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Arch Neurol. 2006 Aug;63(8):1154-60.

Topography of dopamine transporter availability in progressive supranuclear palsy: a voxelwise [123I]beta-CIT SPECT analysis.

Author information

1
Department of Neurology, Medical University Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria. klaus.seppi@uibk.ac.at

Abstract

BACKGROUND:

Dopaminergic loss can be visualized by means of iodine I 123-labeled 2beta-carbomethoxy-3beta-(4-iodophenyl)tropane ([(123)I]beta-CIT) single-photon emission computed tomography (SPECT) in several neurodegenerative parkinsonian disorders. Most previous SPECT studies have adopted region-of-interest methods for analysis, which are subjective and operator dependent.

OBJECTIVE:

To objectively localize the cerebral dopamine transporter status in the early stages of progressive supranuclear palsy (PSP).

DESIGN:

Prospective study.

SETTING:

Parkinson disease outpatient clinic.

PATIENTS:

Fourteen patients with PSP, 17 with Parkinson disease (PD), 15 with Parkinson-variant multiple-system atrophy (MSA-P), and 13 healthy control subjects, matched for age and disease duration.

INTERVENTIONS:

Statistical parametric mapping applied to [(123)I]beta-CIT SPECT.

MAIN OUTCOME MEASURES:

Differences in [(123)I]beta-CIT uptake.

RESULTS:

All patients with the different parkinsonian disorders showed a significant decrease in striatal [(123)I]beta-CIT uptake without any overlap with the control group. In patients with MSA-P and PSP, an additional reduction in brainstem [(123)I]beta-CIT signal compared with controls and patients with PD was identified with statistical parametric mapping. Midbrain [(123)I]beta-CIT uptake discriminated atypical parkinsonian disorders from PD with an overall correct classification of 91.3%. On the other hand, [(123)I]beta-CIT SPECT failed to discriminate PSP and MSA-P.

CONCLUSION:

By applying statistical parametric mapping to [(123)I]beta-CIT SPECT images of patients with PSP, a widespread decline of monoaminergic transporter availability including the striatum and brainstem was localized in PSP, discriminating patients with PSP from patients with PD, but not from those with MSA-P. Quantification of midbrain dopamine transporter signal may therefore enhance the utility of SPECT imaging in the differential diagnosis of patients with parkinsonism.

PMID:
16908744
DOI:
10.1001/archneur.63.8.1154
[Indexed for MEDLINE]

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