Skip to main content
SpringerLink
Log in

Pre- and postsynaptic dopamine SPECT in the early phase of idiopathic parkinsonism: a population-based study

  • Original Article
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to assess the diagnostic contribution of pre- and postsynaptic dopamine SPECT in drug-naïve patients with early idiopathic parkinsonism and to investigate possible differences between idiopathic Parkinson’s disease (PD) and atypical parkinsonian syndromes (APS) and possible differences in motor subtypes of parkinsonism.

Methods

A group of 128 newly diagnosed idiopathic parkinsonian patients and 48 healthy controls was studied. Presynaptic baseline SPECT with 123I-FP-CIT was performed in all patients and in 120 patients also a baseline postsynaptic SPECT with 123I-IBZM. Clinical diagnoses were reassessed after 12 months.

Results

Presynaptic uptake in the putamen and caudate was significantly reduced in patients compared to controls. Presynaptic uptake ratios were not different between PD patients and patients with APS, and postsynaptic uptake in APS was not significantly reduced compared to PD or controls. In half of the APS patients both pre- and postsynaptic uptake ratios were reduced on the same side in the striatum. Impaired motor performance was associated with decreased presynaptic uptake in the putamen in PD. The postural instability and gait difficulty (PIGD) subtype of PD had lower presynaptic uptake ratios than patients with tremor-dominated (TD) symptoms.

Conclusion

Not only presynaptic putamen uptake ratios, but also caudate ratios were reduced in a majority of the patients in our study. At baseline scan, i.e. in an early stage of the disease, the accuracy of excluding APS in the whole study population was 85% using a combination of pre- and postsynaptic SPECT. Already at baseline, lower presynaptic SPECT ratios were seen in PD with PIGD at onset compared to those with TD subtype.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Hughes AJ, Daniel SE, Lees AJ. Improved accuracy of clinical diagnosis of Lewy body Parkinson’s disease. Neurology 2001;57:1497–9.

    CAS  PubMed  Google Scholar 

  2. Hughes AJ, Daniel SE, Ben-Shlomo Y, Lees AJ. The accuracy of diagnosis of parkinsonian syndromes in a specialist movement disorder service. Brain 2002;125:861–70.

    Article  PubMed  Google Scholar 

  3. Gibb WR, Lees AJ. The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson’s disease. J Neurol Neurosurg Psychiatry 1988;51:745–52.

    Article  CAS  PubMed  Google Scholar 

  4. Litvan I, Agid Y, Calne D, Campbell G, Dubois B, Duvoisin RC, et al. Clinical research criteria for the diagnosis of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome): report of the NINDS-SPSP international workshop. Neurology 1996;47:1–9.

    CAS  PubMed  Google Scholar 

  5. Gilman S, Low PA, Quinn N, Albanese A, Ben-Shlomo Y, Fowler CJ, et al. Consensus statement on the diagnosis of multiple system atrophy. J Neurol Sci 1999;163:94–8.

    Article  CAS  PubMed  Google Scholar 

  6. Gilman S, Wenning GK, Low PA, Brooks DJ, Mathias CJ, Trojanowski JQ, et al. Second consensus statement on the diagnosis of multiple system atrophy. Neurology 2008;71:670–6.

    Article  CAS  PubMed  Google Scholar 

  7. Benamer TS, Patterson J, Grosset DG, Booij J, de Bruin K, van Royen E, et al. Accurate differentiation of parkinsonism and essential tremor using visual assessment of [123I]-FP-CIT SPECT imaging: the [123I]-FP-CIT study group. Mov Disord 2000;15:503–10.

    Article  CAS  PubMed  Google Scholar 

  8. Marshall V, Grosset D. Role of dopamine transporter imaging in routine clinical practice. Mov Disord 2003;18:1415–23.

    Article  PubMed  Google Scholar 

  9. Vlaar AM, van Kroonenburgh MJ, Kessels AG, Weber WE. Meta-analysis of the literature on diagnostic accuracy of SPECT in parkinsonian syndromes. BMC Neurol 2007;7:27.

    Article  PubMed  Google Scholar 

  10. Lorberboym M, Treves TA, Melamed E, Lampl Y, Hellmann M, Djaldetti R. [123I]-FP/CIT SPECT imaging for distinguishing drug-induced parkinsonism from Parkinson’s disease. Mov Disord 2006;21:510–4.

    Article  PubMed  Google Scholar 

  11. Scherfler C, Schwarz J, Antonini A, Grosset D, Valldeoriola F, Marek K, et al. Role of DAT-SPECT in the diagnostic work up of parkinsonism. Mov Disord 2007;22:1229–38.

    Article  PubMed  Google Scholar 

  12. Videbaek C, Toska K, Scheideler MA, Paulson OB, Moos Knudsen G. SPECT tracer [(123)I]IBZM has similar affinity to dopamine D2 and D3 receptors. Synapse 2000;38:338–42.

    Article  CAS  PubMed  Google Scholar 

  13. Schwarz J, Tatsch K, Gasser T, Arnold G, Pogarell O, Künig G, et al. 123I-IBZM binding compared with long-term clinical follow up in patients with de novo parkinsonism. Mov Disord 1998;13:16–9.

    Article  CAS  PubMed  Google Scholar 

  14. van Royen E, Verhoeff NF, Speelman JD, Wolters EC, Kuiper MA, Janssen AG. Multiple system atrophy and progressive supranuclear palsy. Diminished striatal D2 dopamine receptor activity demonstrated by 123I-IBZM single photon emission computed tomography. Arch Neurol 1993;50:513–6.

    PubMed  Google Scholar 

  15. Kim YJ, Ichise M, Ballinger JR, Vines D, Erami SS, Tatschida T, et al. Combination of dopamine transporter and D2 receptor SPECT in the diagnostic evaluation of PD, MSA, and PSP. Mov Disord 2002;17:303–12.

    Article  PubMed  Google Scholar 

  16. Plotkin M, Amthauer H, Klaffke S, Kühn A, Lüdemann L, Arnold G, et al. Combined 123I-FP-CIT and 123I-IBZM SPECT for the diagnosis of parkinsonian syndromes: study on 72 patients. J Neural Transm 2005;112:677–92.

    Article  CAS  PubMed  Google Scholar 

  17. Koch W, Hamann C, Radau PE, Tatsch K. Does combined imaging of the pre- and postsynaptic dopaminergic system increase the diagnostic accuracy in the differential diagnosis of parkinsonism? Eur J Nucl Med Mol Imaging 2007;34:1265–73.

    Article  PubMed  Google Scholar 

  18. Felicio AC, Shih MC, Godeiro-Junior C, Andrade LA, Bressan RA, Ferraz HB. Molecular imaging studies in Parkinson disease: reducing diagnostic uncertainty. Neurologist 2009;15:6–16.

    Article  PubMed  Google Scholar 

  19. Litvan I, Bhatia KP, Burn DJ, Goetz CG, Lang AE, McKeith I, et al. Movement Disorders Society Scientific Issues Committee report: SIC Task Force appraisal of clinical diagnostic criteria for Parkinsonian disorders. Mov Disord 2003;18:467–86.

    Article  PubMed  Google Scholar 

  20. McKeith IG, Dickson DW, Lowe J, Emre M, O’Brien JT, Feldman H, et al. Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology 2005;65:1863–72.

    Article  CAS  PubMed  Google Scholar 

  21. Fahn S, Elton RL, the UPDRS Development Committee. Unified Parkinson’s disease rating scale. In: Fahn S, Marsden CD, Calne D, Goldstein M, editors. Recent developments in Parkinson’s disease. Florham Park: Macmillan Healthcare Information 1987:153–163.

  22. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–98.

    Article  CAS  PubMed  Google Scholar 

  23. Jankovic J, McDermott M, Carter J, Gauthier S, Goetz C, Golbe L, et al. Variable expression of Parkinson’s disease: a base-line analysis of the DATATOP cohort. The Parkinson Study Group. Neurology 1990;40:1529–34.

    CAS  PubMed  Google Scholar 

  24. Hudson HM, Larkin RS. Accelerated image reconstruction using ordered subsets of projection data. IEEE Trans Med Imaging 1994;13:601–9.

    Article  CAS  PubMed  Google Scholar 

  25. Ogawa K, Harata Y, Ichihara T, Kubo A, Hashimoto S. A practical method for position-dependent Compton-scatter correction in single photon emission CT. IEEE Trans Med Imaging 1991;10:408–12.

    Article  CAS  PubMed  Google Scholar 

  26. Løkkegaard A, Werdelin LM, Friberg L. Clinical impact of diagnostic SPET investigations with a dopamine re-uptake ligand. Eur J Nucl Med Mol Imaging 2002;29:1623–9.

    Article  PubMed  Google Scholar 

  27. Pirker W. Correlation of dopamine transporter imaging with parkinsonian motor handicap: how close is it? Mov Disord 2003;18 Suppl 7:S43–51.

    Article  PubMed  Google Scholar 

  28. Benamer HT, Patterson J, Wyper DJ, Hadley DM, Macphee GJ, Grosset DG. Correlation of Parkinson’s disease severity and duration with 123I-FP-CIT SPECT striatal uptake. Mov Disord 2000;15:692–8.

    Article  CAS  PubMed  Google Scholar 

  29. Spiegel J, Hellwig D, Samnick S, Jost W, Möllers MO, Fassbender K, et al. Striatal FP-CIT uptake differs in the subtypes of early Parkinson’s disease. J Neural Transm 2007;114:331–5.

    Article  CAS  PubMed  Google Scholar 

  30. Schwarz J, Antonini A, Tatsch K, Kirsch CM, Oertel WH, Leenders KL. Comparison of 123I-IBZM SPECT and 11C-raclopride PET findings in patients with parkinsonism. Nucl Med Commun 1994;15:806–13.

    Article  CAS  PubMed  Google Scholar 

  31. Alves G, Larsen JP, Emre M, Wentzel-Larsen T, Aarsland D. Changes in motor subtype and risk for incident dementia in Parkinson’s disease. Mov Disord 2006;21:1123–30.

    Article  PubMed  Google Scholar 

  32. Aarsland D, Brønnick K, Larsen JP, Tysnes OB, Alves G, Norwegian ParkWest Study Group. Cognitive impairment in incident, untreated Parkinson disease: the Norwegian ParkWest study. Neurology 2009;72:1121–6.

    Article  CAS  PubMed  Google Scholar 

  33. Pirker W, Djamshidian S, Asenbaum S, Gerschlager W, Tribl G, Hoffmann M, et al. Progression of dopaminergic degeneration in Parkinson’s disease and atypical parkinsonism: a longitudinal beta-CIT SPECT study. Mov Disord 2002;17:45–53.

    Article  PubMed  Google Scholar 

  34. Haaxma CA, Bloem BR, Borm GF, Oyen WJ, Leenders KL, Eshuis S, et al. Gender differences in Parkinson’s disease. J Neurol Neurosurg Psychiatry 2007;78:819–24.

    Article  PubMed  Google Scholar 

  35. Berti V, Pupi A, Ramat S, Vanzi E, De Cristofaro MT, Pellicanò G, et al. Clinical correlation of the binding potential with 123I-FP-CIT in de novo idiopathic Parkinson’s disease patients. Eur J Nucl Med Mol Imaging 2008;35:2220–6.

    Article  PubMed  Google Scholar 

  36. Catafau AM, Bullich S, Danús M, Penengo MM, Cot A, Abanades S, et al. Test-retest variability and reliability of 123I-IBZM SPECT measurement of striatal dopamine D2 receptor availability in healthy volunteers and influence of iterative reconstruction algorithms. Synapse 2008;62:62–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This study was supported by grants from The Swedish Medical Research Council, The Parkinson Foundation in Sweden, The Swedish Association of Persons with Neurological Disabilities, The University of Umeå, the Foundation for Clinical Neuroscience at Umeå University Hospital, Västerbotten County Council (ALF) and King Gustaf V’s and Queen Victoria’s foundation.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Radiation Sciences, Diagnostic Radiology, Umeå University, 901 85, Umeå, Sweden

    Susanna Jakobson Mo & Katrine Riklund

  2. Department of Radiation Sciences, Radiation Physics, Umeå University, 901 85, Umeå, Sweden

    Anne Larsson & Lennart Johansson

  3. Department of Pharmacology and Clinical Neuroscience, Neurology, Umeå University, 901 85, Umeå, Sweden

    Jan Linder & Lars Forsgren

Authors
  1. Susanna Jakobson Mo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jan Linder
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lars Forsgren
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anne Larsson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lennart Johansson
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Katrine Riklund
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Susanna Jakobson Mo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mo, S.J., Linder, J., Forsgren, L. et al. Pre- and postsynaptic dopamine SPECT in the early phase of idiopathic parkinsonism: a population-based study. Eur J Nucl Med Mol Imaging 37, 2154–2164 (2010). https://doi.org/10.1007/s00259-010-1520-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-010-1520-3

Keywords

Search

Navigation