Differential distribution of striatal [123I]β-CIT in Parkinson’s disease and progressive supranuclear palsy, evaluated with single-photon emission tomography |
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| Authors: | C Messa M A Volonté F Fazio F Zito A Carpinelli A d’Amico G Rizzo R M Moresco E Paulesu M Franceschi G Lucignani |
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| Institution: | (1) INB-CNR, University of Milan, H San Raffaele Institute of Milan, Italy, IT |
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| Abstract: | Functional imaging of the presynaptic dopaminergic activity using single-photon emission tomography (SPET) and iodine-123
labelled 2-β-carboxymethoxy-3-β-(4-iodophenyl)tropane (123I]β-CIT) is important for the assessment of disease severity and progression in patients with Parkinson’s disease (PD). However,
its capability to discriminate between different extrapyramidal disorders has not yet been assessed. The aim of this study
was to evaluate the possibility of differentiating patients with PD and with progressive supranuclear palsy (PSP) by means
of this method. The distribution of 123I]β-CIT in the basal ganglia was assessed in six normal subjects, 13 petients with PD and five patients with PSP in whom the
disease was mild. SPET images were obtained 24±2 h after i.v. injection of the tracer using a brain-dedicated system (CERASPECT).
MR and SPET images were co-registered in four normal subjects and used to define a standard set of 16 circular regions of
interest (ROIs) on the slice showing the highest striatal activity. The basal ganglia ROIs corresponded to (1) the head of
caudate, (2) a region of transition between the head of caudate and the anterior putamen, (3) the anterior putamen and (4)
the posterior putamen. A ratio of specific to non-displaceable striatal uptake was calculated normalising the activity of
the basal ganglia ROIs to that of the occipital cortex (V3′′). ANOVA revealed a global reduction of V3′′ in all ROIs of PD
and PSP patients compared with normal controls (P<0.0001). A Mann-Whitney U test showed that the difference between PD and PSP patients was statistically significant for the caudate region only (Z value: 2.6; P<0.01). By subtracting V3′′ caudate values from those of the putamen, differentiation from PSP was possible in 10/13 PD patients.
In conclusion, analysis of 123I]β-CIT distribution in discrete striatal areas provides information on the relative caudate-putamen damage, with different
values being obtained in patients clinically diagnosed as having either PD or PSP.
Received 1 February and in revised form 7 May 1998 |
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| Keywords: | : Iodine-123-β -CIT Single-photon emission tomography Extrapyramidal disorders |
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