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Bhattacharjee S, Paramanandam V, Bhattacharya A. Analysis of the Effect of Dopamine Transporter Scan on the Diagnosis and Management in a Tertiary Neurology Center. Neurohospitalist 2019; 9:144-150. [PMID: 31244971 DOI: 10.1177/1941874419829293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background and Purpose The dopamine transporter scan or DaT scan is abnormal in presynaptic parkinsonism but normal in nondegenerative or postsynaptic parkinsonism. In this study, we tried to ascertain the impact of DaT scan on the diagnosis and clinical management and if the semiquantitative analysis of the DaT scans has any correlation with the clinical symptoms. Methods The electronic and nonelectronic records of patients of Plymouth Hospital NHS Trust, United Kingdom, from 2011 to 2015 were studied to find the indication, outcome, and the impact of the scan on the management of patients. The DaT scan results were assessed visually and semiquantitatively by the Department of Nuclear Medicine. The available data were statistically analyzed with the help of Microsoft XL2010 and GraphPad software. Results A total of 258 people had DaT scan. The scan results suggested an alternate diagnosis in 50.5% of clinically diagnosed patients with Parkinson disease. Similarly, DaT scan changed the diagnosis of 40% of patients with clinical diagnosis of vascular parkinsonism, 25% of clinically diagnosed drug-induced parkinsonism, and 54% of patients with possible Lewy body dementia. Visual assessment of the DaT scan revealed that more than 60% had grade 2 abnormalities. The distribution volume ratio, a semiquantitative tool for tracer uptake, was significantly less in the patients with akinetic-rigid subtype of Parkinson disease in comparison to a tremor predominant subtype. Conclusions Dopamine transporter scan had a significant impact in diagnosis and management.
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Affiliation(s)
- Shakya Bhattacharjee
- Neurology, Royal Cornwall Hospital, Truro, United Kingdom and Plymouth Hospital NHS Trust, Plymouth, UK
| | - Vijayashankar Paramanandam
- Toronto Western Hospital, Toronto, Ontario, Canada
- Neurology, Stanley Medical College, Chennai, Tamil Nadu, India
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Matsusue E, Fujihara Y, Tanaka K, Aozasa Y, Shimoda M, Nakayasu H, Nakamura K, Ogawa T. The utility of the combined use of 123I-FP-CIT SPECT and neuromelanin MRI in differentiating Parkinson's disease from other parkinsonian syndromes. Acta Radiol 2019; 60:230-238. [PMID: 29804474 DOI: 10.1177/0284185118778871] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Neuromelanin magnetic resonance imaging (NmMRI) and 123I-FP-CIT dopamine transporter single photon emission computed tomography (DAT-SPECT) provide specific information that distinguishes Parkinson's disease (PD) from non-degenerative parkinsonian syndrome (NDPS). PURPOSE To determine whether a multiparametric scoring system (MSS) could improve accuracy compared to each parameter of DAT-SPECT and NmMRI in differentiating PD from NDPS. MATERIAL AND METHODS A total of 49 patients, including 14 with NDPS, 30 with PD, and five with atypical parkinsonian disorder (APD) underwent both NmMRI and DAT-SPECT and were evaluated. The average (Ave) and the asymmetry index (AI) were calculated in the substantia nigra compacta area (SNc-area), SNc midbrain-tegmentum contrast ratio (SNc-CR), and specific binding ratio (SBR). Cut-off values were determined, using receiver operating characteristic (ROC) analysis, for the differentiation of PD from NDPS on the statistically significant parameters. All cases were scored as either 1 (PD) or 0 (NDPS) for each parameter according to its threshold. These individual scores were totaled for each case, yielding a combined score for each case to obtain a cut-off value for the MSS. RESULTS The Ave-SNc-area, Ave-SNc-CR, and Ave-SBR in PD were significantly lower than those in NDPS. The AI-SNc-area and AI-SBR in PD were significantly higher than those in NDPS. Of the five parameters, the highest accuracy was 93% for the Ave-SNc-area. For the MSS, a cut-off value of 3 was the accuracy of 96%. Besides, no significant difference was observed between PD and APD on all parameters. CONCLUSION An MSS has comparable or better accuracy compared to each parameter of DAT-SPECT and NmMRI in distinguishing PD from NDPS.
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Affiliation(s)
- Eiji Matsusue
- Department of Radiology, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Yoshio Fujihara
- Department of Radiology, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Kenichiro Tanaka
- Department of Neurology, Tottori prefectural Central Hospital, Tottori, Japan
| | - Yuki Aozasa
- Department of Neurology, Tottori prefectural Central Hospital, Tottori, Japan
| | - Manabu Shimoda
- Department of Neurology, Tottori prefectural Central Hospital, Tottori, Japan
| | - Hiroyuki Nakayasu
- Department of Neurology, Tottori prefectural Central Hospital, Tottori, Japan
| | - Kazuhiko Nakamura
- Department of Radiology, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Toshihide Ogawa
- Division of Radiology, Department of Pathophysiological Therapeutic Science, Tottori University, Tottori, Japan
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Stephenson D, Hill D, Cedarbaum JM, Tome M, Vamvakas S, Romero K, Conrado DJ, Dexter DT, Seibyl J, Jennings D, Nicholas T, Matthews D, Xie Z, Imam S, Maguire P, Russell D, Gordon MF, Stebbins GT, Somer E, Gallagher J, Roach A, Basseches P, Grosset D, Marek K. The Qualification of an Enrichment Biomarker for Clinical Trials Targeting Early Stages of Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2019; 9:553-563. [PMID: 31306141 PMCID: PMC6700608 DOI: 10.3233/jpd-191648] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/31/2019] [Indexed: 12/12/2022]
Abstract
As therapeutic trials target early stages of Parkinson's disease (PD), appropriate patient selection based purely on clinical criteria poses significant challenges. Members of the Critical Path for Parkinson's Consortium formally submitted documentation to the European Medicines Agency (EMA) supporting the use of Dopamine Transporter (DAT) neuroimaging in early PD. Regulatory documents included a comprehensive literature review, a proposed analysis plan of both observational and clinical trial data, and an assessment of biomarker reproducibility and reliability. The research plan included longitudinal analysis of the Parkinson Research Examination of CEP-1347 Trial (PRECEPT) and the Parkinson's Progression Markers Initiative (PPMI) study to estimate the degree of enrichment achieved and impact on future trials in subjects with early motor PD. The presence of reduced striatal DAT binding based on visual reads of single photon emission tomography (SPECT) scans in early motor PD subjects was an independent predictor of faster decline in UPDRS Parts II and III as compared to subjects with scans without evidence of dopaminergic deficit (SWEDD) over 24 months. The EMA issued in 2018 a full Qualification Opinion for the use of DAT as an enrichment biomarker in PD trials targeting subjects with early motor symptoms. Exclusion of SWEDD subjects in future clinical trials targeting early motor PD subjects aims to enrich clinical trial populations with idiopathic PD patients, improve statistical power, and exclude subjects who are unlikely to progress clinically from being exposed to novel test therapeutics.
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Affiliation(s)
| | | | | | - Maria Tome
- European Medicines Agency, Amsterdam, Netherlands
| | | | | | | | | | - John Seibyl
- Institute for Neurodegenerative Disorders, New Haven, CT, USA
| | | | | | | | | | - Syed Imam
- U.S. Food and Drug Administration, National Center for Toxicological Research, Jefferson, AR, USA
| | | | - David Russell
- Institute for Neurodegenerative Disorders, New Haven, CT, USA
| | | | | | | | | | | | | | | | - Kenneth Marek
- Institute for Neurodegenerative Disorders, New Haven, CT, USA
| | - on behalf of the Critical Path for Parkinson’s Consortium
- Critical Path Institute, Tucson, AZ, USA
- University College London, UK
- Biogen, Cambridge, MA, USA
- European Medicines Agency, Amsterdam, Netherlands
- Parkinson’s UK, London, UK
- Institute for Neurodegenerative Disorders, New Haven, CT, USA
- Denali Therapeutics, San Francisco, CA, USA
- Pfizer, Groton, CT, USA
- ADM Diagnostics, Northbrook, IL, USA
- UCB, Brussels, Belgium
- CPP Scientific Advisor, PA, USA
- GE Healthcare, London, UK
- Merck & Co., Philadelphia, PA, USA
- University of Glasgow, Scotland
- Rush University, Chicago, IL, USA
- U.S. Food and Drug Administration, National Center for Toxicological Research, Jefferson, AR, USA
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Ortelli P, Ferrazzoli D, Zarucchi M, Maestri R, Frazzitta G. Asymmetric Dopaminergic Degeneration and Attentional Resources in Parkinson's Disease. Front Neurosci 2018; 12:972. [PMID: 30618591 PMCID: PMC6304447 DOI: 10.3389/fnins.2018.00972] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 12/04/2018] [Indexed: 12/24/2022] Open
Abstract
Background: Attention is crucial to voluntary perform actions in Parkinson's disease (PD), allowing patients to bypass the impaired habitual motor control. The asymmetrical degeneration of the dopaminergic system could affect the attentional functions. Objective: To investigate the relationship between the asymmetric dopaminergic degeneration and the attentional resources in Parkinsonian patients with right-side (RPD) and left-side (LPD) motor symptoms predominance. Methods: 50 RPD, 50 LPD, and 34 healthy controls underwent visual (V), auditory (A), and multiple choices (MC) reaction time (RTs) tasks. For PD patients, these tasks were performed before and after a 4-week intensive, motor-cognitive rehabilitation treatment (MIRT). The effectiveness of treatment was evaluated assessing Unified Parkinson's disease Rating Scale (UPDRS) III and Timed-up and Go Test (TUG). Results: RTs did not differ between PD patients and healthy controls. Before MIRT, no differences between LPD and RPD patients were observed in RTs (p = 0.20), UPDRS III (p = 0.60), and TUG (p = 0.38). No differences in dopaminergic medication were found between groups (p = 0.44 and p = 0.66 before and after MIRT, respectively). After MIRT, LPD patients showed a significant reduction in MC RTs (p = 0.05), V RTs (p = 0.02), and MC-V RTs. A significant association between changes in RTs and improvements in UPDRS III and TUG was observed in LPD patients. Conclusion: attention does not differ among RPD patients, LPD patients and healthy controls. Only LPD patients improved their performances on attentional tasks after MIRT. We argue that the increased early susceptibility of the left nigrostriatal system to degeneration affects differently the cognitive modifiability and the neuroplastic potential. Our results could provide insight into new therapeutic approaches, highlighting the importance to design different treatments for RPD patients and LPD patients.
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Affiliation(s)
- Paola Ortelli
- Department of Parkinson's Disease, Movement Disorders and Brain Injury Rehabilitation, Moriggia-Pelascini Hospital, Como, Italy
| | - Davide Ferrazzoli
- Department of Parkinson's Disease, Movement Disorders and Brain Injury Rehabilitation, Moriggia-Pelascini Hospital, Como, Italy
| | - Marianna Zarucchi
- Department of Parkinson's Disease, Movement Disorders and Brain Injury Rehabilitation, Moriggia-Pelascini Hospital, Como, Italy
| | - Roberto Maestri
- Istituti Clinici Scientifici Maugeri - Istituto di Ricovero e Cura a Carattere Scientifico, Biomedical Engineering Unit of Montescano Institute, Pavia, Italy
| | - Giuseppe Frazzitta
- Department of Parkinson's Disease, Movement Disorders and Brain Injury Rehabilitation, Moriggia-Pelascini Hospital, Como, Italy
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Chen Y, Vastenhouw B, Wu C, Goorden MC, Beekman FJ. Optimized image acquisition for dopamine transporter imaging with ultra-high resolution clinical pinhole SPECT. ACTA ACUST UNITED AC 2018; 63:225002. [DOI: 10.1088/1361-6560/aae76c] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Noyce A, Bandopadhyay R. Parkinson's Disease: Basic Pathomechanisms and a Clinical Overview. ADVANCES IN NEUROBIOLOGY 2018; 15:55-92. [PMID: 28674978 DOI: 10.1007/978-3-319-57193-5_3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PD is a common and a debilitating degenerative movement disorder. The number of patients is increasing worldwide and as yet there is no cure for the disease. The majority of existing treatments target motor symptom control. Over the last two decades the impact of the genetic contribution to PD has been appreciated. Significant discoveries have been made, which have advanced our understanding of the pathophysiological and molecular basis of PD. In this chapter we outline current knowledge of the clinical aspects of PD and the basic mechanistic understanding.
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Affiliation(s)
- Alastair Noyce
- Department of Molecular Neuroscience, Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, 1, Wakefield Street, London, WC1N 1PJ, UK
| | - Rina Bandopadhyay
- Department of Molecular Neuroscience, Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, 1, Wakefield Street, London, WC1N 1PJ, UK.
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Thobois S, Prange S, Scheiber C, Broussolle E. What a neurologist should know about PET and SPECT functional imaging for parkinsonism: A practical perspective. Parkinsonism Relat Disord 2018; 59:93-100. [PMID: 30181086 DOI: 10.1016/j.parkreldis.2018.08.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 08/23/2018] [Accepted: 08/24/2018] [Indexed: 12/16/2022]
Abstract
The diagnosis of a parkinsonian syndrome based on clinical criteria remains sometimes difficult, especially at disease onset. Brain or heart molecular imaging techniques (SPECT or PET) can provide a major help to improve and speed up diagnosis, influencing treatment strategies. Presynaptic dopaminergic imaging using either [18F]-Dopa PET or 123I -2β-Carbomethoxy-3β-(4-Iodophenyl)- N-(3-Fluoropropyl) Nortropane ([123I]-Ioflupane)SPECT demonstrates or rules out the presence of a dopaminergic degenerative process. This allows to distinguish Parkinson's disease, Parkinson "plus" syndromes and dementia with Lewy bodies (reduced radiotracers binding) from essential tremor, psychogenic, post-neuroleptic or vascular parkinsonisms, dopa-responsive dystonia and Alzheimer's disease (normal radiotracers binding). For differential diagnosis between Parkinson's disease and Parkinson "plus" syndromes, brain molecular imaging with [18F]-Fluorodeoxyglucose ([18F]-FDG) PET or 99mTc-HMPAO SPECT can provide useful information, whereas [18F]-Dopa PET or [123I]-Ioflupane does not separate these entities. Finally, sympathetic cardiac [123I]-Metaiodobenzylguanidine ([123I]-MIBG) scintigraphy or SPECT can help distinguishing Parkinson's disease and dementia with Lew bodies (decreased binding) from multiple system atrophy and progressive supranuclear palsy (normal binding). New radiotracers notably those targeting the pathological process itself such as Tau aggregates are under development and may provide interesting informations to delineate the different Parkinson "plus" syndromes.
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Affiliation(s)
- Stéphane Thobois
- Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, F-69675, Bron, France; Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, Lyon, France; Univ Lyon, Faculté de Médecine et de Maïeutique Lyon Sud Charles Mérieux, F-69921, Oullins, France.
| | - Stéphane Prange
- Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, F-69675, Bron, France; Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, Lyon, France
| | - Christian Scheiber
- Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Médecine Nucléaire, Lyon, France
| | - Emmanuel Broussolle
- Univ Lyon, Institut des Sciences Cognitives Marc Jeannerod, CNRS, UMR 5229, F-69675, Bron, France; Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie C, Centre Expert Parkinson, Lyon, France; Univ Lyon, Faculté de Médecine et de Maïeutique Lyon Sud Charles Mérieux, F-69921, Oullins, France
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Bhattacharjee S. Reader response: Teaching NeuroImages: A rare case of giant perivascular spaces in the midbrain manifesting as atypical parkinsonism. Neurology 2018; 91:191-192. [DOI: 10.1212/wnl.0000000000005848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Matsusue E, Fujihara Y, Tanaka K, Aozasa Y, Shimoda M, Nakayasu H, Nakamura K, Ogawa T. The Utility of the Combined Use of 123I-FP-CIT and 123I-MIBG Myocardial Scintigraphy in Differentiating Parkinson's Disease from Other Parkinsonian Syndromes. Yonago Acta Med 2018; 61:117-127. [PMID: 29946218 PMCID: PMC6015794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 05/11/2018] [Indexed: 09/27/2023]
Abstract
BACKGROUND 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy and 123I-FP-CIT dopamine transporter single photon emission computed tomography (DAT-SPECT) provide specific information that distinguish Parkinson's disease (PD) from parkinsonian syndromes other than PD (non-PD), including atypical parkinsonian disorder (APD) and non-PD other than APD (nPD-nAPD). The purpose of this study was to determine whether combining DAT-SPECT and MIBG myocardial scintigraphy using multiparametric scoring system (MSS) could improve diagnostic test accuracy in discriminating PD from APD or discriminating PD from nPD-nAPD. METHODS A total of 52 patients, including 36 PD, eight APD and eight nPD-nAPD, underwent both MIBG myocardial scintigraphy and DAT-SPECT, were evaluated. The heart-to-mediastinum (H/M) ratios (early and delayed), washout-rate (WR), the average (Ave) and asymmetry index (AI) of specific binding ratio (SBR) were calculated. Cutoff values were determined, using ROC analysis, for discriminating PD from APD and for discriminating PD from nPD-nAPD, on five parameters. All cases were scored as either 1 (PD) or 0 (nPD-nAPD or APD) for each parameter according to its threshold in each discrimination. These individual scores were summed for each case, yielding a combined score to obtain a cutoff value for the MSS in each discrimination. RESULTS For discriminating PD from nPD-nAPD, the highest accuracy was 80% at a cutoff value of 19% for the WR and a cut off value of 2 improved diagnostic accuracy to 84% for MSS. For discriminating PD from APD, the highest accuracy was 86% at a cutoff value of 2.8 for the H/M ratio (late) and a cut off value of 2 showed diagnostic accuracy of 86% for MSS. CONCLUSION A MSS has comparable or better accuracy compared to each parameter of MIBG myocardial scintigraphy and DAT-SPECT in distinguishing PD from nPD-nAPD or distinguishing PD from APD.
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Affiliation(s)
- Eiji Matsusue
- Department of Radiology, Tottori Prefectural Central Hospital, Tottori 680-0901, Japan
| | - Yoshio Fujihara
- Department of Radiology, Tottori Prefectural Central Hospital, Tottori 680-0901, Japan
| | - Kenichiro Tanaka
- †Department of Neurology, Tottori Prefectural Central Hospital, Tottori 680-0901, Japan
| | - Yuki Aozasa
- †Department of Neurology, Tottori Prefectural Central Hospital, Tottori 680-0901, Japan
| | - Manabu Shimoda
- †Department of Neurology, Tottori Prefectural Central Hospital, Tottori 680-0901, Japan
| | - Hiroyuki Nakayasu
- †Department of Neurology, Tottori Prefectural Central Hospital, Tottori 680-0901, Japan
| | - Kazuhiko Nakamura
- Department of Radiology, Tottori Prefectural Central Hospital, Tottori 680-0901, Japan
| | - Toshihide Ogawa
- ‡Division of Radiology, Department of Pathophysiological Therapeutic Science, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
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Ikeda K, Yanagihashi M, Miura K, Ishikawa Y, Hirayama T, Takazawa T, Kano O, Kawabe K, Mizumura N, Iwasaki Y. Zonisamide cotreatment delays striatal dopamine transporter reduction in Parkinson disease: A retrospective, observational cohort study. J Neurol Sci 2018; 391:5-9. [PMID: 30103971 DOI: 10.1016/j.jns.2018.05.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 03/31/2018] [Accepted: 05/16/2018] [Indexed: 11/19/2022]
Abstract
This study examined whether zonisamide (ZNS) cotreatment delays dopamine transporter (DAT) reduction on SPECT in Parkinson disease (PD) patients. The study participants met the following criteria: (i) age ≥ 40 years; (ii) HY stage = 2 or 3; (iii) average specific binding ratio (SBR) ≥2.00; (iv) levodopa administration without a prior history of ZNS use before the first DAT-SPECT (baseline). Attending physicians initially determined whether ZNS (25 mg/day) should be used or not. Levodopa and other anti-PD medications were not restricted. The second DAT-SPECT (endpoint) was conducted 1.2 ± 0.2 years after the first DAT-SPECT. Clinicoradiological changes of HY stage, UPDRS parts II to IV, dyskinesia subscore, and SBR were calculated. Statistical differences were analyzed by Student's t-test, ANOVA, or multilogistic analysis. ZNS cotreatment improved wearing off and prevented the development of dyskinesia without additional administration of selegiline, entacapone, and dopamine receptor agonists. The endpoint SBR reduced significantly in the non-ZNS group compared to the baseline (P < .01). The SBR decline rate reduced significantly in the ZNS group (P < .01). ZNS was an independent preventive factor for SBR reduction. These results suggested a beneficial potential that ZNS preserves striatal presynaptic DAT expression and slows disease progression in early-stage PD.
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Affiliation(s)
- Ken Ikeda
- Department of Neurology, Toho University Omori Medical Center, Tokyo, Japan.
| | - Masaru Yanagihashi
- Department of Neurology, Toho University Omori Medical Center, Tokyo, Japan
| | - Ken Miura
- Department of Neurology, Toho University Omori Medical Center, Tokyo, Japan
| | - Yuichi Ishikawa
- Department of Neurology, Toho University Omori Medical Center, Tokyo, Japan
| | - Takehisa Hirayama
- Department of Neurology, Toho University Omori Medical Center, Tokyo, Japan
| | - Takanori Takazawa
- Department of Neurology, Toho University Omori Medical Center, Tokyo, Japan
| | - Osamu Kano
- Department of Neurology, Toho University Omori Medical Center, Tokyo, Japan
| | - Kiyokazu Kawabe
- Department of Neurology, Toho University Omori Medical Center, Tokyo, Japan
| | - Nao Mizumura
- Department of Radiology, Toho University Omori Medical Center, Tokyo, Japan
| | - Yasuo Iwasaki
- Department of Neurology, Toho University Omori Medical Center, Tokyo, Japan
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Affiliation(s)
- Dietrich Haubenberger
- From the Clinical Trials Unit, Office of the Clinical Director (D.H.), and the Human Motor Control Section, Medical Neurology Branch (M.H.), National Institute of Neurological Disorders and Stroke Intramural Research Program, National Institutes of Health, Bethesda, MD
| | - Mark Hallett
- From the Clinical Trials Unit, Office of the Clinical Director (D.H.), and the Human Motor Control Section, Medical Neurology Branch (M.H.), National Institute of Neurological Disorders and Stroke Intramural Research Program, National Institutes of Health, Bethesda, MD
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Lechien J, Blecic S, Huet K, Delvaux V, Piccaluga M, Roland V, Harmegnies B, Saussez S. Voice quality outcomes of idiopathic Parkinson's disease medical treatment: A systematic review. Clin Otolaryngol 2018; 43:882-903. [DOI: 10.1111/coa.13082] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2018] [Indexed: 11/30/2022]
Affiliation(s)
- J.R. Lechien
- Laboratory of Anatomy and Cell Biology; Faculty of Medicine; UMONS Research Institute for Health Sciences and Technology; University of Mons; Mons Belgium
- Laboratory of Phonetics; Faculty of Psychology; Research Institute for Language sciences and Technology; University of Mons; Mons Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery; RHMS Baudour, EpiCURA Hospital; Baudour Belgium
| | - S. Blecic
- Department of Neurology; EpiCURA Hospital; Baudour Belgium
| | - K. Huet
- Laboratory of Phonetics; Faculty of Psychology; Research Institute for Language sciences and Technology; University of Mons; Mons Belgium
| | - V. Delvaux
- Laboratory of Phonetics; Faculty of Psychology; Research Institute for Language sciences and Technology; University of Mons; Mons Belgium
| | - M. Piccaluga
- Laboratory of Phonetics; Faculty of Psychology; Research Institute for Language sciences and Technology; University of Mons; Mons Belgium
| | - V. Roland
- Laboratory of Phonetics; Faculty of Psychology; Research Institute for Language sciences and Technology; University of Mons; Mons Belgium
| | - B. Harmegnies
- Laboratory of Phonetics; Faculty of Psychology; Research Institute for Language sciences and Technology; University of Mons; Mons Belgium
| | - S. Saussez
- Laboratory of Anatomy and Cell Biology; Faculty of Medicine; UMONS Research Institute for Health Sciences and Technology; University of Mons; Mons Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery; RHMS Baudour, EpiCURA Hospital; Baudour Belgium
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Neuroimaging in Parkinson's disease: focus on substantia nigra and nigro-striatal projection. Curr Opin Neurol 2018; 30:416-426. [PMID: 28537985 DOI: 10.1097/wco.0000000000000463] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE OF REVIEW The diagnosis of Parkinson disease is based on clinical features; however, unmet need is an imaging signature for Parkinson disease and the early differential diagnosis with atypical parkinsonisms. A summary of the molecular imaging and MRI recent evidences for Parkinson disease diagnosis will be presented in this review. RECENT FINDINGS The nigro-striatal dysfunction explored by dopamine transporter imaging is not a mandatory diagnostic criterion for Parkinson disease, recent evidence supported its utility as in-vivo proof of degenerative parkinsonisms, and there might be compensatory mechanisms leading to an early overestimation. The visualization of abnormalities in substantia nigra by MRI has been recently described as sensitive and specific tool for Parkinson disease diagnosis, even in preclinical conditions, whereas it is not useful for distinguishing between Parkinson disease and atypical parkinsonisms. The relationship between the nigral anatomical changes, evaluated as structural alterations or neuromelanin signal decrease and the dopaminergic nigro-striatal function needs to be further clarified. SUMMARY With the hopeful advent of potential neuroprotective drugs for PD, it is crucial to have imaging measures that are able to detect at risk subjects. Moreover it is desirable to increase the knowledge about which measure better predicts the probability and the time of clinical conversion to PD.
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Stam MK, Verwer EE, Booij J, Adriaanse SM, de Bruin CM, de Wit TC. Performance evaluation of a novel brain-dedicated SPECT system. EJNMMI Phys 2018; 5:4. [PMID: 29492787 PMCID: PMC5833889 DOI: 10.1186/s40658-018-0203-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 01/05/2018] [Indexed: 11/10/2022] Open
Affiliation(s)
- M K Stam
- Department of Radiology and Nuclear Medicine, Academic Medical Center, PO box 22660, 1100, DD, Amsterdam, The Netherlands
| | - E E Verwer
- Department of Radiology and Nuclear Medicine, Academic Medical Center, PO box 22660, 1100, DD, Amsterdam, The Netherlands
| | - J Booij
- Department of Radiology and Nuclear Medicine, Academic Medical Center, PO box 22660, 1100, DD, Amsterdam, The Netherlands
| | - S M Adriaanse
- Department of Radiology and Nuclear Medicine, Academic Medical Center, PO box 22660, 1100, DD, Amsterdam, The Netherlands
| | - C M de Bruin
- Department of Radiology and Nuclear Medicine, Academic Medical Center, PO box 22660, 1100, DD, Amsterdam, The Netherlands
| | - T C de Wit
- Department of Radiology and Nuclear Medicine, Academic Medical Center, PO box 22660, 1100, DD, Amsterdam, The Netherlands.
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Pavese N, Tai YF. Nigrosome Imaging and Neuromelanin Sensitive MRI in Diagnostic Evaluation of Parkinsonism. Mov Disord Clin Pract 2018; 5:131-140. [PMID: 30363419 DOI: 10.1002/mdc3.12590] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 12/02/2017] [Accepted: 12/24/2017] [Indexed: 12/24/2022] Open
Abstract
Background Recent developments in magnetic resonance imaging (MRI) techniques have offered new research opportunities to visualize in vivo substantia nigra pathology in Parkinson's disease (PD). This paper summarizes the main findings of nigrosome imaging and neuromelanin sensitive MRI studies in patients with PD and other parkinsonisms. Methods The PubMed database was searched from 2005 to 2017 using the following keywords: Parkinson's disease and parkinsonism, in combination with MRI, nigrosome, neuromelanin, and iron. Only publications in English were included. Results Nigrosome or dorsal nigral hyperintensity abnormalities are studied using T2* and susceptibility weighted imaging MRI sequences in most studies, whereas Neuromelanin imaging is usually performed using T1-weighted fast spin echo sequence. Nigrosome abnormalities have been consistently demonstrated in PD patients, and nigrosome imaging has high sensitivity and specificity in distinguishing PD from healthy controls, though it is unable to reliably separate PD from atypical parkinsonisms. Reduced neuromelanin-related signals and/or volume loss in neuromelanin containing structures have been found in PD patients, and neuromelanin sensitive MRI imaging can also discriminate PD patients from healthy controls with high accuracy, though there is a degree of heterogeneity in the imaging findings. Preliminary findings suggested that longitudinal change of neuromelanin signal could be detected in PD, raising the possibility of using it as a marker of disease progression. Conclusion Nigrosome imaging and neuromelanin sensitive MRI are promising tools to study nigral pathology and to improve the diagnosis of PD. However, further studies are required to standardize analysis approaches, confirm longitudinal changes, and assess their generalizability.
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Affiliation(s)
- Nicola Pavese
- Newcastle Magnetic Resonance Centre & Positron Emission Tomography Centre Newcastle University Newcastle Upon Tyne United Kingdom.,Department of Nuclear Medicine and PET Centre Aarhus University Hospital Nørrebrogade 44, 8000, Aarhus Denmark
| | - Yen F Tai
- Division of Brain Sciences Imperial College London London United Kingdom
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66
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Nakajima A, Shimo Y, Sekimoto S, Kamagata K, Jo T, Oyama G, Umemura A, Hattori N. Dopamine transporter imaging predicts motor responsiveness to levodopa challenge in patients with Parkinson's disease: A pilot study of DATSCAN for subthalamic deep brain stimulation. J Neurol Sci 2018; 385:134-139. [PMID: 29406893 DOI: 10.1016/j.jns.2017.12.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 12/18/2017] [Accepted: 12/25/2017] [Indexed: 01/06/2023]
Abstract
Imaging studies are necessary prior to subthalamic deep brain stimulation (STN-DBS). Dopamine transporter (DAT) imaging is a powerful tool for visualizing dopamine terminals in the striatum, but its usefulness in STN-DBS is unclear. Here, we retrospectively investigated the relationship between motor symptoms and the specific binding ratio (SBR) on DAT imaging in patients with Parkinson's disease (PD). We included 23 consecutive patients (9 female; 14 male) who were evaluated for DBS eligibility between October 2013 and October 2014 and subsequently received bilateral STN-DBS. Correlation and simple regression analyses were performed on SBR values and clinical parameters before and after surgery. SBR value was negatively correlated with Unified Parkinson's Disease Rating Scale (UPDRS) motor score in the "ON" state before surgery (rs=-0.637, p=0.001) and positively correlated with the reduction of the levodopa equivalent daily dose by surgery (r=0.422, p=0.045). A simple regression analysis revealed that SBR value was positively correlated with UPDRS motor score improvement after levodopa challenge before surgery (p=0.001, R2=0.423). DAT imaging may be useful in STN-DBS candidate selection and the identification of the therapeutic mechanism of STN-DBS in patients with advanced PD and motor symptom fluctuations.
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Affiliation(s)
- Asuka Nakajima
- Department of Neurology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Yasushi Shimo
- Department of Neurology, School of Medicine, Juntendo University, Tokyo, Japan; Department of Research and Therapeutics for Movement Disorders, School of Medicine, Juntendo University, Tokyo, Japan.
| | - Satoko Sekimoto
- Department of Neurology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Koji Kamagata
- Department of Radiology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Takayuki Jo
- Department of Neurology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Genko Oyama
- Department of Neurology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Atsushi Umemura
- Department of Research and Therapeutics for Movement Disorders, School of Medicine, Juntendo University, Tokyo, Japan; Department of Neurosurgery, School of Medicine, Juntendo University, Tokyo, Japan
| | - Nobutaka Hattori
- Department of Neurology, School of Medicine, Juntendo University, Tokyo, Japan
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67
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More SV, Choi DK. Emerging preclinical pharmacological targets for Parkinson's disease. Oncotarget 2018; 7:29835-63. [PMID: 26988916 PMCID: PMC5045437 DOI: 10.18632/oncotarget.8104] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 02/08/2016] [Indexed: 12/14/2022] Open
Abstract
Parkinson's disease (PD) is a progressive neurological condition caused by the degeneration of dopaminergic neurons in the basal ganglia. It is the most prevalent form of Parkinsonism, categorized by cardinal features such as bradykinesia, rigidity, tremors, and postural instability. Due to the multicentric pathology of PD involving inflammation, oxidative stress, excitotoxicity, apoptosis, and protein aggregation, it has become difficult to pin-point a single therapeutic target and evaluate its potential application. Currently available drugs for treating PD provide only symptomatic relief and do not decrease or avert disease progression resulting in poor patient satisfaction and compliance. Significant amount of understanding concerning the pathophysiology of PD has offered a range of potential targets for PD. Several emerging targets including AAV-hAADC gene therapy, phosphodiesterase-4, potassium channels, myeloperoxidase, acetylcholinesterase, MAO-B, dopamine, A2A, mGlu5, and 5-HT-1A/1B receptors are in different stages of clinical development. Additionally, alternative interventions such as deep brain stimulation, thalamotomy, transcranial magnetic stimulation, and gamma knife surgery, are also being developed for patients with advanced PD. As much as these therapeutic targets hold potential to delay the onset and reverse the disease, more targets and alternative interventions need to be examined in different stages of PD. In this review, we discuss various emerging preclinical pharmacological targets that may serve as a new promising neuroprotective strategy that could actually help alleviate PD and its symptoms.
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Affiliation(s)
- Sandeep Vasant More
- Department of Biotechnology, College of Biomedical and Health Science, Konkuk University, Chungju, South Korea
| | - Dong-Kug Choi
- Department of Biotechnology, College of Biomedical and Health Science, Konkuk University, Chungju, South Korea
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68
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Matsusue E, Fujihara Y, Tanaka K, Aozasa Y, Shimoda M, Nakayasu H, Nakamura K, Ogawa T. The Utility of the Combined Use of 123I-FP-CIT and 123I-MIBG Myocardial Scintigraphy in Differentiating Parkinson’s Disease from Other Parkinsonian Syndromes. Yonago Acta Med 2018. [DOI: 10.33160/yam.2018.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Eiji Matsusue
- *Department of Radiology, Tottori Prefectural Central Hospital, Tottori 680-0901, Japan
| | - Yoshio Fujihara
- *Department of Radiology, Tottori Prefectural Central Hospital, Tottori 680-0901, Japan
| | - Kenichiro Tanaka
- †Department of Neurology, Tottori Prefectural Central Hospital, Tottori 680-0901, Japan
| | - Yuki Aozasa
- †Department of Neurology, Tottori Prefectural Central Hospital, Tottori 680-0901, Japan
| | - Manabu Shimoda
- †Department of Neurology, Tottori Prefectural Central Hospital, Tottori 680-0901, Japan
| | - Hiroyuki Nakayasu
- †Department of Neurology, Tottori Prefectural Central Hospital, Tottori 680-0901, Japan
| | - Kazuhiko Nakamura
- *Department of Radiology, Tottori Prefectural Central Hospital, Tottori 680-0901, Japan
| | - Toshihide Ogawa
- ‡Division of Radiology, Department of Pathophysiological Therapeutic Science, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
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Schwarz ST, Xing Y, Naidu S, Birchall J, Skelly R, Perkins A, Evans J, Sare G, Martin-Bastida A, Bajaj N, Gowland P, Piccini P, Auer DP. Protocol of a single group prospective observational study on the diagnostic value of 3T susceptibility weighted MRI of nigrosome-1 in patients with parkinsonian symptoms: the N3 iPD study (nigrosomal iron imaging in Parkinson's disease). BMJ Open 2017; 7:e016904. [PMID: 29247084 PMCID: PMC5736049 DOI: 10.1136/bmjopen-2017-016904] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Parkinson's disease (PD) is the most common movement disorder in the elderly and is characterised clinically by bradykinesia, tremor and rigidity. Diagnosing Parkinson's can be difficult especially in the early stages. High-resolution nigrosome MRI offers promising diagnostic accuracy of patients with established clinical symptoms; however, it is unclear whether this may help to establish the diagnosis in the early stages of PD, when there is diagnostic uncertainty. In this scenario, a single photon emission CT scan using a radioactive dopamine transporter ligand can help to establish the diagnosis, or clinical follow-up may eventually clarify the diagnosis. A non-invasive, cost-effective diagnostic test that could replace this would be desirable. We therefore aim to prospectively test whether nigrosome MRI is as useful as DaTSCAN to establish the correct diagnosis in people with minor or unclear symptoms suspicious for PD. METHODS AND ANALYSIS In a prospective study we will recruit 145 patients with unclear symptoms possibly caused by Parkinson's from three movement disorder centres in the UK to take part in the study. We will record the Movement Disorder Society - Unified Parkinson's Disease Rating Scale, and participants will undergo DaTSCAN and high-resolution susceptibility weighted MRI at a field strength of 3T. DaTSCANs will be assessed visually and semiquantitatively; MRI scans will be visually assessed for signal loss in nigrosome-1 by blinded investigators. We will compare how the diagnosis suggested by MRI compares with the diagnosis based on DaTSCAN and will also validate the diagnosis based on the two tests with a clinical examination performed at least 1 year after the initial presentation as a surrogate gold standard diagnostic test. ETHICS AND DISSEMINATION The local ethics commission (Health Research Authority East Midlands - Derby Research Ethics Committee) has approved this study (REC ref.: 16/EM/0229). The study is being carried out under the principles of the Declaration of Helsinki (64th, 2013) and Good Clinical Practice standards. We have included a number of 15 research-funded DaTSCAN in the research protocol. This is to compensate for study site-specific National Health Service funding for this investigation in affected patients. We therefore have also obtained approval from the Administration of Radioactive Substances Administration Committee (ARSAC Ref 253/3629/35864). All findings will be presented at relevant scientific meetings and published in peer-reviewed journals, on the study website, and disseminated in lay and social media where appropriate. TRIAL REGISTRATION NUMBER NCT03022357; Pre-results.
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Affiliation(s)
- Stefan T Schwarz
- Radiological Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Radiology, Cardiff and Vale University Health Board, Cardiff University Hospitals, Cardiff, UK
- Cardiff University Brain Research Imaging Centre (CUBRIC), University of Cardiff, Cardiff, UK
| | - Yue Xing
- Radiological Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
- Nottingham University Hospitals, Department of Nuclear Medicine, Queen's Medical Centre, Nottingham, UK
| | - Saadnah Naidu
- Radiological Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Jim Birchall
- Department of Nuclear Medicine, Derby Teaching Hospitals NHS Foundation Trust, Derby, UK
| | - Rob Skelly
- Department of Elderly Medicine, Derby Teaching Hospitals NHS Foundation Trust, Derby, UK
| | - Alan Perkins
- Radiological Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
- Nottingham University Hospitals, Department of Nuclear Medicine, Queen's Medical Centre, Nottingham, UK
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | - Jonathan Evans
- Department of Neurology, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK
| | - Gill Sare
- Department of Neurology, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK
| | - Antonio Martin-Bastida
- Centre for Neuroinflammation and Neurodegeneration, Imperial College London, London, W12 0NN, UK
| | - Nin Bajaj
- Department of Neurology, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, UK
| | - Penny Gowland
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | - Paola Piccini
- Centre for Neuroinflammation and Neurodegeneration, Imperial College London, London, W12 0NN, UK
| | - Dorothee P Auer
- Radiological Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
- Nottingham NIHR Biomedical Research Centre, Nottingham University Hospital Trusts and University of Nottingham, Nottingham, UK
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70
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Yoshii F, Moriya Y, Ohnuki T, Ryo M, Takahashi W, Kohara S, Hashimoto J. 123 I-Meta-iodobenzylguanidine (MIBG) myocardial scintigraphy in patients showing scans without evidence of dopaminergic deficits (SWEDDs). Clin Neurol Neurosurg 2017; 160:73-77. [DOI: 10.1016/j.clineuro.2017.06.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 06/06/2017] [Accepted: 06/25/2017] [Indexed: 11/29/2022]
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71
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Jaakkola E, Joutsa J, Mäkinen E, Johansson J, Kaasinen V. Ventral striatal dopaminergic defect is associated with hallucinations in Parkinson's disease. Eur J Neurol 2017; 24:1341-1347. [PMID: 28834102 DOI: 10.1111/ene.13390] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 06/27/2017] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND PURPOSE Visual hallucinations (VHs) are a common complication of Parkinson's disease (PD). The pathogenesis of VHs in PD is still largely unclear. The aim of this study was to investigate the dopaminergic mechanisms of VHs and specifically whether the degree of striatal dopamine transporter (DAT) function or extrastriatal serotonin transporter (SERT) function can predict the appearance of VHs in patients with PD. METHODS Twenty-two PD patients scanned with [123 I]FP-CIT single photon emission computed tomography at an early stage of their disease who later developed VHs were identified and compared with 48 non-hallucinating PD patients. The groups were matched for age, medication, disease duration and motor symptom severity. Clinical follow-up after the scan was a median (range) of 6.9 (3.8-9.6) years. Imaging analyses were performed with both regions-of-interest-based and voxel-based (Statistical Parametric Mapping) methods for the striatal and extrastriatal regions. RESULTS The median interval between the scan and the emergence of VHs was 4.8 years. Patients who developed VHs had 18.4% lower DAT binding in the right ventral striatum (P = 0.009), 16.7% lower binding in the left ventral striatum (P = 0.02) and 18.8% lower binding in the right putamen (P = 0.03) compared to patients who did not develop VHs. CONCLUSIONS Low striatal DAT function may predispose PD patients to VHs, and the regional distribution of the findings suggests a particular role of the ventral striatum. This is in line with non-PD research that has implicated ventral striatal dysfunction in psychosis.
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Affiliation(s)
- E Jaakkola
- Department of Neurology, University of Turku, Turku, Finland.,Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland.,Department of Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - J Joutsa
- Department of Neurology, University of Turku, Turku, Finland.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.,Turku PET Centre, Turku University Hospital, Turku, Finland
| | - E Mäkinen
- Department of Neurology, University of Turku, Turku, Finland.,Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland.,Department of Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - J Johansson
- Turku PET Centre, Turku University Hospital, Turku, Finland
| | - V Kaasinen
- Department of Neurology, University of Turku, Turku, Finland.,Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland.,Turku PET Centre, Turku University Hospital, Turku, Finland
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72
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Clinical utility of visualisation of nigrosome-1 in patients with Parkinson’s disease. Eur Radiol 2017; 28:718-726. [DOI: 10.1007/s00330-017-4950-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 05/30/2017] [Accepted: 06/15/2017] [Indexed: 10/19/2022]
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73
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Abstract
New methods for the diagnosis and new treatments for Parkinson's disease (PD) were explained. As imaging tools, neuromelanin imaging using brain MRI, meta-iodobenzylguanidine (MIBG) cardiac scintigraphy, dopamine transporter scintigraphy, and transcranial sonography were introduced. Olfactory dysfunction and REM sleep behavior disorders (RBD), which are important non-motor symptoms, and the new Clinical Criteria for PD launched by Movement Disorder Society (MDS) were also described. Investigative new medications and new anti-PD medications, which recently became available in Japan, were introduced. I explained the rationale of early treatment, strategy of initial treatment, the significance of continuous dopaminergic stimulation, strategy of treatment for advanced PD, and deep brain stimulation as a surgical treatment together with promising new treatments including gene therapy and cell transplantation.
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74
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Oustwani CS, Korutz AW, Lester MS, Kianirad Y, Simuni T, Hijaz TA. Can loss of the swallow tail sign help distinguish between Parkinson Disease and the Parkinson-Plus syndromes? Clin Imaging 2017; 44:66-69. [PMID: 28460362 DOI: 10.1016/j.clinimag.2017.04.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 03/11/2017] [Accepted: 04/14/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine if loss of the swallow tail sign (STS) can distinguish Parkinson Disease (PD) from the Parkinson-Plus syndromes. METHODS Twenty-five patients with PD, 21 with Parkinson-Plus syndromes, and 14 control patients were included. Presence of the STS was assessed. RESULTS The STS was present in 79% of controls, statistically greater than the PD/Parkinson-Plus patients. There was no difference in the presence of the STS between the PD/Parkinson-Plus subgroups or when scanning at 1.5 T or 3 T. CONCLUSIONS Loss of the STS could not distinguish between PD and Parkinson-Plus patients. The STS can be identified at both 1.5 T and 3 T.
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Affiliation(s)
- Christopher Sami Oustwani
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Alexander William Korutz
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Malisa Siri Lester
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Yasaman Kianirad
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Tanya Simuni
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Tarek Aref Hijaz
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
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Ueda J, Yoshimura H, Shimizu K, Hino M, Kohara N. Combined visual and semi-quantitative assessment of 123I-FP-CIT SPECT for the diagnosis of dopaminergic neurodegenerative diseases. Neurol Sci 2017; 38:1187-1191. [PMID: 28389938 DOI: 10.1007/s10072-017-2936-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 03/23/2017] [Indexed: 11/27/2022]
Abstract
Visual and semi-quantitative assessments of 123I-FP-CIT single-photon emission computed tomography (SPECT) are useful for the diagnosis of dopaminergic neurodegenerative diseases (dNDD), including Parkinson's disease, dementia with Lewy bodies, progressive supranuclear palsy, multiple system atrophy, and corticobasal degeneration. However, the diagnostic value of combined visual and semi-quantitative assessment in dNDD remains unclear. Among 239 consecutive patients with a newly diagnosed possible parkinsonian syndrome who underwent 123I-FP-CIT SPECT in our medical center, 114 patients with a disease duration less than 7 years were diagnosed as dNDD with the established criteria or as non-dNDD according to clinical judgment. We retrospectively examined their clinical characteristics and visual and semi-quantitative assessments of 123I-FP-CIT SPECT. The striatal binding ratio (SBR) was used as a semi-quantitative measure of 123I-FP-CIT SPECT. We calculated the sensitivity and specificity of visual assessment alone, semi-quantitative assessment alone, and combined visual and semi-quantitative assessment for the diagnosis of dNDD. SBR was correlated with visual assessment. Some dNDD patients with a normal visual assessment had an abnormal SBR, and vice versa. There was no statistically significant difference between sensitivity of the diagnosis with visual assessment alone and semi-quantitative assessment alone (91.2 vs. 86.8%, respectively, p = 0.29). Combined visual and semi-quantitative assessment demonstrated superior sensitivity (96.7%) to visual assessment (p = 0.03) or semi-quantitative assessment (p = 0.003) alone with equal specificity. Visual and semi-quantitative assessments of 123I-FP-CIT SPECT are helpful for the diagnosis of dNDD, and combined visual and semi-quantitative assessment shows superior sensitivity with equal specificity.
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Affiliation(s)
- Jun Ueda
- Department of Neurology, Kobe City Medical Center General Hospital, 2-1-1, Minatojimaminamimachi, Chuo-ku, Kobe City, 650-0047, Japan
| | - Hajime Yoshimura
- Department of Neurology, Kobe City Medical Center General Hospital, 2-1-1, Minatojimaminamimachi, Chuo-ku, Kobe City, 650-0047, Japan.
| | - Keiji Shimizu
- Department of Radiology, Kobe City Medical Center General Hospital, 2-1-1, Minatojimaminamimachi, Chuo-ku, Kobe City, 650-0047, Japan
| | - Megumu Hino
- Department of Radiology, Kobe City Medical Center General Hospital, 2-1-1, Minatojimaminamimachi, Chuo-ku, Kobe City, 650-0047, Japan
| | - Nobuo Kohara
- Department of Neurology, Kobe City Medical Center General Hospital, 2-1-1, Minatojimaminamimachi, Chuo-ku, Kobe City, 650-0047, Japan
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76
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Ramani L, Malek N, Patterson J, Nissen T, Newman EJ. Relationship between [ 123 I]-FP-CIT SPECT and clinical progression in Parkinson's disease. Acta Neurol Scand 2017; 135:400-406. [PMID: 27255673 DOI: 10.1111/ane.12613] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND The demonstration of presynaptic dopaminergic deficiency on [123 I]-FP-CIT SPECT imaging is a useful ancillary tool in the diagnosis of Parkinson's disease (PD). Whilst there is evidence of a cross-sectional relationship between the degree of dopaminergic deficiency and severity of bradykinesia and rigidity, longitudinal studies are rare. Moreover, the relationship between motor subtypes and their dopaminergic deficient state is not well characterized. AIM Our primary aim was to assess the correlations between dopaminergic deficiency on baseline [123 I]-FP-CIT SPECT imaging with the progression of motor severity in patients classified by motor subtype, and the development of motor complications. Our secondary aim was to assess the correlation between UPDRS-III subscores and the time to onset of motor complications. METHODS 42 PD patients with abnormal baseline [123 I]-FP-CIT SPECT scans and at least 3 years of clinical follow-up were classified by motor subtype: akinetic-rigid, tremor-dominant or mixed. UPDRS-III scores at baseline and at 3-year follow-up, and time to onset of motor complications were recorded. RESULTS [123 I]-FP-CIT uptake ratios were inversely correlated with UPDRS-III scores at 3 years only in akinetic-rigid patients (r=-.51, P=.04). Time to onset of motor complications was inversely correlated with UPDRS-III subscores for bradykinesia and rigidity at baseline (r=-.52, P=.02) and at 3 years (r=-.54, P=.01). CONCLUSION The degree of dopaminergic deficiency on baseline [123 I]-FP-CIT SPECT inversely correlates with motor severity at 3-year follow-up in akinetic-rigid patients only. Furthermore, UPDRS-III subscores for bradykinesia and rigidity at baseline show an inverse correlation with time to onset of motor complications across all PD subtypes.
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Affiliation(s)
- L. Ramani
- University of Glasgow School of Medicine; Glasgow UK
| | - N. Malek
- Department of Neurology; Institute of Neurological Sciences; Southern General Hospital; Glasgow UK
| | - J. Patterson
- Department of Neurology; Institute of Neurological Sciences; Southern General Hospital; Glasgow UK
| | - T. Nissen
- Department of Neurology; Institute of Neurological Sciences; Southern General Hospital; Glasgow UK
| | - E. J. Newman
- Department of Neurology; Institute of Neurological Sciences; Southern General Hospital; Glasgow UK
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Yoshii F, Ryo M, Baba Y, Koide T, Hashimoto J. Combined use of dopamine transporter imaging (DAT-SPECT) and 123 I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy for diagnosing Parkinson's disease. J Neurol Sci 2017; 375:80-85. [DOI: 10.1016/j.jns.2017.01.042] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 12/31/2016] [Accepted: 01/13/2017] [Indexed: 01/05/2023]
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78
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Mallik AK, Drzezga A, Minoshima S. Molecular Imaging and Precision Medicine in Dementia and Movement Disorders. PET Clin 2017; 12:119-136. [DOI: 10.1016/j.cpet.2016.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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79
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Diagnostic imaging of dementia with Lewy bodies by susceptibility-weighted imaging of nigrosomes versus striatal dopamine transporter single-photon emission computed tomography: a retrospective observational study. Neuroradiology 2016; 59:89-98. [DOI: 10.1007/s00234-016-1773-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 12/06/2016] [Indexed: 11/26/2022]
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80
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Nicastro N, Garibotto V, Poncet A, Badoud S, Burkhard PR. Establishing On-Site Reference Values for (123)I-FP-CIT SPECT (DaTSCAN®) Using a Cohort of Individuals with Non-Degenerative Conditions. Mol Imaging Biol 2016; 18:302-12. [PMID: 26341194 DOI: 10.1007/s11307-015-0889-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE To overcome the issue of reference values for DaTSCAN® requiring healthy controls, we propose an original approach using scans from individuals with non-degenerative conditions performed at one single center following the same acquisition protocol. PROCEDURES From a cohort of 970 consecutive patients, we identified 182 patients with a clinical diagnosis of non-degenerative parkinsonism or tremor and a visually normal DATSCAN®. Caudate nucleus (C), putamen (P), and striatum (S) uptake values, C/P ratios, and asymmetry indexes (AI) were calculated using semi-quantitative methods. Outcomes were assessed according to age and gender, and reference limits were established using the percentile approach. RESULTS A significant negative linear effect of age was found upon striatal nuclei uptake of 0.21-0.22 per decade (6.8%/decade for striatum), whereas a potential gender influence proved unclear. Inferior reference limits were established at the 5th percentile. C/P ratios and AIs were not influenced by age or gender, and superior reference limits were set at the 95th percentile. CONCLUSIONS We here propose a convenient approach to calculate site-specific reference limits for DaTSCAN® outcomes not requiring scanning healthy controls. The method appears to yield robust values that range within nearly identical limits as those obtained in healthy subjects.
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Affiliation(s)
- Nicolas Nicastro
- Department of Neurology, Geneva University Hospitals, 4, rue Gabrielle Perret-Gentil, 1205, Geneva, Switzerland
| | - Valentina Garibotto
- Department of Nuclear Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Antoine Poncet
- Department of Epidemiology, Geneva University Hospitals, Geneva, Switzerland
| | - Simon Badoud
- Department of Neurology, Geneva University Hospitals, 4, rue Gabrielle Perret-Gentil, 1205, Geneva, Switzerland.,Physiology Unit, Department of Medicine, University of Fribourg, Geneva, Switzerland
| | - Pierre R Burkhard
- Department of Neurology, Geneva University Hospitals, 4, rue Gabrielle Perret-Gentil, 1205, Geneva, Switzerland.
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Son SJ, Kim M, Park H. Imaging analysis of Parkinson's disease patients using SPECT and tractography. Sci Rep 2016; 6:38070. [PMID: 27901100 PMCID: PMC5128922 DOI: 10.1038/srep38070] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 11/04/2016] [Indexed: 12/13/2022] Open
Abstract
Parkinson's disease (PD) is a degenerative disorder that affects the central nervous system. PD-related alterations in structural and functional neuroimaging have not been fully explored. This study explored multi-modal PD neuroimaging and its application for predicting clinical scores on the Movement Disorder Society-sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Multi-modal imaging that combined 123I-Ioflupane single-photon emission computed tomography (SPECT) and diffusion tensor imaging (DTI) were adopted to incorporate complementary brain imaging information. SPECT and DTI images of normal controls (NC; n = 45) and PD patients (n = 45) were obtained from a database. The specific binding ratio (SBR) was calculated from SPECT. Tractography was performed using DTI. Group-wise differences between NC and PD patients were quantified using SBR of SPECT and structural connectivity of DTI for regions of interest (ROIs) related to PD. MDS-UPDRS scores were predicted using multi-modal imaging features in a partial least-squares regression framework. Three regions and four connections within the cortico-basal ganglia thalamocortical circuit were identified using SBR and DTI, respectively. Predicted MDS-UPDRS scores using identified regions and connections and actual MDS-UPDRS scores showed a meaningful correlation (r = 0.6854, p < 0.001). Our study provided insight on regions and connections that are instrumental in PD.
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Affiliation(s)
- Seong-Jin Son
- Department of Electronic, Electrical, and Computer Engineering, Sungkyunkwan University, Suwon, Korea
| | - Mansu Kim
- Department of Electronic, Electrical, and Computer Engineering, Sungkyunkwan University, Suwon, Korea
| | - Hyunjin Park
- School of Electronic and Electrical Engineering, Sungkyunkwan University, Korea
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science, Korea
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Interest of multi-modal imaging in bilateral lesions of basal ganglia: A case report of a post-anoxic dystonia. Eur J Nucl Med Mol Imaging 2016; 43:2098-9. [DOI: 10.1007/s00259-016-3413-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 04/28/2016] [Indexed: 10/21/2022]
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Graebner AK, Tarsy D, Shih LC, Vanderhorst V, Kulkarni O, Kaplan S, Simon DK. Clinical Impact of 123I-Ioflupane SPECT (DaTscan) in a Movement Disorder Center. NEURODEGENER DIS 2016; 17:38-43. [PMID: 27614874 DOI: 10.1159/000447561] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 06/07/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS The clinical diagnosis of degenerative forms of parkinsonism is imperfect, with past studies reporting a high rate of misdiagnosis by neurologists and movement disorder specialists, particularly early in the disease course. 123I-ioflupane SPECT (DaTscan) is a diagnostic neuroimaging tool used to distinguish essential tremor from tremor due to degenerative parkinsonisms. The present study expands upon prior studies of the clinical impact of DaTscan imaging in movement disorder centers by assessing quantitative estimates of diagnostic certainty, the impact on subsequent clinical decisions, and the degree to which the asymmetry in the results corresponds to laterality by clinical history and examination. METHODS In a prospective, observational study of the impact of DaTscan imaging in a movement disorder center over the course of 18 months, 4 specialists completed a questionnaire at the time they ordered imaging and again within 1 month after imaging. RESULTS Twenty-seven patients underwent DaTscan imaging; the result was normal in 4 cases (14.8%), abnormal in 22 cases (81.4%), and equivocal in 1 case (3.7%). In all cases of a normal result, the post-scan-predicted chance of degenerative parkinsonism decreased compared to the pre-scan prediction (p < 0.05), and in all cases of abnormal scan, the post-scan chance of degenerative parkinsonism increased or remained high (p < 0.0001). Clinical impacts were observed following imaging in a total of 24 patients (88.9%), including changes in medications for 18 patients and psychological impacts for 11 patients. Asymmetric clinical symptoms were corroborated based on the expected asymmetry of dopamine uptake deficits in 57.1% of the cases, were not present in 23.8%, and were opposite of expectations in 19.0% of the scans. CONCLUSION DaTscan imaging results have an impact on physician's confidence in the diagnosis of parkinsonism and may also have a psychological impact on patients. DaTscan imaging may be a useful adjunct to clinical history and examination in selected patients.
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Affiliation(s)
- Allison K Graebner
- Parkinson's Disease and Movement Disorders Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass., USA
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Hida K, Nonokuma M, Kuwabara Y, Tani T, Takano K, Yoshimitsu K. Creation and validation of an I-123 FP-CIT template for statistical image analysis using high-resolution SPECT for parkinsonian patients. Ann Nucl Med 2016; 30:477-83. [PMID: 27225162 PMCID: PMC4961732 DOI: 10.1007/s12149-016-1085-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 05/12/2016] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The aim of this study was to create a new template for the anatomical normalization of I-123 FP-CIT SPECT images of Japanese people to evaluate dopamine transporter binding. METHODS The subjects consisted of 16 normal control subjects (5 females and 11 males; mean age ± SD, 51.6 ± 9.5 years, ranging from 25 to 62 years) and 21 parkinsonian patients (7 females and 14 males; mean age ± SD, 70.7 ± 9.4 years, ranging from 49 to 85 years). All normal control subjects and 21 patients with parkinsonism underwent MRI. A total of 148 MBq of I-123 FP-CIT was intravenously injected as a bolus, and a SPECT scan was started 4 h later. Data were analyzed with the Statistical Parametric Mapping 8 (SPM8) software. At first, I-123 FP-CIT SPECT images were co-registered to MRI images and MRI images were normalized to Montreal Neurological Institute (MNI) space using a gray.nii template. Co-registered I-123 FP-CIT SPECT images were normalized using the predetermined normalization parameters for MRI images. Then, anatomically normalized I-123 FP-CIT SPECT images were divided by background counts individually measured using ROIs set on the cerebral cortices. The I-123 FP-CIT template was created by averaging the normalized SPECT images of the 16 normal control subjects. Thereafter, the averaged MRI images of the 16 normal control subjects were also created. RESULTS A visual inspection revealed that there were no apparent differences between the I-123 FP-CIT images subjected to the two methods of anatomical normalization in normal control subjects. However, a group comparison by a paired t test using SPM8 revealed that the I-123 FP-CIT binding was significantly higher in the substriatal and temporal regions in I-123 FP-CIT images directly normalized with the I-123 FP-CIT template than in those normalized by the predetermined parameters with MRI, while it was higher in the bilateral frontal cortical regions in the latter than in the former images. CONCLUSION We successfully created an I-123 FP-CIT template for Japanese people. This template is thought to be useful and reliable for the statistical analysis of I-123 FP-CIT images, although some problems exist in the evaluation of parkinsonian patients. The results of a paired t test using SPM suggest that we should use the same normalization method in statistical image analyses.
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Affiliation(s)
- Kosuke Hida
- Department of Radiology, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
| | - Masanari Nonokuma
- Department of Radiology, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Yasuo Kuwabara
- Department of Radiology, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Tomonobu Tani
- Department of Radiology, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Koichi Takano
- Department of Radiology, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Kengo Yoshimitsu
- Department of Radiology, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
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86
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Bhattacharjee S, Shankar PV, Elkider M. Dopamine transporter single-photon emission computed tomography brain scan: A reliable way to distinguish between degenerative and drug-induced parkinsonism. Indian J Nucl Med 2016; 31:249-50. [PMID: 27385908 PMCID: PMC4918501 DOI: 10.4103/0972-3919.183620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Functional volumetric analysis of striatum using F-18 FP-CIT PET in patients with idiopathic Parkinson's disease and normal subjects. Ann Nucl Med 2016; 30:572-8. [PMID: 27283185 DOI: 10.1007/s12149-016-1096-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 06/03/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE We applied a simple isocontour volume-of-interest (VOI) method to analyze the whole striatum in an F-18 FP-CIT PET image and to investigate the usefulness of the method in differentiating healthy subjects from idiopathic Parkinson's disease (IPD) patients and the correlation of the value of functional volume parameters with the motor symptoms in patients with IPD. METHODS Forty-three IPD patients and 23 age-matched healthy controls underwent F-18 FP-CIT PET. Using a dedicated workstation, VOIs for the whole striatum were drawn automatically with the gradient delineation method. The SUVmax, SUVmean, functional volume (FV), striatal volume activity (SVA), striatal-specific binding (SSB), and volume-specific uptake ratio (VSUR) were compared between the IPD patients and the normal subjects. In the IPD patients, the correlation between the clinical factor and the functional parameters was assessed. RESULTS The SUVmax, SUVmean, FV, SVA, SSB, and VSUR were significantly lower in the IPD patients than in the normal subjects. In the receiver operating characteristic analysis, those parameters had significant and good-to-excellent accuracy. In the patients with IPD, a moderate negative correlation was revealed between the SUVmax and H&Y stage, the SUVmean and H&Y stage, SVA and H&Y stage, the VSUR and H&Y stage, the FV and bradykinesia, and the SVA and bradykinesia. CONCLUSION The functional volumetric analysis of the striatum based on simple isocontour VOI was a useful method of analyzing the F-18 FP-CIT PET image. Not only can it be easily applied in daily clinical practice, but it can also be used as a clinical parameter to discriminate IPD and to correlate it with the disease severity.
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88
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Garrido A, Vilas D, Tolosa E. Update on the Diagnosis and Management of Progressive Supranuclear Palsy. CURRENT GERIATRICS REPORTS 2016. [DOI: 10.1007/s13670-016-0172-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Henriksen JN, Eriksson BOM. Parkinsonism as a side effect of infliximab. BMJ Case Rep 2016; 2016:bcr-2016-214802. [PMID: 27151053 DOI: 10.1136/bcr-2016-214802] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
We present a case of a 64-year-old man with Crohn's disease who developed parkinsonism after starting treatment with infliximab (Remicade). The patient had a 30-year history of Crohn's disease with previous surgical procedures and treatment with methotrexate. Treatment was augmented with infliximab, and 3 days after the first dose of 400 mg, a resting tremor began in the left leg. Over 4 months, symptoms progressed and now involved the right leg as well as both hands. There was no clinical effect of infliximab treatment, and the treatment was withdrawn 4 months later. The patient then experienced gradual, but continual, improvement of the resting tremor after withdrawal of infliximab. To the best of our knowledge, this is the first case report describing a patient developing parkinsonism after starting treatment with infliximab, with symptoms remitting on discontinuation.
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90
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Hansen AK, Knudsen K, Lillethorup TP, Landau AM, Parbo P, Fedorova T, Audrain H, Bender D, Østergaard K, Brooks DJ, Borghammer P. In vivo imaging of neuromelanin in Parkinson's disease using 18F-AV-1451 PET. Brain 2016; 139:2039-49. [PMID: 27190023 DOI: 10.1093/brain/aww098] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 03/14/2016] [Indexed: 11/13/2022] Open
Abstract
The tau tangle ligand (18)F-AV-1451 ((18)F-T807) binds to neuromelanin in the midbrain, and may therefore be a measure of the pigmented dopaminergic neuronal count in the substantia nigra. Parkinson's disease is characterized by progressive loss of dopaminergic neurons. Extrapolation of post-mortem data predicts that a ∼30% decline of nigral dopamine neurons is necessary to cause motor symptoms in Parkinson's disease. Putamen dopamine terminal loss at disease onset most likely exceeds that of the nigral cell bodies and has been estimated to be of the order of 50-70%. We investigated the utility of (18)F-AV-1451 positron emission tomography to visualize the concentration of nigral neuromelanin in Parkinson's disease and correlated the findings to dopamine transporter density, measured by (123)I-FP-CIT single photon emission computed tomography. A total of 17 patients with idiopathic Parkinson's disease and 16 age- and sex-matched control subjects had (18)F-AV-1451 positron emission tomography using a Siemens high-resolution research tomograph. Twelve patients with Parkinson's disease also received a standardized (123)I-FP-CIT single photon emission computed tomography scan at our imaging facility. Many of the patients with Parkinson's disease displayed visually apparent decreased (18)F-AV-1451 signal in the midbrain. On quantitation, patients showed a 30% mean decrease in total nigral (18)F-AV-1451 volume of distribution compared with controls (P = 0.004), but there was an overlap of the individual ranges. We saw no significant correlation between symptom dominant side and contralateral nigral volume of distribution. There was no correlation between nigral (18)F-AV-1451 volume of distribution and age or time since diagnosis. In the subset of 12 patients, who also had a (123)I-FP-CIT scan, the mean total striatal dopamine transporter signal was decreased by 45% and the mean total (18)F-AV-1451 substantia nigra volume of distribution was decreased by 33% after median disease duration of 4.7 years (0.5-12.4 years). (18)F-AV-1451 positron emission tomography may be the first radiotracer to reflect the loss of pigmented neurons in the substantia nigra of parkinsonian patients. The magnitude of the nigral signal loss was smaller than the decrease in striatal dopamine transporter signal measured by dopamine transporter single photon emission computed tomography. These findings suggest a more severe loss of striatal nerve terminal function compared with neuronal cell bodies, in accordance with the post-mortem literature.
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Affiliation(s)
- Allan K Hansen
- 1 Department of Nuclear Medicine and PET-Centre, Aarhus University Hospital, Denmark
| | - Karoline Knudsen
- 1 Department of Nuclear Medicine and PET-Centre, Aarhus University Hospital, Denmark
| | - Thea P Lillethorup
- 1 Department of Nuclear Medicine and PET-Centre, Aarhus University Hospital, Denmark
| | - Anne M Landau
- 1 Department of Nuclear Medicine and PET-Centre, Aarhus University Hospital, Denmark 2 Translational Neuropsychiatry Unit, Institute of Clinical Medicine, Aarhus University, Denmark
| | - Peter Parbo
- 1 Department of Nuclear Medicine and PET-Centre, Aarhus University Hospital, Denmark
| | - Tatyana Fedorova
- 1 Department of Nuclear Medicine and PET-Centre, Aarhus University Hospital, Denmark
| | - Hélène Audrain
- 1 Department of Nuclear Medicine and PET-Centre, Aarhus University Hospital, Denmark
| | - Dirk Bender
- 1 Department of Nuclear Medicine and PET-Centre, Aarhus University Hospital, Denmark
| | - Karen Østergaard
- 3 Department of Neurology, Institute of Clinical Medicine, Aarhus University, Denmark
| | - David J Brooks
- 1 Department of Nuclear Medicine and PET-Centre, Aarhus University Hospital, Denmark 4 Division of Neuroscience, Department of Medicine, Imperial College London, UK 5 Division of Neuroscience, Newcastle University, UK
| | - Per Borghammer
- 1 Department of Nuclear Medicine and PET-Centre, Aarhus University Hospital, Denmark
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King MA, Mukherjee JM, Könik A, Zubal IG, Dey J, Licho R. Design of a Multi-Pinhole Collimator for I-123 DaTscan Imaging on Dual-Headed SPECT Systems in Combination with a Fan-Beam Collimator. IEEE TRANSACTIONS ON NUCLEAR SCIENCE 2016; 63:90-97. [PMID: 27182078 PMCID: PMC4864598 DOI: 10.1109/tns.2016.2515519] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
For the 2011 FDA approved Parkinson's Disease (PD) SPECT imaging agent I-123 labeled DaTscan, the volume of interest (VOI) is the interior portion of the brain. However imaging of the occipital lobe is also required with PD for calculation of the striatal binding ratio (SBR), a parameter of significance in early diagnosis, differentiation of PD from other disorders with similar clinical presentations, and monitoring progression. Thus we propose the usage of a combination of a multi-pinhole (MPH) collimator on one head of the SPECT system and a fan-beam on the other. The MPH would be designed to provide high resolution and sensitivity for imaging of the interior portion of the brain. The fan-beam collimator would provide lower resolution but complete sampling of the brain addressing data sufficiency and allowing a volume-of-interest to be defined over the occipital lobe for calculation of SBR's. Herein we focus on the design of the MPH component of the combined system. Combined reconstruction will be addressed in a subsequent publication. An analysis of 46 clinical DaTscan studies was performed to provide information to define the VOI, and design of a MPH collimator to image this VOI. The system spatial resolution for the MPH was set to 4.7 mm, which is comparable to that of clinical PET systems, and significantly smaller than that of fan-beam collimators employed in SPECT. With this set, we compared system sensitivities for three aperture array designs, and selected the 3 × 3 array due to it being the highest of the three. The combined sensitivity of the apertures for it was similar to that of an ultra-high resolution fan-beam (LEUHRF) collimator, but smaller than that of a high-resolution fan-beam collimator (LEHRF). On the basis of these results we propose the further exploration of this design through simulations, and the development of combined MPH and fan-beam reconstruction.
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Affiliation(s)
- Michael A. King
- Department of Radiology, University of Massachusetts Medical School Worcester, MA 01655 USA
| | - Joyeeta M Mukherjee
- Department of Radiology, University of Massachusetts Medical School Worcester, MA 01655 USA
| | - Arda Könik
- Department of Radiology, University of Massachusetts Medical School Worcester, MA 01655 USA
| | | | - Joyoni Dey
- Department of Physics & Astronomy, Louisiana State University, LA
| | - Robert Licho
- Department of Radiology, UMassMemorial Healthcare, Worcester, MA 01655 USA
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Abstract
INTRODUCTION Drug-induced movement disorders (DIMDs) can be elicited by several kinds of pharmaceutical agents. The major groups of offending drugs include antidepressants, antipsychotics, antiepileptics, antimicrobials, antiarrhythmics, mood stabilisers and gastrointestinal drugs among others. AREAS COVERED This paper reviews literature covering each movement disorder induced by commercially available pharmaceuticals. Considering the magnitude of the topic, only the most prominent examples of offending agents were reported in each paragraph paying a special attention to the brief description of the pathomechanism and therapeutic options if available. EXPERT OPINION As the treatment of some DIMDs is quite challenging, a preventive approach is preferable. Accordingly, the use of the offending agents should be strictly limited to appropriate indications and they should be applied in as low doses and as short duration as the patient's condition allows. As most of DIMDs are related to an unspecific adverse action of medications in the basal ganglia and the cerebellum, future research should focus on better characterisation of the neurochemical profile of the affected functional systems, in addition to the development of drugs with higher selectivity and better side-effect profile.
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Affiliation(s)
- Dénes Zádori
- University of Szeged, Albert Szent-Györgyi Clinical Center, Department of Neurology, Faculty of Medicine , Semmelweis u. 6, H-6725 Szeged , Hungary +36 62 545351 ; +36 62 545597 ;
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Jaakkola E, Joutsa J, Kaasinen V. Predictors of normal and abnormal outcome in clinical brain dopamine transporter imaging. J Neural Transm (Vienna) 2015; 123:205-9. [PMID: 26676600 DOI: 10.1007/s00702-015-1495-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 12/01/2015] [Indexed: 10/22/2022]
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Rodriguez-Porcel F, Jamali S, Duker AP, Espay AJ. Dopamine transporter scanning in the evaluation of patients with suspected Parkinsonism: a case-based user’s guide. Expert Rev Neurother 2015; 16:23-9. [DOI: 10.1586/14737175.2015.1120160] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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95
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Weingarten CP, Sundman MH, Hickey P, Chen NK. Neuroimaging of Parkinson's disease: Expanding views. Neurosci Biobehav Rev 2015; 59:16-52. [PMID: 26409344 PMCID: PMC4763948 DOI: 10.1016/j.neubiorev.2015.09.007] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 09/07/2015] [Accepted: 09/15/2015] [Indexed: 12/14/2022]
Abstract
Advances in molecular and structural and functional neuroimaging are rapidly expanding the complexity of neurobiological understanding of Parkinson's disease (PD). This review article begins with an introduction to PD neurobiology as a foundation for interpreting neuroimaging findings that may further lead to more integrated and comprehensive understanding of PD. Diverse areas of PD neuroimaging are then reviewed and summarized, including positron emission tomography, single photon emission computed tomography, magnetic resonance spectroscopy and imaging, transcranial sonography, magnetoencephalography, and multimodal imaging, with focus on human studies published over the last five years. These included studies on differential diagnosis, co-morbidity, genetic and prodromal PD, and treatments from L-DOPA to brain stimulation approaches, transplantation and gene therapies. Overall, neuroimaging has shown that PD is a neurodegenerative disorder involving many neurotransmitters, brain regions, structural and functional connections, and neurocognitive systems. A broad neurobiological understanding of PD will be essential for translational efforts to develop better treatments and preventive strategies. Many questions remain and we conclude with some suggestions for future directions of neuroimaging of PD.
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Affiliation(s)
- Carol P Weingarten
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, United States.
| | - Mark H Sundman
- Brain Imaging and Analysis Center, Duke University Medical Center, United States
| | - Patrick Hickey
- Department of Neurology, Duke University School of Medicine, United States
| | - Nan-kuei Chen
- Brain Imaging and Analysis Center, Duke University Medical Center, United States; Department of Radiology, Duke University School of Medicine, United States
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Abstract
Differential diagnoses among Parkinson's disease (PD), multiple system atrophy (MSA), and progressive supranuclear palsy syndrome (PSPS) are often difficult. Hence, we investigated whether diffusion kurtosis imaging (DKI) could detect pathological changes that occur in these disorders and be used to differentiate between such patients. Fourteen patients (five with PD, four MSA, and five PSPS) and six healthy controls were examined using a 1.5-T scanner. Mean kurtosis (MK), fractional anisotropy, and mean diffusivity maps were generated, and these values of the midbrain tegmentum (MBT) and pontine crossing tract (PCT), as well as MBT/PCT ratios, were obtained. We found no significant differences in MBT and PCT values on DKI maps among the groups. In contrast, MBT/PCT ratios from MK maps were significantly increased in the MSA group and decreased in the PSPS group compared with the other groups. MBT/PCT ratios from mean diffusivity maps showed a significant increase in the PSPS group. Therefore, quantitative DKI analyses, particularly the MBT/PCT ratio from MK maps, can differentiate patients with parkinsonisms.
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Kamagata K, Hatano T, Okuzumi A, Motoi Y, Abe O, Shimoji K, Kamiya K, Suzuki M, Hori M, Kumamaru KK, Hattori N, Aoki S. Neurite orientation dispersion and density imaging in the substantia nigra in idiopathic Parkinson disease. Eur Radiol 2015; 26:2567-77. [PMID: 26515546 DOI: 10.1007/s00330-015-4066-8] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 10/02/2015] [Accepted: 10/09/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES We used neurite orientation dispersion and density imaging (NODDI) to quantify changes in the substantia nigra pars compacta (SNpc) and striatum in Parkinson disease (PD). METHODS Diffusion-weighted magnetic resonance images were acquired from 58 PD patients and 36 age- and sex-matched controls. The intracellular volume fraction (Vic), orientation dispersion index (OD), and isotropic volume fraction (Viso) of the basal ganglia were compared between groups. Multivariate logistic regression analysis determined which diffusion parameters were independent predictors of PD. Receiver operating characteristic (ROC) analysis compared the diagnostic accuracies of the evaluated indices. Pearson coefficient analysis correlated each diffusional parameter with disease severity. RESULTS Vic in the contralateral SNpc and putamen were significantly lower in PD patients than in healthy controls (P < 0.00058). Vic and OD in the SNpc and putamen showed significant negative correlations (P < 0.05) with disease severity. Multivariate logistic analysis revealed that Vic (P = 0.0000046) and mean diffusivity (P = 0.019) in the contralateral SNpc were the independent predictors of PD. In the ROC analysis, Vic in the contralateral SNpc showed the best diagnostic performance (mean cutoff, 0.62; sensitivity, 0.88; specificity, 0.83). CONCLUSION NODDI is likely to be useful for diagnosing PD and assessing its progression. KEY POINTS • Neurite orientation dispersion and density imaging (NODDI) is a new diffusion MRI technique • NODDI estimates neurite microstructure more specifically than diffusion tensor imaging • By using NODDI, nigrostriatal alterations in PD can be evaluated in vivo • NOODI is useful for diagnosing PD and assessing its disease progression.
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Affiliation(s)
- Koji Kamagata
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Taku Hatano
- Department of Neurology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Ayami Okuzumi
- Department of Neurology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Yumiko Motoi
- Department of Neurology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Osamu Abe
- Department of Radiology, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Keigo Shimoji
- Department of Diagnostic Radiology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaecho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Kouhei Kamiya
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan
| | - Michimasa Suzuki
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Masaaki Hori
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Kanako K Kumamaru
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Shigeki Aoki
- Department of Radiology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
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98
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Emission Computed Tomography for the Diagnosis of Mandibular Invasion by Head and Neck Cancers: A Systematic Review and Meta-Analysis. J Oral Maxillofac Surg 2015; 73:1875.e1-11. [DOI: 10.1016/j.joms.2015.04.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 04/28/2015] [Accepted: 04/29/2015] [Indexed: 01/18/2023]
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99
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DeMaagd G, Philip A. Parkinson's Disease and Its Management: Part 1: Disease Entity, Risk Factors, Pathophysiology, Clinical Presentation, and Diagnosis. P & T : A PEER-REVIEWED JOURNAL FOR FORMULARY MANAGEMENT 2015; 40:504-532. [PMID: 26236139 PMCID: PMC4517533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This article-the first of a five-part series-discusses possible causes, symptoms, diagnosis, and goals for treatment of Parkinson's disease. Identifying diseases that have similar presentations is an important component of the diagnostic process.
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100
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Štenc Bradvica I, Mihaljević I, Butković-Soldo S, Kadojić D, Titlić M, Bradvica M, Kralik K. Transcranial sonography and the pocket smell test in the differential diagnosis between parkinson's disease and essential tremor. Neurol Sci 2015; 36:1403-10. [PMID: 25787809 DOI: 10.1007/s10072-015-2152-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 03/05/2015] [Indexed: 11/29/2022]
Abstract
The aim of this study was to determine the specificity and sensitivity of transcranial sonography (TCS) and the Pocket Smell Test (PST) in differing Parkinson's disease from essential tremor. The results were compared with the dopamin transporter scan (DaTSCAN) findings. Based on the DaTSCAN finding we formed a group of patients with essential tremor (51 patients) and a group with the Parkinson's disease (59 patients). The control group consisted of 26 healthy one. To evaluate the olfactory dysfunction the PST was used, whereas by TCS the substantia nigra hyperechogenicity was marked. The sensitivity and specificity of each diagnostic method was statistically calculated. In confirming Parkinson's disease the specificity of TCS was 88.2 % and the sensitivity 94.9 %. The specificity of PST was 80.4 % whereas the sensitivity was 74.6 %. TCS and PST should be performed to evaluate which patients need to be examined by DaTSCAN.
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Affiliation(s)
- Ivanka Štenc Bradvica
- Department of Neurology, Faculty of Medicine, Osijek University Hospital, "Josip Juraj Strossmayer" University of Osijek, Osijek, Croatia,
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