PET imaging of the dopamine transporter in progressive supranuclear palsy and Parkinson's disease

• Published in: Neurology Vol. 52; no. 6; pp. 1221 - 1226
• Main Authors: ILGIN, N, ZUBIETA, J, REICH, S. G, DANNALS, R. F, RAVERT, H. T, FROST, J. J
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 12-04-1999
• Subjects: Biological and medical sciences; Carbon Radioisotopes; Carrier Proteins - metabolism; Cocaine - analogs & derivatives; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dopamine Plasma Membrane Transport Proteins; Dopamine Uptake Inhibitors; Humans; Medical sciences; Membrane Glycoproteins; Membrane Transport Proteins; Middle Aged; Nerve Tissue Proteins; Neurology; Parkinson Disease - diagnostic imaging; Parkinson Disease - metabolism; Supranuclear Palsy, Progressive - diagnostic imaging; Supranuclear Palsy, Progressive - metabolism; Tomography, Emission-Computed; Radionuclide study; Human; Nervous system diseases; Dopamine; Biological transport; Central nervous system; Supranuclear ophthalmoplegia; Parkinson disease; Exploration; Cerebral disorder; Progressive; Eye disease; Central nervous system disease; Degenerative disease; Oculomotor syndrome; Brain stem syndrome; Comparative study; Extrapyramidal syndrome; Brain (vertebrata); Positron; Emission tomography
• ISSN: 0028-3878; 1526-632X
• DOI: 10.1212/WNL.52.6.1221

To differentiate the patterns of dopamine transporter loss between idiopathic PD and progressive supranuclear palsy (PSP).
We used the radiotracer [11C]-WIN 35,428 and PET. Regional striatal dopamine transporter binding was measured in the caudate, anterior putamen, and posterior putamen of six patients with L-dopa-responsive stage 2 PD, six patients with PSP, and six age-comparable healthy controls.
In patients with idiopathic PD, the most marked abnormality was observed in the posterior putamen (77% reduction), whereas transporter density in the anterior putamen (60% reduction) and the caudate (44% reduction) was less affected. Unlike the patients with PD, the PSP group showed a relatively uniform degree of involvement in the caudate (40% reduction), anterior putamen (47% reduction), and posterior putamen (51% reduction). When posterior putamen/caudate ratios were calculated, these values were significantly lower in patients with PD than they were in patients with PSP (p = 0.0008) and the control group (p < 0.0001).
Patients with PD have a more pronounced loss of dopamine transporters in the posterior putamen due to a subdivisional involvement of nigrostriatal dopaminergic projections in idiopathic PD. This technique is useful in the determination of neurochemical changes underlying PD and PSP, thus differentiating between them.