99mTc-TRODAT-1 SPECT Imaging in Early and Late Onset Parkinson’s Disease

Document Type: Original Article

Authors

1 Department of Neurology, Mashhad University of Medical Sciences, Mashhad, Iran

2 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Objective(s): 99mTc-TRODAT-1, which binds to the dopamine transporter, could be used to image the dopaminergic system in diagnosis of Parkinson’s disease (PD). PD can be classified into two groups: late onset Parkinson’s disease (LOPD) and early onset Parkinson’s disease (EOPD). In this study we tried to determine the TRODAT SPECT findings in EOPD as compared to LOPD.
Methods: Fifteen patients were studied. The diagnosis of PD was defined by clinical criteria based on UK Parkinson’s Disease Society Brain Bank criteria. Six patients whose age at onset of PD were younger than 50 were defined as patients with EOPD and 9 patients with older than 50 years were defined as patients with LOPD. All patients underwent 99mTc-TRODAT Brain SPECT.
Results: There was a significant decrease of striatal 99mTc-TRODAT-1 (TRODAT) binding in PD patients in both EOPD and LOPD. No significant difference was noticed between EOPD and LOPD in disease stage and symptoms. In visual analysis, 20 (66.67%) caudate nucleuses had decreased tracer uptake while all 30 (100%) putamens had decreased or absent tracer uptake. No significant difference between EOPD and LOPD was noticed in visual analysis. Striatum, Caudate and Putamen uptake ratio to background were calculated. No significant difference was noticed between EOPD and LOPD in these ratios. However there was significant difference in visual analysis (tracer uptake) as well as in uptake ratio between putamen and caudate nucleuses in both groups (P=0.001). On the other word, we found more diminished uptake in putamen as compared the caudate. Frequency and severity of putamen involvement were much more than caudate.
Conclusion: 99mTc-TRODAT-1 SPECT imaging showed lower presynaptical dopami-nergical terminals density in both EOPD and LOPD. There was no difference between EOPD and LOPD in TRODAT uptake. Putamen showed more involvement and more diminished TRODAT uptake.

 

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  1. Shyu WC, Lin SZ, Chiang MF, Pang CY, Chen SY, Hsin YL, et al. Early-onset Parkinson’s disease in a Chinese population: 99mTc-TRODAT-1 SPECT, Parkin gene analysisand clinical study. Parkinsonism Relat Disord. 2005;11(3):173-80.
  2. Huang WS, Lin SZ, Lin JC, Wey SP, Ting G, Liu RS. Evaluation of early-stage Parkinson’s disease with 99mTc-TRODAT-1 imaging. J Nucl Med. 2001;42(9):1303-8.
  3. Chou KL, Hurtig HI, Stern MB, Colcher A, Ravina B, Newberg A, et al. Diagnostic accuracy of (99mTc) TRODAT-1 SPECT imaging in early Parkinson’s disease. Parkinsonism Relat Disord. 2004;10(6):375-9.
  4. Schrag A, Ben-Shlomo Y, Brown R, Marsden CD, Quinn N. Young onset Parkinson’s disease revisited-clinical features, natural history, and mortality. Mov Disord. 1998;13(6):885-94.
  5. Lucking CB, Durr A, Bonifati V, Vaughan J, De Michele G, Gasser T, et al. Association between early-onset Parkinson’s disease and mutations in the parkin gene. French Parkinson’s Disease Genetics Study Group. N Engl J Med. 2000;342(21):1560-7.
  6. Felicio AC, Godeiro-Junior C, Shih MC, Borges V, Silva SM, Aguiar Pde C, et al. Evaluation of patients with Clinically Unclear Parkinsonian Syndromes submitted to brain SPECT imaging using the technetium-99m labeled tracer TRODAT-1. J Neurol Sci. 2010;291(1-2):64-8.
  7. Lai SC, Weng YH, Yen TC, Tsai CC, Chang HC, Wey SP, et al. Imaging early-stage corticobasal degeneration with (99mTc)TRODAT-1 SPET. Nucl Med Commun. 2004;25(4):339-45.
  8. Felicio AC, Godeiro-Junior C, Moriyama TS, Shih MC, Hoexter MQ, Borges V, et al. Degenerative parkinsonism in patients with psychogenic parkinsonism: a dopamine transporter imaging study. Clin Neurol Neurosurg. 2010;112(4):282-5.
  9. Huang WS, Ma KH, Chou YH, Chen CY, Liu RS, Liu JC. 99mTc-TRODAT-SPECT in healthy and 6-OHDA lesioned parkinsonian monkeys: comparison with 18F-FDOPA PET. Nucl Med Commun. 2003;24(1):77-83.
  10. Kao PF, Tzen KY, Yen TC, Lu CS, Weng YH, Wey SP, et al. The optimal imaging time for (99Tcm) TRODAT-1/SPET in normal subjects and patients with Parkinson’s disease. Nucl Med Commun. 2001;22(2):151-4.
  11. Guttman M, Burkholder J, Kish SJ, Hussey D, Wilson A, DaSilva J, et al. [11C]RTI-32 PET studies of the dopamine transporter in early dopamine-naive Parkinson’s disease: implications for the symptomatic threshold. Neurology. 1997;48(6):1578-83.
  12. Wilson JM, Levey AI, Rajput A, Ang L, Guttman M, Shannak K, et al. Differential changes in neurochemical markers of striatal dopamine nerve terminals in idiopathic Parkinson’s disease. Neurology. 1996;47(3):718-26.
  13. Shih MC, Franco de Andrade LA, Amaro E Jr, Felicio AC, Ferraz HB, Wagner J, et al. Higher nigrostriatal dopamine neuron loss in early than late onset Parkinson’s disease?- a (99mTc)-TRODAT-1 SPECT study. Mov Disord. 2007;22(6):863-6.
  14. Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992;55(3):181-4.
  15. Hughes AJ, Daniel SE, Lees AJ. Improved accuracy of clinical diagnosis of Lewy body Parkinson’s disease. Neurology. 2001;57(8):1497-9.
  16. Hoehn MW, Yahr MD. Parkinsonism: onset, progression, and mortality. Neurology. 1967;17(5):427-42.
  17. Weng YH, Yen TC, Chen MC, Kao PF, Tzen KY, Chen RS, et al. Sensitivity and specificity of 99mTc- TRODAT-1 SPECT imaging in differentiating patients with idiopathic Parkinson’s disease from healthy subjects. J Nucl Med. 2004;45(3):393-401.
  18. Mozley PD, Schneider JS, Acton PD, Plössl K, Stern MB, Siderowf A, et al. Binding of [99mTc]TRODAT-1 to dopamine transporters in patients with Parkinson’s disease and in healthy volunteers. J Nucl Med. 2000;41(4):584-9.
  19. Uhl GR. Neurotransmitter transporters (plus): a promising new gene family. Trends Neurosci. 1992;15(7):265-8.
  20. Kaufman MJ, Madras BK. Severe depletion of cocaine recognition sites associated with the dopamine transporter in Parkinson’s-diseased striatum. Synapse. 1991;9(1):43-9.
  21. Nagasawa H, Tanji H, Itoyama Y, Saito H, Kimura I, Fujiwara T, et al. Brain 6-(18F)fluorodopa metabolism in early and late onset of Parkinson’s disease studied by positron emission tomography. J Neurol Sci. 1996;144(1-2):70-6.
  22. De La Fuente-Fernández R, Lim AS, Sossi V, Adam MJ, Ruth TJ, Calne DB, et al. Age and severity of nigrostriatal damage at onset of Parkinson’s disease. Synapse. 2003;47(2):152-8.