneration. T2r asymmetry was not linked to the more severely affected hemisphere. The respective lower T2r within the left or right target region was significantly correlated to the outcome in terms of UPDRS III improvement in “off” state (Pearson correlation 0.82 corresponding to p ≪ 0.01). Patients with T2r of STN lower than 50 ms showed no response to DBS in the UPDRS. The maximum T2r for SN correlated to the improvement between UPDRS “off” minus and “on” (Dopamine response) but failed to predict DBS outcome. Conclusions The lower boundaries of T2r in the STN predict motor outcome in DBS. T2r asymmetry in the STN is not associated with increased clinical symptoms, but with response to therapy. Thus, patients with very low T2r may be inappropriate candidates for DBS. Parkinson's disease features are reflected in spatially resolved measurement of MR T2-relaxation times. Deep brain stimulation therapy target identification can be assisted by measurement of MR T2-relaxation times. T2r asymmetry in the subthalamic nucleus is not associated with increased clinical symptoms, but with response to therapy. Lower boundaries of T2r in the STN predict motor outcome in Deep brain stimulation therapy Patient selection criteria may be improved by including parameters based on MR relaxometry.
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Smart K, Durso R, Morgan J, McNamara P. A potential case of remission of Parkinson's disease. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2016; 13:311-315. [PMID: 27379905 DOI: 10.1515/jcim-2016-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 05/24/2016] [Indexed: 11/15/2022]
Abstract
We present the case of a 78-year-old male who, 16 years ago, was diagnosed with Parkinson's disease (PD) by a neurologist. He initially presented with left-hand tremor, stooped posture, shuffling gait, and frequent falls, which eventually progressed to bilateral motor symptoms after 3 years. Since 2012, his symptoms and signs have almost completely remitted, and he has been off all pharmacotherapy for that time. The accuracy of the initial PD diagnosis is supported by an appropriate clinical presentation, history of positive response to Sinemet, and an abnormal SPECT DaT scan; thus this case suggests the possibility of remission of symptoms in some patients. We propose that the patient's long history of meditation practice may have been one contributing factor of this improvement as meditation has been shown to release dopamine in the striatum.
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Brooks DJ. Molecular imaging of dopamine transporters. Ageing Res Rev 2016; 30:114-21. [PMID: 26802555 DOI: 10.1016/j.arr.2015.12.009] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 12/26/2015] [Accepted: 12/29/2015] [Indexed: 12/31/2022]
Abstract
The dopamine transporter (DAT) is responsible for clearance of dopamine from the synaptic cleft after its release. Imaging DAT availability provides a measure of dopamine terminal function and a method for detecting the striatal dopamine terminal dysfunction present in idiopathic Parkinson's disease (PD) and atypical neurodegenerative parkinsonian disorders such as multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD). DAT imaging with positron emission tomography (PET) or single photon emission computed tomography (SPECT) can be used to support or refute a diagnosis of dopamine deficient parkinsonism in cases where this is unclear and rationalise a trial of dopamine replacement agents as therapy. It can also detect subclinical dopaminergic dysfunction when present in subjects at risk for PD such as relatives of patients, susceptibility gene mutation carriers, and subjects with late onset hyposmia or sleep disorders. The presence of normal DAT availability on imaging can help categorise "subjects without evidence of dopamine deficiency" (SWEDDs) who on occasion mimic PD and include dystonic tremors, drug-induced and psychogenic parkinsonism in their ranks. Reduced levels of baseline striatal DAT availability on PET or SPECT scanning, however, should be regarded as supportive rather than diagnostic of dopamine deficient parkinsonism.
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Is Parkinson's Disease with History of Agent Orange Exposure Different from Idiopathic Parkinson's Disease? Dement Neurocogn Disord 2016; 15:75-81. [PMID: 30906346 PMCID: PMC6427963 DOI: 10.12779/dnd.2016.15.3.75] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 09/20/2016] [Accepted: 09/20/2016] [Indexed: 11/27/2022] Open
Abstract
Background and Purpose During Vietnam War, many Korean soldiers were dispatched to fight in the war where they were exposed to Agent Orange. Until now, there exist only limited evidence on existence of association between exposure to Agent Orange and Parkinson's disease (PD). To elucidate the effects of Agent Orange exposure on PD, we compared the clinical characteristics and radiolabeled 18F-FP-CIT PET uptake between patients with Agent Orange exposure and patients with Agent Orange no-exposure. Methods We retrospectively evaluated 143 patients exposed to Agent Orange and 500 patients with no exposure to Agent Orange from our movement clinics database. The differences between clinical characteristics and pattern of 18F-FP-CIT PET uptake were investigated. Results Among Unified Parkinson's Disease Rating Scale III motor subscales, tremor at rest, rigidity, finger taps, and rapid alternating movement was significantly higher in patients exposed to Agent Orange as compared to patients with no exposure to Agent Orange. The facial expression score was significantly lower in patients exposed to Agent Orange as compared to patients with no exposure to Agent Orange. Compared to patients not exposed to Agent Orange, all basal ganglia areas (contra- and ipsilateral caudate nucleus, anterior putamen, and posterior putamen) showed a lower18F-FP-CIT uptake and higher asymmetry index of anterior and posterior putamen was found in patients exposed to Agent Orange. The caudate/putamen ratio was significantly lower in patients exposed to Agent Orange as compared to patients with no exposure to Agent Orange. Conclusions This study showed a different clinical profile and FP-CIT PET findings between patients exposed to Agent Orange as compared to patients with no exposure to Agent Orange. This finding suggests the possibility of different pathophysiology of PD in patients exposed to Agent Orange from idiopathic PD.
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Burciu RG, Chung JW, Shukla P, Ofori E, Li H, McFarland NR, Okun MS, Vaillancourt DE. Functional MRI of disease progression in Parkinson disease and atypical parkinsonian syndromes. Neurology 2016; 87:709-17. [PMID: 27421545 DOI: 10.1212/wnl.0000000000002985] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 05/09/2016] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To explore longitudinal changes in brain activity in patients with Parkinson disease (PD), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP) using task-based functional MRI (fMRI). METHODS A total of 112 individuals were scanned 1 year apart while performing a unimanual grip force task: 46 PD, 13 MSA, 19 PSP, and 34 healthy controls. The outcome measure was percent signal change in prespecified regions of interest: putamen, primary motor cortex (M1), supplementary motor area (SMA), and superior motor regions of the cerebellum (lobules V-VI). RESULTS Patients with PD showed a decline in functional activity over the course of 1 year in the putamen and M1 compared to controls. Changes after 1 year in MSA were exclusively extrastriatal, and included a reduction in functional activity in M1, SMA, and superior cerebellum. In PSP, all regions of interest were less active at 1 year compared to baseline. The functional activity of these regions did not change in the control group. CONCLUSIONS We provide evidence using task-based fMRI for cortical and striatal functional deterioration in PD over a 1-year period of time. Results also describe more widespread and unique patterns of functional changes in MSA and PSP compared to PD, suggesting distinct rates of disease progression in parkinsonian disorders that may assist in future clinical studies testing the potential efficacy of disease-modifying therapies.
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Affiliation(s)
- Roxana G Burciu
- From the Department of Applied Physiology and Kinesiology (R.G.B., J.W.C., P.S., E.O., D.E.V.) and the Departments of Neurology (N.R.M., M.S.O., D.E.V.) and Neurosurgery (M.S.O.), Center for Movement Disorders and Neurorestoration, and Department of Biomedical Engineering (D.E.V.), University of Florida, Gainesville; and Department of Public Health Sciences (H.L.), Medical University of South Carolina, Charleston
| | - Jae Woo Chung
- From the Department of Applied Physiology and Kinesiology (R.G.B., J.W.C., P.S., E.O., D.E.V.) and the Departments of Neurology (N.R.M., M.S.O., D.E.V.) and Neurosurgery (M.S.O.), Center for Movement Disorders and Neurorestoration, and Department of Biomedical Engineering (D.E.V.), University of Florida, Gainesville; and Department of Public Health Sciences (H.L.), Medical University of South Carolina, Charleston
| | - Priyank Shukla
- From the Department of Applied Physiology and Kinesiology (R.G.B., J.W.C., P.S., E.O., D.E.V.) and the Departments of Neurology (N.R.M., M.S.O., D.E.V.) and Neurosurgery (M.S.O.), Center for Movement Disorders and Neurorestoration, and Department of Biomedical Engineering (D.E.V.), University of Florida, Gainesville; and Department of Public Health Sciences (H.L.), Medical University of South Carolina, Charleston
| | - Edward Ofori
- From the Department of Applied Physiology and Kinesiology (R.G.B., J.W.C., P.S., E.O., D.E.V.) and the Departments of Neurology (N.R.M., M.S.O., D.E.V.) and Neurosurgery (M.S.O.), Center for Movement Disorders and Neurorestoration, and Department of Biomedical Engineering (D.E.V.), University of Florida, Gainesville; and Department of Public Health Sciences (H.L.), Medical University of South Carolina, Charleston
| | - Hong Li
- From the Department of Applied Physiology and Kinesiology (R.G.B., J.W.C., P.S., E.O., D.E.V.) and the Departments of Neurology (N.R.M., M.S.O., D.E.V.) and Neurosurgery (M.S.O.), Center for Movement Disorders and Neurorestoration, and Department of Biomedical Engineering (D.E.V.), University of Florida, Gainesville; and Department of Public Health Sciences (H.L.), Medical University of South Carolina, Charleston
| | - Nikolaus R McFarland
- From the Department of Applied Physiology and Kinesiology (R.G.B., J.W.C., P.S., E.O., D.E.V.) and the Departments of Neurology (N.R.M., M.S.O., D.E.V.) and Neurosurgery (M.S.O.), Center for Movement Disorders and Neurorestoration, and Department of Biomedical Engineering (D.E.V.), University of Florida, Gainesville; and Department of Public Health Sciences (H.L.), Medical University of South Carolina, Charleston
| | - Michael S Okun
- From the Department of Applied Physiology and Kinesiology (R.G.B., J.W.C., P.S., E.O., D.E.V.) and the Departments of Neurology (N.R.M., M.S.O., D.E.V.) and Neurosurgery (M.S.O.), Center for Movement Disorders and Neurorestoration, and Department of Biomedical Engineering (D.E.V.), University of Florida, Gainesville; and Department of Public Health Sciences (H.L.), Medical University of South Carolina, Charleston
| | - David E Vaillancourt
- From the Department of Applied Physiology and Kinesiology (R.G.B., J.W.C., P.S., E.O., D.E.V.) and the Departments of Neurology (N.R.M., M.S.O., D.E.V.) and Neurosurgery (M.S.O.), Center for Movement Disorders and Neurorestoration, and Department of Biomedical Engineering (D.E.V.), University of Florida, Gainesville; and Department of Public Health Sciences (H.L.), Medical University of South Carolina, Charleston.
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Abstract
In recent decades, identification of the dopaminergic deficit in Parkinson's disease has spawned an explo sion of research in the molecular neurobiology of the basal ganglia. In vivo imaging has provided a tool to bridge developments in basic neuroscience and clinicial neurology. Imaging studies have opened a unique window on the neurochemical pathophysiology of Parkinson's disease and more specifically on the onset, progression and physiology of the degenerative process. As we are poised on the brink of new protective and restorative therapies for Parkinson's disease, the potential of imaging to teach us about in vivo brain neurochemistry offers both promise and challenge. NEUROSCIENTIST 5:333-340, 1999
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Affiliation(s)
- Kenneth Marek
- Department of Neurology Yale University School of Medicine
New Haven, Connecticut
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Bae YJ, Kim JM, Kim E, Lee KM, Kang SY, Park HS, Kim KJ, Kim YE, Oh ES, Yun JY, Kim JS, Jeong HJ, Jeon B, Kim SE. Loss of Nigral Hyperintensity on 3 Tesla MRI of Parkinsonism: Comparison With (123) I-FP-CIT SPECT. Mov Disord 2016; 31:684-92. [PMID: 26990970 DOI: 10.1002/mds.26584] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 01/06/2016] [Accepted: 01/25/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate whether 3 Tesla susceptibility-weighted imaging can detect the alteration of substantia nigra hyperintensity in Parkinson's disease (PD), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP) and to assess the concordance between the loss of nigral hyperintensity on 3 Tesla susceptibility-weighted imaging and the nigrostriatal dopaminergic degeneration indicated by (123) I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl)-nortropane single photon emission computerized tomography. METHODS Consecutive subjects with suspected parkinsonism were included, and clinical diagnosis was solidified during clinical follow-up. Two blinded neuroradiologists interpreted the nigral hyperintensity on susceptibility-weighted imaging. The performance of susceptibility-weighted imaging for detection of nigral hyperintensity loss was estimated on the basis of the clinical diagnosis and compared with single photon emission computerized tomography results. RESULTS The study included 210 subjects (126 PD, 11 MSA, 11 PSP patients, 26 healthy controls, 36 disease controls). The presence or absence of nigral hyperintensity was accurately visualized in 112 PD, 7 MSA, and 11 PSP patients and 53 controls. We identified 16 false-negative cases and 11 false-positive cases. The sensitivity and specificity of susceptibility-weighted imaging were 88.8% and 83.6%, respectively. The concordance rate between susceptibility-weighted imaging and single photon emission computerized tomography was 86.2%. CONCLUSIONS The loss of nigral hyperintensity on susceptibility-weighted imaging suggested nigrostriatal dopaminergic degeneration in a large portion of patients with parkinsonism, which was indicated by (123) I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl)-nortropane single photon emission computerized tomography. In consideration of false-negative and -positive cases, well-designed imaging protocols should be introduced to improve the performance of nigral hyperintensity imaging. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Yun Jung Bae
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jong-Min Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Eunhee Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Kyung Mi Lee
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.,Department of Radiology, Kyung Hee University Hospital, Seoul, Korea
| | - Seo Young Kang
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Hyun Soo Park
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Kyeong Joon Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Young Eun Kim
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Eung Seok Oh
- Department of Neurology, Chungnam National University Hospital, Daejeon, Korea
| | - Ji Young Yun
- Department of Neurology, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Ji Seon Kim
- Department of Neurology, Chungbuk National University Hospital, Cheongju, Korea
| | - Hye-Jin Jeong
- Neuroscience Research Institute, Gachon University of Medicine and Science, Incheon, Korea
| | - Beomseok Jeon
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sang Eun Kim
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.,Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
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Brooks DJ, Tambasco N. Imaging synucleinopathies. Mov Disord 2016; 31:814-29. [PMID: 26879635 DOI: 10.1002/mds.26547] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 12/18/2015] [Accepted: 12/20/2015] [Indexed: 01/05/2023] Open
Abstract
In this review the structural and functional imaging changes associated with the synucleinopathies PD, MSA, and dementias associated with Lewy bodies are reviewed. The role of imaging for supporting differential diagnosis, detecting subclinical disease, and following disease progression is discussed and its potential use for monitoring disease progression is debated. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- David J Brooks
- Dept of Nuclear Medicine, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Dept of Medicine, Imperial College London, London, United Kingdom.,Division of Neurology, Newcastle University, Newcastle, United Kingdom
| | - Nicola Tambasco
- Dept of Neurology, Azienda Ospedaliera e Universitaria di Perugia, Perugia, Italy
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