RESEARCH: SPECT in the diagnostic evaluation of PD, MSA, and PSP

[Guest guest]

Pam, there seems to more and more reports that PET, SPECT and MRI (diffusion weighted may be able to help DX PD from PD.

Thank you for your great resource and reference work.

Al

[Guest guest]

Pam, there seems to more and more reports that PET, SPECT and MRI (diffusion weighted may be able to help DX PD from PD.

Thank you for your great resource and reference work.

Al

[Guest guest]

Mov Disord 2002 Mar;17(2):303-12

Combination of dopamine transporter and D2 receptor SPECT in the diagnostic

evaluation of PD, MSA, and PSP.

Kim YJ, Ichise M, Ballinger JR, Vines D, Erami SS, Tatschida T, Lang AE.

Morton & Gloria Shulman Movement Disorders Center and the Division of

Neurology

(Department of Medicine), The Toronto Western Hospital, Toronto, Ontario,

Canada.

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 [(123)I]beta-CIT (for DAT) and

[(123)I]IBF (for D2) were performed in 18 patients with PD (12 dopa-naive

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 = V(3)/V(2)) 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. Copyright

2002

Movement Disorder Society.

PMID: 11921116 [PubMed - in process]