Drug-naive patients with Parkinson's disease in Hoehn and Yahr stages I and II show a bilateral decrease in striatal dopamine transporters as revealed by [123I]β-CIT SPECT

• Published in: Journal of neurology Vol. 245; no. 1; pp. 14 - 20
• Main Authors: TISSINGH, G, BERGMANS, P, BOOIJ, J, WINOGRODZKA, A, VAN ROYEN, E. A, STOOF, J. C, WOLTERS, E. C
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01-01-1998
• Subjects: Adult; Aged; Biological and medical sciences; Carrier Proteins - metabolism; Case-Control Studies; Cocaine - analogs & derivatives; Corpus Striatum - diagnostic imaging; Corpus Striatum - metabolism; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Discriminant Analysis; Disease Progression; Dopamine - metabolism; Dopamine Plasma Membrane Transport Proteins; Female; Functional Laterality - physiology; Humans; Iodine Radioisotopes; Male; Medical sciences; Membrane Glycoproteins; Membrane Transport Proteins; Middle Aged; Nerve Tissue Proteins - metabolism; Neurology; Parkinson Disease - drug therapy; Parkinson Disease - metabolism; Tomography, Emission-Computed, Single-Photon - methods; Radionuclide study; Human; Nervous system diseases; Dopamine; Pathophysiology; Ligand; Early phase; Biological transport; Parkinson disease; Corpus striatum; Photon; Cerebral disorder; Central nervous system disease; Adult; Degenerative disease; Severity score; Diagnosis; Extrapyramidal syndrome; Emission tomography
• ISSN: 0340-5354; 1432-1459
• DOI: 10.1007/s004150050168

Ten healthy subjects and 16 patients with early Parkinson's disease (PD) were examined with single photon emission computed tomography (SPECT) and [123I]beta-CIT, a ligand for the dopamine (DA) transporter. Only drug-naive patients were examined since the expression of and binding to DA transporters may be influenced by dopaminergic medication. The main finding was a significant reduction in [123I]beta-CIT binding in the ipsi- and contralateral striatal regions, especially in the putamen, which showed a mean reduction of 65% of the control mean. Discriminant function analysis of the putaminal [123I]beta-CIT binding measures classified 100% of the cases in the correct group. Disease severity correlated negatively and highly significantly with the binding measures. Tremor ratings did not correlate with the SPECT measures, whereas rigidity, and to a lesser extent bradykinesia, did. Patients with unilateral PD showed a bilateral loss of striatal DA transporters. Our findings indicate that with [123I]beta-CIT SPECT it is possible to diagnose PD in subjects with very mild symptoms and signs. Moreover, finding a bilateral loss of striatal DA transporters in patients with unilateral PD also suggests that it may be possible to identify subjects in the preclinical phase of the disease.