Document Detail

Combination of dopamine transporter and D2 receptor SPECT in the diagnostic evaluation of PD, MSA, and PSP.
MedLine Citation:
PMID:  11921116     Owner:  NLM     Status:  MEDLINE    
It is often difficult to differentiate clinically between Parkinson's disease (PD), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP). The objective of this work was to investigate whether combined pre- and postsynaptic dopaminergic single photon emission computed tomography (SPECT) scanning can reliably demonstrate changes in the nigrostriatal dopaminergic system and help differentiate between normal controls, PD, MSA, and PSP patients. We performed SPECT evaluation of the dopamine transporter (DAT) and dopamine D2 receptors (D2). SPECT scans using [123I]beta-CIT (for DAT) and [123I]IBF (for D2) were performed in 18 patients with PD (12 dopa-naïve and 6 on levodopa and/or dopamine agonists), 7 with MSA of the striatonigral degeneration type, 6 with PSP, and 29 normal controls. Antiparkinsonian drugs were withheld for at least 12 hours before the scans. DAT and D2 binding potentials (Rv = V3/V2) were measured for caudate, anterior, and posterior putamen on the sides ipsilateral and contralateral to the worst motor symptoms. DAT binding in the posterior putamen was markedly reduced in all patients. However, D2 binding in posterior putamen was significantly increased in dopa-untreated PD, being greater than the normal range in 4 of 12 (33%), and it was significantly reduced in MSA, being below the normal range in 5 of 7 (71%). None of the patients with PD showed reduced D2 binding below the normal range in posterior putamen. The degree of DAT binding could not discriminate between the patient groups. The ratio of posterior putamen to caudate percentage D2 Rv compared with the controls showed an opposite pattern between PD or PSP and MSA; the caudate was greater in 16 of 18 with PD and 6 of 6 with PSP, whereas caudate was less in 5 of 7 with MSA. These findings suggest that DAT SPECT may be useful in differentiating parkinsonism from controls and D2 SPECT in further differentiating MSA from Parkinson's disease and possibly PSP.
Yun J Kim; Masanori Ichise; James R Ballinger; Douglas Vines; Sean S Erami; Tatsuro Tatschida; Anthony E Lang
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Movement disorders : official journal of the Movement Disorder Society     Volume:  17     ISSN:  0885-3185     ISO Abbreviation:  Mov. Disord.     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-03-28     Completed Date:  2002-05-17     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  8610688     Medline TA:  Mov Disord     Country:  United States    
Other Details:
Languages:  eng     Pagination:  303-12     Citation Subset:  IM    
Copyright Information:
Copyright 2002 Movement Disorder Society.
Morton & Gloria Shulman Movement Disorders Center and the Division of Neurology (Department of Medicine), The Toronto Western Hospital, Toronto, Ontario, Canada.
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MeSH Terms
Brain / physiopathology,  radionuclide imaging
Diagnosis, Differential
Dopamine Plasma Membrane Transport Proteins
Iodine Radioisotopes / diagnostic use
Membrane Glycoproteins*
Membrane Transport Proteins / physiology*
Middle Aged
Multiple System Atrophy / physiopathology,  radionuclide imaging*
Nerve Tissue Proteins*
Neurologic Examination
Parkinson Disease / physiopathology,  radionuclide imaging*
Receptors, Dopamine D2 / physiology*
Sensitivity and Specificity
Supranuclear Palsy, Progressive / physiopathology,  radionuclide imaging*
Tomography, Emission-Computed, Single-Photon*
Reg. No./Substance:
0/Dopamine Plasma Membrane Transport Proteins; 0/Iodine Radioisotopes; 0/Membrane Glycoproteins; 0/Membrane Transport Proteins; 0/Nerve Tissue Proteins; 0/Receptors, Dopamine D2; 0/SLC6A3 protein, human

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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