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Maiti B, Perlmutter JS. Imaging in Movement Disorders. Continuum (Minneap Minn) 2023; 29:194-218. [PMID: 36795878 DOI: 10.1212/con.0000000000001210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVE This article reviews commonly used imaging modalities in movement disorders, particularly parkinsonism. The review includes the diagnostic utility, role in differential diagnosis, reflection of pathophysiology, and limitations of neuroimaging in the setting of movement disorders. It also introduces promising new imaging modalities and describes the current status of research. LATEST DEVELOPMENTS Iron-sensitive MRI sequences and neuromelanin-sensitive MRI can be used to directly assess the integrity of nigral dopaminergic neurons and thus may reflect disease pathology and progression throughout the full range of severity in Parkinson disease (PD). The striatal uptake of presynaptic radiotracers in their terminal axons as currently assessed using clinically approved positron emission tomography (PET) or single-photon emission computed tomography (SPECT) imaging correlates with nigral pathology and disease severity only in early PD. Cholinergic PET, using radiotracers that target the presynaptic vesicular acetylcholine transporter, constitutes a substantial advance and may provide crucial insights into the pathophysiology of clinical symptoms such as dementia, freezing, and falls. ESSENTIAL POINTS In the absence of valid, direct, objective biomarkers of intracellular misfolded α-synuclein, PD remains a clinical diagnosis. The clinical utility of PET- or SPECT-based striatal measures is currently limited given their lack of specificity and inability to reflect nigral pathology in moderate to severe PD. These scans may be more sensitive than clinical examination to detect nigrostriatal deficiency that occurs in multiple parkinsonian syndromes and may still be recommended for clinical use in the future to identify prodromal PD if and when disease-modifying treatments become available. Multimodal imaging to evaluate underlying nigral pathology and its functional consequences may hold the key to future advances.
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Disentangling nigral and putaminal contribution to motor impairment and levodopa response in Parkinson's disease. NPJ Parkinsons Dis 2022; 8:132. [PMID: 36241644 PMCID: PMC9568583 DOI: 10.1038/s41531-022-00401-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/28/2022] [Indexed: 11/08/2022] Open
Abstract
The extent to which the degeneration of the substantia nigra (SN) and putamen each contribute to motor impairment in Parkinson's disease (PD) is unclear, as they are usually investigated using different imaging modalities. To examine the pathophysiological significance of the SN and putamen in both motor impairment and the levodopa response in PD using diffusion microstructure imaging (DMI). In this monocentric retrospective cross-sectional study, DMI parameters from 108 patients with PD and 35 healthy controls (HC) were analyzed using a voxel- and region-based approach. Linear models were applied to investigate the association between individual DMI parameters and Movement Disorder Society Unified Parkinson's Disease Rating Scale-Part 3 performance in ON- and OFF-states, as well as the levodopa response, controlling for age and sex. Voxel- and region-based group comparisons of DMI parameters between PD and HC revealed significant differences in the SN and putamen. In PD, a poorer MDS-UPDRS-III performance in the ON-state was associated with increased free fluid in the SN (b-weight = 65.79, p = 0.004) and putamen (b-weight = 86.00, p = 0.006), and contrariwise with the demise of cells in both structures. The levodopa response was inversely associated with free fluid both in the SN (b-weight = -83.61, p = 0.009) and putamen (b-weight = -176.56, p < 0.001). Interestingly, when the two structures were assessed together, the integrity of the putamen, but not the SN, served as a predictor for the levodopa response (b-weight = -158.03, p < 0.001). Structural alterations in the SN and putamen can be measured by diffusion microstructure imaging in PD. They are associated with poorer motor performance in the ON-state, as well as a reduced response to levodopa. While both nigral and putaminal integrity are required for good performance in the ON-state, it is putaminal integrity alone that determines the levodopa response. Therefore, the structural integrity of the putamen is crucial for the improvement of motor symptoms to dopaminergic medication, and might therefore serve as a promising biomarker for motor staging.
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Liu Z, Moon HS, Li Z, Laforest R, Perlmutter JS, Norris SA, Jha AK. A tissue-fraction estimation-based segmentation method for quantitative dopamine transporter SPECT. Med Phys 2022; 49:5121-5137. [PMID: 35635327 PMCID: PMC9703616 DOI: 10.1002/mp.15778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/25/2022] [Accepted: 05/16/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Quantitative measures of dopamine transporter (DaT) uptake in caudate, putamen, and globus pallidus (GP) derived from dopamine transporter-single-photon emission computed tomography (DaT-SPECT) images have potential as biomarkers for measuring the severity of Parkinson's disease. Reliable quantification of this uptake requires accurate segmentation of the considered regions. However, segmentation of these regions from DaT-SPECT images is challenging, a major reason being partial-volume effects (PVEs) in SPECT. The PVEs arise from two sources, namely the limited system resolution and reconstruction of images over finite-sized voxel grids. The limited system resolution results in blurred boundaries of the different regions. The finite voxel size leads to TFEs, that is, voxels contain a mixture of regions. Thus, there is an important need for methods that can account for the PVEs, including the TFEs, and accurately segment the caudate, putamen, and GP, from DaT-SPECT images. PURPOSE Design and objectively evaluate a fully automated tissue-fraction estimation-based segmentation method that segments the caudate, putamen, and GP from DaT-SPECT images. METHODS The proposed method estimates the posterior mean of the fractional volumes occupied by the caudate, putamen, and GP within each voxel of a three-dimensional DaT-SPECT image. The estimate is obtained by minimizing a cost function based on the binary cross-entropy loss between the true and estimated fractional volumes over a population of SPECT images, where the distribution of true fractional volumes is obtained from existing populations of clinical magnetic resonance images. The method is implemented using a supervised deep-learning-based approach. RESULTS Evaluations using clinically guided highly realistic simulation studies show that the proposed method accurately segmented the caudate, putamen, and GP with high mean Dice similarity coefficients of ∼ 0.80 and significantly outperformed (p < 0.01 $p < 0.01$ ) all other considered segmentation methods. Further, an objective evaluation of the proposed method on the task of quantifying regional uptake shows that the method yielded reliable quantification with low ensemble normalized root mean square error (NRMSE) < 20% for all the considered regions. In particular, the method yielded an even lower ensemble NRMSE of ∼ 10% for the caudate and putamen. CONCLUSIONS The proposed tissue-fraction estimation-based segmentation method for DaT-SPECT images demonstrated the ability to accurately segment the caudate, putamen, and GP, and reliably quantify the uptake within these regions. The results motivate further evaluation of the method with physical-phantom and patient studies.
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Affiliation(s)
- Ziping Liu
- Department of Biomedical Engineering, Washington University, St. Louis, Missouri, USA
| | - Hae Sol Moon
- Department of Biomedical Engineering, Washington University, St. Louis, Missouri, USA
| | - Zekun Li
- Department of Biomedical Engineering, Washington University, St. Louis, Missouri, USA
| | - Richard Laforest
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Joel S. Perlmutter
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Neurology,Washington University School of Medicine, St. Louis, Missouri, USA
| | - Scott A. Norris
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Neurology,Washington University School of Medicine, St. Louis, Missouri, USA
| | - Abhinav K. Jha
- Department of Biomedical Engineering, Washington University, St. Louis, Missouri, USA
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
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Furukawa K, Shima A, Kambe D, Nishida A, Wada I, Sakamaki H, Yoshimura K, Terada Y, Sakato Y, Mitsuhashi M, Sawamura M, Nakanishi E, Taruno Y, Yamakado H, Fushimi Y, Okada T, Nakamoto Y, Takahashi R, Sawamoto N. Motor progression and nigrostriatal neurodegeneration in Parkinson’s disease. Ann Neurol 2022; 92:110-121. [DOI: 10.1002/ana.26373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 04/03/2022] [Accepted: 04/11/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Koji Furukawa
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Atsushi Shima
- Human Brain Research Center Kyoto University Graduate School of Medicine Kyoto Japan
| | - Daisuke Kambe
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Akira Nishida
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Ikko Wada
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Haruhi Sakamaki
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Kenji Yoshimura
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Yuta Terada
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Yusuke Sakato
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Masahiro Mitsuhashi
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Masanori Sawamura
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Etsuro Nakanishi
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Yosuke Taruno
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Hodaka Yamakado
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine Kyoto University Graduate School of Medicine Kyoto Japan
| | - Tomohisa Okada
- Human Brain Research Center Kyoto University Graduate School of Medicine Kyoto Japan
- Department of Diagnostic Imaging and Nuclear Medicine Kyoto University Graduate School of Medicine Kyoto Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine Kyoto University Graduate School of Medicine Kyoto Japan
| | - Ryosuke Takahashi
- Department of Neurology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Nobukatsu Sawamoto
- Department of Human Health Sciences Kyoto University Graduate School of Medicine Kyoto Japan
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Norris SA, White H, Tanenbaum A, Williams EL, Cruchaga C, Tian L, Schmidt RE, Perlmutter JS. Severe acute neurotoxicity reflects absolute intra-carotid 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine dose in non-human primates. J Neurosci Methods 2022; 366:109406. [PMID: 34767855 DOI: 10.1016/j.jneumeth.2021.109406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/18/2021] [Accepted: 11/02/2021] [Indexed: 11/18/2022]
Affiliation(s)
- S A Norris
- Departments of Neurology, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO 63110, USA; Departments of Radiology, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO 63110, USA.
| | - Hcb White
- Departments of Neurology, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO 63110, USA
| | - A Tanenbaum
- Departments of Neurology, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO 63110, USA
| | - E L Williams
- Departments of Neurology, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO 63110, USA
| | - C Cruchaga
- Departments of Psychiatry, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO 63110, USA
| | - L Tian
- Departments of Neurology, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO 63110, USA
| | - R E Schmidt
- Departments of Pathology, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO 63110, USA
| | - J S Perlmutter
- Departments of Neurology, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO 63110, USA; Departments of Radiology, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO 63110, USA; Departments of Neuroscience, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO 63110, USA; Departments of Physical, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO 63110, USA; Departments of Occupational Therapy, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO 63110, USA
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Brücke T, Brücke C. Dopamine transporter (DAT) imaging in Parkinson's disease and related disorders. J Neural Transm (Vienna) 2021; 129:581-594. [PMID: 34910248 DOI: 10.1007/s00702-021-02452-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/30/2021] [Indexed: 11/27/2022]
Abstract
This review gives an insight into the beginnings of dopamine transporter (DAT) imaging in the early 1990s, focussing on single photon emission tomography (SPECT). The development of the method and its consolidation as a now widely used clinical tool is described. The role of DAT-SPECT in the diagnosis and differential diagnosis of PD, atypical parkinsonian syndromes and several other different neurological disorders is reviewed. Finally the clinical research using DAT-SPECT as a biomarker for the progression of PD, for the detection of a preclinical dopaminergic lesion and its correlation with neuropathological findings is outlined.
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Affiliation(s)
- Thomas Brücke
- Ottakring Clinic, Neurological Department, Verein zur Förderung der Wissenschaftlichen Forschung am Wilhelminenspital (FWFW), Montleartstrasse 37, 1160, Vienna, Austria.
- , Linke Wienzeile 12, 1060, Vienna, Austria.
| | - Christof Brücke
- Department for Neurology, Medical University Vienna, Währingergürtel 18-20, 1090, Vienna, Austria
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Palermo G, Giannoni S, Bellini G, Siciliano G, Ceravolo R. Dopamine Transporter Imaging, Current Status of a Potential Biomarker: A Comprehensive Review. Int J Mol Sci 2021; 22:11234. [PMID: 34681899 PMCID: PMC8538800 DOI: 10.3390/ijms222011234] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 11/16/2022] Open
Abstract
A major goal of current clinical research in Parkinson's disease (PD) is the validation and standardization of biomarkers enabling early diagnosis, predicting outcomes, understanding PD pathophysiology, and demonstrating target engagement in clinical trials. Molecular imaging with specific dopamine-related tracers offers a practical indirect imaging biomarker of PD, serving as a powerful tool to assess the status of presynaptic nigrostriatal terminals. In this review we provide an update on the dopamine transporter (DAT) imaging in PD and translate recent findings to potentially valuable clinical practice applications. The role of DAT imaging as diagnostic, preclinical and predictive biomarker is discussed, especially in view of recent evidence questioning the incontrovertible correlation between striatal DAT binding and nigral cell or axon counts.
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Affiliation(s)
- Giovanni Palermo
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.P.); (S.G.); (G.B.); (G.S.)
| | - Sara Giannoni
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.P.); (S.G.); (G.B.); (G.S.)
- Unit of Neurology, San Giuseppe Hospital, 50053 Empoli, Italy
| | - Gabriele Bellini
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.P.); (S.G.); (G.B.); (G.S.)
| | - Gabriele Siciliano
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.P.); (S.G.); (G.B.); (G.S.)
| | - Roberto Ceravolo
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (G.P.); (S.G.); (G.B.); (G.S.)
- Center for Neurodegenerative Diseases, Unit of Neurology, Parkinson’s Disease and Movement Disorders, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
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Juri C, Kramer V, Riss PJ, Soza-Ried C, Haeger A, Pruzzo R, Rösch F, Amaral H, Chana-Cuevas P. [18F]PR04.MZ PET/CT Imaging for Evaluation of Nigrostriatal Neuron Integrity in Patients With Parkinson Disease. Clin Nucl Med 2021; 46:119-124. [PMID: 33323728 PMCID: PMC7774816 DOI: 10.1097/rlu.0000000000003430] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/14/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Degeneration of dopaminergic, nigrostriatal neurons is the hallmark of Parkinson disease (PD), and PET quantification of dopamine transporters is a widely accepted method for differential diagnosis between idiopathic PD and essential tremor. [18F]PR04.MZ is a new PET tracer with excellent imaging properties allowing for precise quantification of striatal and extrastriatal dopamine transporter. Here we describe our initial experience with [18F]PR04.MZ PET/CT in a larger cohort of healthy controls and PD patients as a proof-of-concept study for this tracer. METHODS Eighteen healthy subjects, 19 early PD patients (Hoehn-Yahr I-II), and 13 moderate-advanced PD patients (Hoehn-Yahr III-IV) underwent static PET/CT scans 60 to 90 minutes after injection of 5.16 ± 1.03 mCi (191 ± 38 MBq) [18F]PR04.MZ. Specific binding ratios (SBRs) were calculated for caudate nucleus, anterior putamen, posterior putamen, substantia nigra (SNpc), compared between different groups and correlated with clinical ratings. RESULTS [18F]PR04.MZ showed very high and specific uptake in the putamen, caudate, and substantia nigra pars compacta and very low nonspecific binding in other brain regions, and SBR values for the control group were 22.3 ± 4.1, 19.1 ± 3.5, and 5.4 ± 1.2, respectively. A reduction of SBR values was observed in all regions and in both initial and moderate PD, ranging from 35% to 89% (P < 0.001). The observed pattern of reduction was posterior putamen > anterior putamen > substantia nigra pars compacta > caudate, with contralateral posterior putamen being the most affected region. Rostrocaudal depletion gradient was evident in all PD patients and progression correlated with motor manifestations. CONCLUSIONS [18F]PR04.MZ PET/CT is a highly sensitive imaging modality for the detection of dopaminergic deficit in nigrostriatal pathways in PD.
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Affiliation(s)
- Carlos Juri
- From the Department of Neurology, Facultad de Medicina, Pontificia Universidad Católica de Chile
- Department of Neurology, Hospital Sotero del Río
| | - Vasko Kramer
- Nuclear Medicine and PET/CT Center PositronMed
- Positronpharma SA, Santiago, Chile
| | | | | | | | | | - Frank Rösch
- Institute of Nuclear Chemistry, Johannes Gutenberg-University, Mainz, Germany
| | - Horacio Amaral
- Nuclear Medicine and PET/CT Center PositronMed
- Positronpharma SA, Santiago, Chile
| | - Pedro Chana-Cuevas
- Centro de Trastornos del Movimiento
- Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Santiago, Chile
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Black KJ, Acevedo HK, Koller JM. Dopamine Buffering Capacity Imaging: A Pharmacodynamic fMRI Method for Staging Parkinson Disease. Front Neurol 2020; 11:370. [PMID: 32477245 PMCID: PMC7232584 DOI: 10.3389/fneur.2020.00370] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 04/14/2020] [Indexed: 11/13/2022] Open
Abstract
We propose a novel pharmacological fMRI (phMRI) method for objectively quantifying disease severity in Parkinson disease (PD). It is based on the clinical observation that the benefit from a dose of levodopa wears off more quickly as PD progresses. Biologically this has been thought to represent decreased buffering capacity for dopamine as nigrostriatal cells die. Buffering capacity has been modeled based on clinical effects, but clinical measurements are influenced by confounding factors. The new method proposes to measure the effect objectively based on the timing of the known response of several brain regions to exogenous levodopa. Such responses are robust and can be quantified using perfusion MRI. Here we present simulation studies based on published clinical dose-response data and an intravenous levodopa infusion. Standard pharmacokinetic-pharmacodynamic methods were used to model the response. Then the effect site rate constant k e was estimated from simulated response data plus Gaussian noise. Predicted time - effect curves sampled at times consistent with phMRI differ substantially based on clinical severity. Estimated k e from noisy input data was recovered with good accuracy. These simulation results support the feasibility of levodopa phMRI hysteresis mapping to measure the severity of dopamine denervation objectively and simultaneously in all brain regions with a robust imaging response to exogenous levodopa.
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Affiliation(s)
- Kevin J. Black
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, United States
- Departments of Neurology, Radiology and Neuroscience, Washington University in St. Louis, St. Louis, MO, United States
| | - Haley K. Acevedo
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, United States
| | - Jonathan M. Koller
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, United States
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Affiliation(s)
- Baijayanta Maiti
- Washington University School of Medicine, St. Louis, Missouri (B.M., J.S.P.)
| | - Joel S Perlmutter
- Washington University School of Medicine, St. Louis, Missouri (B.M., J.S.P.)
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11
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Palermo G, Giannoni S, Frosini D, Morganti R, Volterrani D, Bonuccelli U, Pavese N, Ceravolo R. Dopamine Transporter, Age, and Motor Complications in Parkinson's Disease: A Clinical and Single-Photon Emission Computed Tomography Study. Mov Disord 2020; 35:1028-1036. [PMID: 32154947 DOI: 10.1002/mds.28008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/25/2020] [Accepted: 02/07/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Previous molecular imaging studies comparing dopamine function in vivo between early-onset PD and late-onset PD patients have shown contradictory results, presumably attributable to the aging-related decline in nigrostriatal function. OBJECTIVES (1) To investigate baseline dopamine transporter availability in early-onset PD (<55 years) and late-onset PD (>70 years) patients, z-scores values of putamen and caudate [123 I]-ioflupane uptake were calculated using the respective age-matched controls in order to correct for early presynaptic compensatory mechanisms and age-related dopamine neuron loss; (2) to examine the associations of such baseline single-photon emission computed tomography measures with the emergence of late-disease motor complications. METHODS In this retrospective study, 105 de novo PD patients who underwent [123 I]-ioflupane single-photon emission computed tomography at time of diagnosis were divided into three tertile groups according to age at disease onset (35 early-onset PD and 40 late-onset PD patients). Z-scores were compared between the two groups, and their predictive power for motor complications (during a mean follow-up of 7 years) was evaluated using Cox proportional hazard models. RESULTS Despite a less-severe motor phenotype, early-onset PD patients exhibited more reduced [123 I]-ioflupane binding in the putamen and had a higher and earlier risk for developing motor complications than those with late-onset PD. Lower [123 I]-Ioflupane uptake in the putamen and caudate increased the risk of motor complications. CONCLUSIONS Our findings indicate that a lower dopamine transporter binding in early-onset PD predicts the later development of motor complications, but it is not related to severity of motor symptoms, suggesting age-related differences in striatal compensatory mechanisms in PD. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Giovanni Palermo
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sara Giannoni
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Daniela Frosini
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Duccio Volterrani
- Regional Center of Nuclear Medicine, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ubaldo Bonuccelli
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Nicola Pavese
- Clinical Ageing Research Unit, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.,Department of Clinical Medicine, Nuclear Medicine and PET, Aarhus University, Aarhus, Denmark
| | - Roberto Ceravolo
- Unit of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Perlmutter JS, Stoessl AJ. Striatal DAT SPECT: Caveat Emptor! Mov Disord 2019; 34:1430-1432. [PMID: 31769089 DOI: 10.1002/mds.27811] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 07/08/2019] [Accepted: 07/14/2019] [Indexed: 12/17/2022] Open
Affiliation(s)
- Joel S Perlmutter
- Departments of Neurology, Radiology, Neuroscience and Programs in Physical Therapy and Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
| | - A Jon Stoessl
- Division of Neurology & Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
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Kasanga EA, Owens CL, Cantu MA, Richard AD, Davis RW, McDivitt LM, Blancher B, Pruett BS, Tan C, Gajewski A, Manfredsson FP, Nejtek VA, Salvatore MF. GFR-α1 Expression in Substantia Nigra Increases Bilaterally Following Unilateral Striatal GDNF in Aged Rats and Attenuates Nigral Tyrosine Hydroxylase Loss Following 6-OHDA Nigrostriatal Lesion. ACS Chem Neurosci 2019; 10:4237-4249. [PMID: 31538765 DOI: 10.1021/acschemneuro.9b00291] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Glial cell line-derived neurotrophic factor (GDNF) improved motor function in Parkinson's disease (PD) patients in Phase I clinical trials, and these effects persisted months after GDNF discontinuation. Conversely, phase II clinical trials reported no significant effects on motor improvement vs placebo. The disease duration and the quantity, infusion approach, and duration of GDNF delivery may affect GDNF efficacy in PD treatment. However, identifying mechanisms activated by GDNF that affect nigrostriatal function may reveal additional avenues to partially restore nigrostriatal function. In PD and aging models, GDNF affects tyrosine hydroxylase (TH) expression or phosphorylation in substantia nigra (SN), long after a single GDNF injection in striatum. In aged rats, the GDNF family receptor, GFR-α1, increases TH expression and phosphorylation in SN. To determine if GFR-α1 could be a mechanistic link in long-term GDNF impact, we conducted two studies; first to determine if a single unilateral striatal delivery of GDNF affected GFR-α1 and TH over time (1 day, 1 week, and 4 weeks) in the striatum or SN in aged rats, and second, to determine if soluble GFR-α1 could mitigate TH loss following 6-hydroxydopamine (6-OHDA) lesion. In aged rats, GDNF bilaterally increased ser31 TH phosphorylation and GFR-α1 expression in SN at 1 day and 4 weeks after GDNF, respectively. In striatum, GFR-α1 expression decreased 1 week after GDNF, only on the GDNF-injected side. In 6-OHDA-lesioned rats, recombinant soluble GFR-α1 mitigated nigral, but not striatal, TH protein loss following 6-OHDA. Together, these results show GDNF has immediate and long-term impact on dopamine regulation in the SN, which includes a gradual increase in GFR-α1 expression that may sustain TH expression and dopamine function therein.
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Affiliation(s)
- Ella A Kasanga
- Institute for Healthy Aging , University of North Texas Health Science Center , Fort Worth , Texas 76107 , United States
| | - Catherine L Owens
- Department of Pharmacology, Toxicology, & Neuroscience , Louisiana State University Health Sciences Center , Shreveport , Louisiana 71130 , United States
| | - Mark A Cantu
- Institute for Healthy Aging , University of North Texas Health Science Center , Fort Worth , Texas 76107 , United States
| | - Adam D Richard
- Department of Pharmacology, Toxicology, & Neuroscience , Louisiana State University Health Sciences Center , Shreveport , Louisiana 71130 , United States
| | - Richard W Davis
- Department of Pharmacology, Toxicology, & Neuroscience , Louisiana State University Health Sciences Center , Shreveport , Louisiana 71130 , United States
| | - Lisa M McDivitt
- Department of Pharmacology, Toxicology, & Neuroscience , Louisiana State University Health Sciences Center , Shreveport , Louisiana 71130 , United States
| | - Blake Blancher
- Department of Pharmacology, Toxicology, & Neuroscience , Louisiana State University Health Sciences Center , Shreveport , Louisiana 71130 , United States
| | - Brandon S Pruett
- Department of Pharmacology, Toxicology, & Neuroscience , Louisiana State University Health Sciences Center , Shreveport , Louisiana 71130 , United States
| | - Christopher Tan
- Institute for Healthy Aging , University of North Texas Health Science Center , Fort Worth , Texas 76107 , United States
| | - Austin Gajewski
- Institute for Healthy Aging , University of North Texas Health Science Center , Fort Worth , Texas 76107 , United States
| | - Fredric P Manfredsson
- Parkinson's Disease Research Unit, Department of Neurobiology , Barrow Neurological Institute , Phoenix , Arizona 85013 , United States
| | - Vicki A Nejtek
- Institute for Healthy Aging , University of North Texas Health Science Center , Fort Worth , Texas 76107 , United States
| | - Michael F Salvatore
- Institute for Healthy Aging , University of North Texas Health Science Center , Fort Worth , Texas 76107 , United States
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Lee JY, Yoon EJ, Kim YK, Shin CW, Nam H, Jeong JM, Kim HJ, Jeon B. Nonmotor and Dopamine Transporter Change in REM Sleep Behavior Disorder by Olfactory Impairment. J Mov Disord 2019; 12:103-112. [PMID: 31158943 PMCID: PMC6547034 DOI: 10.14802/jmd.18061] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 03/13/2019] [Indexed: 11/24/2022] Open
Abstract
Objective It is unclear whether the decline in dopamine transporters (DAT) differs among idiopathic rapid eye movement sleep behavior disorder (iRBD) patients with different levels of olfactory impairment. This study aimed to characterize DAT changes in relation to nonmotor features in iRBD patients by olfactory loss. Methods This prospective cohort study consisted of three age-matched groups: 30 polysomnography-confirmed iRBD patients, 30 drug-naïve Parkinson’s disease patients, and 19 healthy controls without olfactory impairment. The iRBD group was divided into two groups based on olfactory testing results. Participants were evaluated for reported prodromal markers and then underwent 18F-FP-CIT positron emission tomography and 3T MRI. Tracer uptakes were analyzed in the caudate, anterior and posterior putamen, substantia nigra, and raphe nuclei. Results Olfactory impairment was defined in 38.5% of iRBD patients. Mild parkinsonian signs and cognitive functions were not different between the two iRBD subgroups; however, additional prodromal features, constipation, and urinary and sexual dysfunctions were found in iRBD patients with olfactory impairment but not in those without. Tracer uptake showed significant group differences in all brain regions, except the raphe nuclei. The iRBD patients with olfactory impairment had uptake reductions in the anterior and posterior putamen, caudate, and substantia nigra (p < 0.016 in all, adjusted for age), which ranged from 0.6 to 0.8 of age-normative values. In contrast, those without olfactory impairment had insignificant changes in all regions ranging above 0.8. Conclusion There was a clear distinction in DAT loss and nonmotor profiles by olfactory status in iRBD.
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Affiliation(s)
- Jee-Young Lee
- Department of Neurology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea.,Department of Neurology, Seoul National University College of Medicine, Seoul, Korea
| | - Eun Jin Yoon
- Department of Nuclear Medicine, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul National University, Seoul, Korea
| | - Yu Kyeong Kim
- Department of Nuclear Medicine, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea.,Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Chae Won Shin
- Department of Neurology, Kyung Hee University Medical Center, Seoul, Korea
| | - Hyunwoo Nam
- Department of Neurology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea.,Department of Neurology, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Min Jeong
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul National University, Seoul, Korea.,Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Han-Joon Kim
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Neurology, Kyung Hee University Medical Center, Seoul, Korea
| | - Beomseok Jeon
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.,Department of Neurology and Movement Disorders Center, Seoul National University Hospital, Seoul, Korea
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15
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Cassidy CM, Zucca FA, Girgis RR, Baker SC, Weinstein JJ, Sharp ME, Bellei C, Valmadre A, Vanegas N, Kegeles LS, Brucato G, Kang UJ, Sulzer D, Zecca L, Abi-Dargham A, Horga G. Neuromelanin-sensitive MRI as a noninvasive proxy measure of dopamine function in the human brain. Proc Natl Acad Sci U S A 2019; 116:5108-5117. [PMID: 30796187 PMCID: PMC6421437 DOI: 10.1073/pnas.1807983116] [Citation(s) in RCA: 123] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Neuromelanin-sensitive MRI (NM-MRI) purports to detect the content of neuromelanin (NM), a product of dopamine metabolism that accumulates with age in dopamine neurons of the substantia nigra (SN). Interindividual variability in dopamine function may result in varying levels of NM accumulation in the SN; however, the ability of NM-MRI to measure dopamine function in nonneurodegenerative conditions has not been established. Here, we validated that NM-MRI signal intensity in postmortem midbrain specimens correlated with regional NM concentration even in the absence of neurodegeneration, a prerequisite for its use as a proxy for dopamine function. We then validated a voxelwise NM-MRI approach with sufficient anatomical sensitivity to resolve SN subregions. Using this approach and a multimodal dataset of molecular PET and fMRI data, we further showed the NM-MRI signal was related to both dopamine release in the dorsal striatum and resting blood flow within the SN. These results suggest that NM-MRI signal in the SN is a proxy for function of dopamine neurons in the nigrostriatal pathway. As a proof of concept for its clinical utility, we show that the NM-MRI signal correlated to severity of psychosis in schizophrenia and individuals at risk for schizophrenia, consistent with the well-established dysfunction of the nigrostriatal pathway in psychosis. Our results indicate that noninvasive NM-MRI is a promising tool that could have diverse research and clinical applications to investigate in vivo the role of dopamine in neuropsychiatric illness.
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Affiliation(s)
- Clifford M Cassidy
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032;
- University of Ottawa Institute of Mental Health Research, affiliated with The Royal, Ottawa, ON K1Z 8N3, Canada
| | - Fabio A Zucca
- Institute of Biomedical Technologies, National Research Council of Italy, Segrate, 20090 Milan, Italy
| | - Ragy R Girgis
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032
| | - Seth C Baker
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032
| | - Jodi J Weinstein
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032
- Department of Psychiatry, Stony Brook University, Stony Brook, NY 11794
| | - Madeleine E Sharp
- Department of Neurology, Columbia University Medical Center, New York, NY 10032
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC H3A 2B4, Canada
| | - Chiara Bellei
- Institute of Biomedical Technologies, National Research Council of Italy, Segrate, 20090 Milan, Italy
| | - Alice Valmadre
- Institute of Biomedical Technologies, National Research Council of Italy, Segrate, 20090 Milan, Italy
| | - Nora Vanegas
- Department of Neurology, Columbia University Medical Center, New York, NY 10032
| | - Lawrence S Kegeles
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032
| | - Gary Brucato
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032
| | - Un Jung Kang
- Department of Neurology, Columbia University Medical Center, New York, NY 10032
| | - David Sulzer
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032
- Department of Neurology, Columbia University Medical Center, New York, NY 10032
| | - Luigi Zecca
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032
- Institute of Biomedical Technologies, National Research Council of Italy, Segrate, 20090 Milan, Italy
| | - Anissa Abi-Dargham
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032
- Department of Psychiatry, Stony Brook University, Stony Brook, NY 11794
| | - Guillermo Horga
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY 10032;
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16
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Abi-Dargham A. From "bedside" to "bench" and back: A translational approach to studying dopamine dysfunction in schizophrenia. Neurosci Biobehav Rev 2018; 110:174-179. [PMID: 30528375 DOI: 10.1016/j.neubiorev.2018.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 11/25/2018] [Accepted: 12/04/2018] [Indexed: 01/07/2023]
Abstract
Despite multiple lines of research, a mechanistic understanding of schizophrenia remains elusive. Neuroimaging studies have yielded observations that can be used in translational studies in animals to attempt to uncover their cellular and circuit basis and their significance for the diseased human brain. Enhanced D2 stimulation in the striatum is a well replicated and established observation in patients with schizophrenia. This "bedside" observation was reproduced "at the bench" level by creating a transgenic mouse overexpressing D2 receptors in dorsal striatum (D2R-OE mouse). The D2R-OE mouse showed multiple behavioral, molecular, electrophysiological and anatomical alterations. Some of these are consistent with findings in patients with schizophrenia, providing construct validity to the model and mechanistic insights for the observations made in humans. Other findings were novel, and provide an opportunity for a reverse translational effort back into the clinic. In this review we will summarize the process of translation and back translation from the D2R-OE mouse and describe the insights into the pathophysiology of the disease gained through this type of translational work.
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Affiliation(s)
- Anissa Abi-Dargham
- Departments of Psychiatry and Radiology, Stony Brook School of Medicine, HSC-T10-087H, 101 Nicolls Road, Stony Brook, NY, 11794-8101, United States.
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17
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Abstract
Positron emission tomography (PET) has revealed key insights into the pathophysiology of movement disorders. This paper will focus on how PET investigations of pathophysiology are particularly relevant to Parkinson disease, a neurodegenerative condition usually starting later in life marked by a varying combination of motor and nonmotor deficits. Various molecular imaging modalities help to determine what changes in brain herald the onset of pathology; can these changes be used to identify presymptomatic individuals who may be appropriate for to-be-developed treatments that may forestall onset of symptoms or slow disease progression; can PET act as a biomarker of disease progression; can molecular imaging help enrich homogenous cohorts for clinical studies; and what other pathophysiologic mechanisms relate to nonmotor manifestations. PET methods include measurements of regional cerebral glucose metabolism and blood flow, selected receptors, specific neurotransmitter systems, postsynaptic signal transducers, and abnormal protein deposition. We will review each of these methodologies and how they are relevant to important clinical issues pertaining to Parkinson disease.
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Affiliation(s)
- Baijayanta Maiti
- Department of Neurology, Washington University in St. Louis, St Louis, MO.
| | - Joel S Perlmutter
- Department of Neurology, Washington University in St. Louis, St Louis, MO; Department of Radiology, Washington University in St. Louis, St Louis, MO; Department of Neuroscience, Washington University in St. Louis, St Louis, MO; Department of Physical Therapy, Washington University in St. Louis, St Louis, MO; Department of Occupational Therapy, Washington University in St. Louis, St Louis, MO
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18
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Criswell SR, Warden MN, Searles Nielsen S, Perlmutter JS, Moerlein SM, Sheppard L, Lenox-Krug J, Checkoway H, Racette BA. Selective D2 receptor PET in manganese-exposed workers. Neurology 2018; 91:e1022-e1030. [PMID: 30097475 PMCID: PMC6140373 DOI: 10.1212/wnl.0000000000006163] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 06/15/2018] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To investigate the associations between manganese (Mn) exposure, D2 dopamine receptors (D2Rs), and parkinsonism using [11C](N-methyl)benperidol (NMB) PET. METHODS We used NMB PET to evaluate 50 workers with a range of Mn exposure: 22 Mn-exposed welders, 15 Mn-exposed workers, and 13 nonexposed workers. Cumulative Mn exposure was estimated from work histories, and movement disorder specialists examined all workers. We calculated NMB D2R nondisplaceable binding potential (BPND) for the striatum, globus pallidus, thalamus, and substantia nigra (SN). Multivariate analysis of covariance with post hoc descriptive discriminate analysis identified regional differences by exposure group. We used linear regression to examine the association among Mn exposure, Unified Parkinson's Disease Rating Scale motor subsection 3 (UPDRS3) score, and regional D2R BPND. RESULTS D2R BPND in the SN had the greatest discriminant power among exposure groups (p < 0.01). Age-adjusted SN D2R BPND was 0.073 (95% confidence interval [CI] 0.022-0.124) greater in Mn-exposed welders and 0.068 (95% CI 0.013-0.124) greater in Mn-exposed workers compared to nonexposed workers. After adjustment for age, SN D2R BPND was 0.0021 (95% CI 0.0005-0.0042) higher for each year of Mn exposure. Each 0.10 increase in SN D2R BPND was associated with a 2.65 (95% CI 0.56-4.75) increase in UPDRS3 score. CONCLUSIONS AND RELEVANCE Nigral D2R BPND increased with Mn exposure and clinical parkinsonism, indicating dose-dependent dopaminergic dysfunction of the SN in Mn neurotoxicity.
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Affiliation(s)
- Susan R Criswell
- From the Department of Neurology (S.R.C., M.N.W., S.S.N., J.S.P., J.L.-K., B.A.R.), Department of Radiology (J.S.P., S.M.M.), Department of Neuroscience (J.S.P.), Program in Physical Therapy (J.S.P.), Program in Occupational Therapy (J.S.P.), and Department of Biochemistry and Molecular Biophysics (S.M.M.), Washington University School of Medicine, St. Louis, MO; Department of Environmental and Occupational Health Sciences (L.S.) and Department of Biostatistics (L.S.), University of Washington, School of Public Health, Seattle; Department of Family Medicine and Public Health (H.C.) and Department of Neurosciences (H.C.), University of California, San Diego, School of Medicine, La Jolla; and School of Public Health (B.A.R.), Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa
| | - Mark N Warden
- From the Department of Neurology (S.R.C., M.N.W., S.S.N., J.S.P., J.L.-K., B.A.R.), Department of Radiology (J.S.P., S.M.M.), Department of Neuroscience (J.S.P.), Program in Physical Therapy (J.S.P.), Program in Occupational Therapy (J.S.P.), and Department of Biochemistry and Molecular Biophysics (S.M.M.), Washington University School of Medicine, St. Louis, MO; Department of Environmental and Occupational Health Sciences (L.S.) and Department of Biostatistics (L.S.), University of Washington, School of Public Health, Seattle; Department of Family Medicine and Public Health (H.C.) and Department of Neurosciences (H.C.), University of California, San Diego, School of Medicine, La Jolla; and School of Public Health (B.A.R.), Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa
| | - Susan Searles Nielsen
- From the Department of Neurology (S.R.C., M.N.W., S.S.N., J.S.P., J.L.-K., B.A.R.), Department of Radiology (J.S.P., S.M.M.), Department of Neuroscience (J.S.P.), Program in Physical Therapy (J.S.P.), Program in Occupational Therapy (J.S.P.), and Department of Biochemistry and Molecular Biophysics (S.M.M.), Washington University School of Medicine, St. Louis, MO; Department of Environmental and Occupational Health Sciences (L.S.) and Department of Biostatistics (L.S.), University of Washington, School of Public Health, Seattle; Department of Family Medicine and Public Health (H.C.) and Department of Neurosciences (H.C.), University of California, San Diego, School of Medicine, La Jolla; and School of Public Health (B.A.R.), Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa
| | - Joel S Perlmutter
- From the Department of Neurology (S.R.C., M.N.W., S.S.N., J.S.P., J.L.-K., B.A.R.), Department of Radiology (J.S.P., S.M.M.), Department of Neuroscience (J.S.P.), Program in Physical Therapy (J.S.P.), Program in Occupational Therapy (J.S.P.), and Department of Biochemistry and Molecular Biophysics (S.M.M.), Washington University School of Medicine, St. Louis, MO; Department of Environmental and Occupational Health Sciences (L.S.) and Department of Biostatistics (L.S.), University of Washington, School of Public Health, Seattle; Department of Family Medicine and Public Health (H.C.) and Department of Neurosciences (H.C.), University of California, San Diego, School of Medicine, La Jolla; and School of Public Health (B.A.R.), Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa
| | - Stephen M Moerlein
- From the Department of Neurology (S.R.C., M.N.W., S.S.N., J.S.P., J.L.-K., B.A.R.), Department of Radiology (J.S.P., S.M.M.), Department of Neuroscience (J.S.P.), Program in Physical Therapy (J.S.P.), Program in Occupational Therapy (J.S.P.), and Department of Biochemistry and Molecular Biophysics (S.M.M.), Washington University School of Medicine, St. Louis, MO; Department of Environmental and Occupational Health Sciences (L.S.) and Department of Biostatistics (L.S.), University of Washington, School of Public Health, Seattle; Department of Family Medicine and Public Health (H.C.) and Department of Neurosciences (H.C.), University of California, San Diego, School of Medicine, La Jolla; and School of Public Health (B.A.R.), Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa
| | - Lianne Sheppard
- From the Department of Neurology (S.R.C., M.N.W., S.S.N., J.S.P., J.L.-K., B.A.R.), Department of Radiology (J.S.P., S.M.M.), Department of Neuroscience (J.S.P.), Program in Physical Therapy (J.S.P.), Program in Occupational Therapy (J.S.P.), and Department of Biochemistry and Molecular Biophysics (S.M.M.), Washington University School of Medicine, St. Louis, MO; Department of Environmental and Occupational Health Sciences (L.S.) and Department of Biostatistics (L.S.), University of Washington, School of Public Health, Seattle; Department of Family Medicine and Public Health (H.C.) and Department of Neurosciences (H.C.), University of California, San Diego, School of Medicine, La Jolla; and School of Public Health (B.A.R.), Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa
| | - Jason Lenox-Krug
- From the Department of Neurology (S.R.C., M.N.W., S.S.N., J.S.P., J.L.-K., B.A.R.), Department of Radiology (J.S.P., S.M.M.), Department of Neuroscience (J.S.P.), Program in Physical Therapy (J.S.P.), Program in Occupational Therapy (J.S.P.), and Department of Biochemistry and Molecular Biophysics (S.M.M.), Washington University School of Medicine, St. Louis, MO; Department of Environmental and Occupational Health Sciences (L.S.) and Department of Biostatistics (L.S.), University of Washington, School of Public Health, Seattle; Department of Family Medicine and Public Health (H.C.) and Department of Neurosciences (H.C.), University of California, San Diego, School of Medicine, La Jolla; and School of Public Health (B.A.R.), Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa
| | - Harvey Checkoway
- From the Department of Neurology (S.R.C., M.N.W., S.S.N., J.S.P., J.L.-K., B.A.R.), Department of Radiology (J.S.P., S.M.M.), Department of Neuroscience (J.S.P.), Program in Physical Therapy (J.S.P.), Program in Occupational Therapy (J.S.P.), and Department of Biochemistry and Molecular Biophysics (S.M.M.), Washington University School of Medicine, St. Louis, MO; Department of Environmental and Occupational Health Sciences (L.S.) and Department of Biostatistics (L.S.), University of Washington, School of Public Health, Seattle; Department of Family Medicine and Public Health (H.C.) and Department of Neurosciences (H.C.), University of California, San Diego, School of Medicine, La Jolla; and School of Public Health (B.A.R.), Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa
| | - Brad A Racette
- From the Department of Neurology (S.R.C., M.N.W., S.S.N., J.S.P., J.L.-K., B.A.R.), Department of Radiology (J.S.P., S.M.M.), Department of Neuroscience (J.S.P.), Program in Physical Therapy (J.S.P.), Program in Occupational Therapy (J.S.P.), and Department of Biochemistry and Molecular Biophysics (S.M.M.), Washington University School of Medicine, St. Louis, MO; Department of Environmental and Occupational Health Sciences (L.S.) and Department of Biostatistics (L.S.), University of Washington, School of Public Health, Seattle; Department of Family Medicine and Public Health (H.C.) and Department of Neurosciences (H.C.), University of California, San Diego, School of Medicine, La Jolla; and School of Public Health (B.A.R.), Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa.
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19
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Johnson M, Salvatore M, Maiolo S, Bobrovskaya L. Tyrosine hydroxylase as a sentinel for central and peripheral tissue responses in Parkinson’s progression: Evidence from clinical studies and neurotoxin models. Prog Neurobiol 2018; 165-167:1-25. [DOI: 10.1016/j.pneurobio.2018.01.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 12/07/2017] [Accepted: 01/10/2018] [Indexed: 12/25/2022]
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20
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Nigrostriatal dopamine transporter availability in early Parkinson's disease. Mov Disord 2018; 33:592-599. [DOI: 10.1002/mds.27316] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 12/22/2017] [Accepted: 01/04/2018] [Indexed: 11/07/2022] Open
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21
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Lillethorup TP, Glud AN, Alstrup AKO, Mikkelsen TW, Nielsen EH, Zaer H, Doudet DJ, Brooks DJ, Sørensen JCH, Orlowski D, Landau AM. Nigrostriatal proteasome inhibition impairs dopamine neurotransmission and motor function in minipigs. Exp Neurol 2018; 303:142-152. [PMID: 29428213 DOI: 10.1016/j.expneurol.2018.02.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 01/29/2018] [Accepted: 02/06/2018] [Indexed: 01/09/2023]
Abstract
Parkinson's disease (PD) is characterized by degeneration of dopaminergic neurons in the substantia nigra leading to slowness and stiffness of limb movement with rest tremor. Using ubiquitin proteasome system inhibitors, rodent models have shown nigrostriatal degeneration and motor impairment. We translated this model to the Göttingen minipig by administering lactacystin into the medial forebrain bundle (MFB). Minipigs underwent positron emission tomography (PET) imaging with (+)-α-[11C]dihydrotetrabenazine ([11C]DTBZ), a marker of vesicular monoamine transporter 2 availability, at baseline and three weeks after the unilateral administration of 100 μg lactacystin into the MFB. Compared to their baseline values, minipigs injected with lactacystin showed on average a 36% decrease in ipsilateral striatal binding potential corresponding to impaired presynaptic dopamine terminals. Behaviourally, minipigs displayed asymmetrical motor disability with spontaneous rotations in one of the animals. Immunoreactivity for tyrosine hydroxylase (TH) and HLA-DR-positive microglia confirmed asymmetrical reduction in nigral TH-positive neurons with an inflammatory response in the lactacystin-injected minipigs. In conclusion, direct injection of lactacystin into the MFB of minipigs provides a model of PD with reduced dopamine neurotransmission, TH-positive neuron reduction, microglial activation and behavioural deficits. This large animal model could be useful in studies of symptomatic and neuroprotective therapies with translatability to human PD.
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Affiliation(s)
- Thea P Lillethorup
- Department of Nuclear Medicine and PET Center, Institute of Clinical Medicine, Aarhus University and Hospital, Denmark
| | - Andreas N Glud
- Center for Experimental Neuroscience (CENSE), Department of Neurosurgery, Institute of Clinical Medicine, Aarhus University, Denmark
| | - Aage K O Alstrup
- Department of Nuclear Medicine and PET Center, Institute of Clinical Medicine, Aarhus University and Hospital, Denmark
| | - Trine W Mikkelsen
- Center for Experimental Neuroscience (CENSE), Department of Neurosurgery, Institute of Clinical Medicine, Aarhus University, Denmark
| | - Erik H Nielsen
- Department of Nuclear Medicine and PET Center, Institute of Clinical Medicine, Aarhus University and Hospital, Denmark
| | - Hamed Zaer
- Center for Experimental Neuroscience (CENSE), Department of Neurosurgery, Institute of Clinical Medicine, Aarhus University, Denmark
| | - Doris J Doudet
- Department of Medicine/Neurology, University of British Columbia, Vancouver, BC, Canada
| | - David J Brooks
- Department of Nuclear Medicine and PET Center, Institute of Clinical Medicine, Aarhus University and Hospital, Denmark; Division of Neuroscience, Department of Medicine, Imperial College London, UK; Division of Neuroscience, Newcastle University, UK
| | - Jens Christian H Sørensen
- Center for Experimental Neuroscience (CENSE), Department of Neurosurgery, Institute of Clinical Medicine, Aarhus University, Denmark
| | - Dariusz Orlowski
- Center for Experimental Neuroscience (CENSE), Department of Neurosurgery, Institute of Clinical Medicine, Aarhus University, Denmark
| | - Anne M Landau
- Department of Nuclear Medicine and PET Center, Institute of Clinical Medicine, Aarhus University and Hospital, Denmark; Translational Neuropsychiatry Unit, Institute of Clinical Medicine, Aarhus University, Denmark.
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22
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Development and Validation of Stability-Indicating UPLC Method for 9-Desmethyl-α-dihydrotetrabenazine. Chromatographia 2017. [DOI: 10.1007/s10337-017-3388-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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23
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Takeda A, Perlmutter JS. Striatal molecular imaging of presynaptic markers: Ready, fire, aim. Neurology 2017; 88:1388-1389. [PMID: 28283591 DOI: 10.1212/wnl.0000000000003827] [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
Affiliation(s)
- Atsushi Takeda
- From the Department of Neurology (A.T.), National Hospital Organization, Sendai-Nishitaga Hospital, Sendai, Miyagi, Japan; and Departments of Neurology, Radiology, and Neuroscience and Programs in Physical Therapy and Occupational Therapy (J.S.P.), Washington University School of Medicine, St. Louis, MO.
| | - Joel S Perlmutter
- From the Department of Neurology (A.T.), National Hospital Organization, Sendai-Nishitaga Hospital, Sendai, Miyagi, Japan; and Departments of Neurology, Radiology, and Neuroscience and Programs in Physical Therapy and Occupational Therapy (J.S.P.), Washington University School of Medicine, St. Louis, MO.
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Strafella AP, Bohnen NI, Perlmutter JS, Eidelberg D, Pavese N, Van Eimeren T, Piccini P, Politis M, Thobois S, Ceravolo R, Higuchi M, Kaasinen V, Masellis M, Peralta MC, Obeso I, Pineda-Pardo JÁ, Cilia R, Ballanger B, Niethammer M, Stoessl JA. Molecular imaging to track Parkinson's disease and atypical parkinsonisms: New imaging frontiers. Mov Disord 2017; 32:181-192. [DOI: 10.1002/mds.26907] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 11/21/2016] [Accepted: 11/27/2016] [Indexed: 12/23/2022] Open
Affiliation(s)
- Antonio P. Strafella
- Morton and Gloria Shulman Movement Disorder Unit & E.J. Safra Parkinson Disease Program, Neurology Div/Dept. Medicine, Toronto Western Hospital, UHN; Krembil Research Institute, UHN; Research Imaging Centre, Campbell Family Mental Health Research Institute, CAMH; University of Toronto; Ontario Canada
| | - Nicolaas I. Bohnen
- University of Michigan & Veterans Administration Medical Center; Ann Arbor Michigan USA
| | - Joel S. Perlmutter
- Neurology, Radiology, Neuroscience, Physical Therapy & Occupational Therapy; Washington University in St. Louis; St. Louis Missouri USA
| | - David Eidelberg
- Center for Neurosciences; The Feinstein Institute for Medical Research; Manhasset New York USA
| | - Nicola Pavese
- Newcastle Magnetic Resonance Centre & Positron Emission Tomography Centre; Newcastle University; Campus for Ageing & Vitality Newcastle upon Tyne United Kingdom
| | - Thilo Van Eimeren
- Multimodal Neuroimaging Group-Department of Nuclear Medicine Department of Neurology-University of Cologne; Institute of Neuroscience and Medicine, Jülich Research Center, German Center for Neurodegenerative Diseases (DZNE); Germany
| | - Paola Piccini
- Neurology Imaging Unit, Centre of Neuroinflammation and Neurodegeneration, Division of Brain Sciences, Hammersmith Campus; Imperial College London; United Kingdom
| | - Marios Politis
- Neurodegeneration Imaging Group, Department of Basic and Clinical Neuroscience, Institute of Psychiatry; Psychology and Neuroscience, King's College London; London United Kingdom
| | - Stephane Thobois
- Hospices Civils de Lyon, Hopital Neurologique Pierre Wertheimer; Université Lyon 1; CNRS, Centre de Neurosciences Cognitives; UMR 5229 Lyon France
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, Movement Disorders and Parkinson Center; University of Pisa; Italy
| | - Makoto Higuchi
- National Institute of Radiological Sciences; National Institutes for Quantum and Radiological Science and Technology; Chiba Japan
| | - Valtteri Kaasinen
- Division of Clinical Neurosciences, Turku University Hospital; Department of Neurology; University of Turku; Turku PET Centre, University of Turku; Turku Finland
| | - Mario Masellis
- Cognitive & Movement Disorders Clinic, Sunnybrook Health Sciences Centre; Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute; University of Toronto; Toronto Ontario Canada
| | - M. Cecilia Peralta
- Movement Disorder and Parkinson's Disease Program; CEMIC University Hospital; Buenos Aires Argentina
| | - Ignacio Obeso
- Centro Integral de Neurociencias (CINAC), Hospitales Madrid Puerta del Sur & Centro de Investigación Biomédica en Red; Enfermedades Neurodegenerativas (CIBERNED); Madrid Spain
| | - Jose Ángel Pineda-Pardo
- Centro Integral de Neurociencias (CINAC), Hospitales Madrid Puerta del Sur & Centro de Investigación Biomédica en Red; Enfermedades Neurodegenerativas (CIBERNED); Madrid Spain
| | - Roberto Cilia
- Parkinson Institute; ASST Gaetano Pini-CTO; Milan Italy
| | - Benedicte Ballanger
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Neuroplasticity & Neuropathology of Olfactory Perception Team; University Lyon; France
| | - Martin Niethammer
- Center for Neurosciences; The Feinstein Institute for Medical Research; Manhasset New York USA
| | - Jon A. Stoessl
- Pacific Parkinson's Research Centre & National Parkinson Foundation Centre of Excellence; University of British Columbia & Vancouver Coastal Health; Vancouver British Columbia Canada
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Mejias M, Yu J, Mackey S, Dinelle K, Sossi V, Doudet DJ. Interpreting DTBZ binding data in rodent: Inherent variability and compensation. Synapse 2016; 70:147-52. [PMID: 26749375 DOI: 10.1002/syn.21883] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 12/17/2015] [Accepted: 01/04/2016] [Indexed: 12/16/2022]
Abstract
[11C]-dihydrotetrabenazine (DTBZ) Positron Emission Tomography was used to evaluate the vesicular monoamine transporter type 2 as an index of dopaminergic function in the striatum of adult Sprague-Dawley rats obtained from two different animal sources (Charles River Laboratories [CR] or UBC's Animal Care Centre [ACC]) and later submitted to two different unilateral lesions of the nigro-striatal pathway. The results showed a significant difference in the striatal binding potential (BP(ND)) at baseline (before lesioning) between the CR and ACC groups providing evidence that the origin of the animals, possibly due to differences in early environmental factors or breeding conditions associated with different animal vendors plays a role in the development of the adult dopaminergic system. Further, in both animal models, an increase in DTBZ BP(ND) was observed, after unilateral intervention, in the striatum contralateral to the lesion, likely reflecting compensatory effects. Based on these findings, we conclude that in unilateral models, the unlesioned side/hemisphere may not be an appropriate control and that care should be taken to control for the origin of the animals in any given study, especially in longitudinal and replication studies.
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Affiliation(s)
- Miguel Mejias
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jing Yu
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Nuclear Medicine, Da Lian Medical University Affiliated Hospital No 2, China
| | - Scott Mackey
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Psychiatry, University of Vermont, Burlington, Vermont
| | - Katie Dinelle
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vesna Sossi
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Doris J Doudet
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Snider J, Müller MLTM, Kotagal V, Koeppe RA, Scott PJH, Frey KA, Albin RL, Bohnen NI. Non-exercise physical activity attenuates motor symptoms in Parkinson disease independent from nigrostriatal degeneration. Parkinsonism Relat Disord 2015; 21:1227-31. [PMID: 26330028 DOI: 10.1016/j.parkreldis.2015.08.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 08/09/2015] [Accepted: 08/24/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the relationship between time spent in non-exercise and exercise physical activity and severity of motor functions in Parkinson disease (PD). BACKGROUND Increasing motor impairments of PD incline many patients to a sedentary lifestyle. We investigated the relationship between duration of both non-exercise and exercise physical activity over a 4-week period using the Community Health Activities Model Program for Seniors (CHAMPS) questionnaire and severity of clinical motor symptoms in PD. We accounted for the magnitude of nigrostriatal degeneration. METHODS Cross-sectional study. PD subjects, n = 48 (40 M); 69.4 ± 7.4 (56-84) years old; 8.4 ± 4.2 (2.5-20) years motor disease duration, mean UPDRS motor score 27.5 ± 10.3 (7-53) and mean MMSE score 28.4 ± 1.9 (22-30) underwent [(11)C]dihydrotetrabenazine (DTBZ) PET imaging to assess nigrostriatal denervation and completed the CHAMPS questionnaire and clinical assessment. RESULTS Bivariate correlations showed an inverse relationship between motor UPDRS severity scores and duration of non-exercise physical activity (R = -0.37, P = 0.0099) but not with duration of exercise physical activity (R = -0.05, P = 0.76) over 4 weeks. Multiple regression analysis using UPDRS motor score as outcome variable demonstrated a significant regressor effect for duration of non-exercise physical activity (F = 6.15, P = 0.017) while accounting for effects of nigrostriatal degeneration (F = 4.93, P = 0.032), levodopa-equivalent dose (LED; F = 1.07, P = 0.31), age (F = 4.37, P = 0.043) and duration of disease (F = 1.46, P = 0.23; total model (F = 5.76, P = 0.0004). CONCLUSIONS Non-exercise physical activity is a correlate of motor symptom severity in PD independent of the magnitude of nigrostriatal degeneration. Non-exercise physical activity may have positive effects on functional performance in PD.
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Affiliation(s)
- Jonathan Snider
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Martijn L T M Müller
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA; University of Michigan, Morris K. Udall Center of Excellence for Parkinson's Disease, Ann Arbor, MI, USA
| | - Vikas Kotagal
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Robert A Koeppe
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA; University of Michigan, Morris K. Udall Center of Excellence for Parkinson's Disease, Ann Arbor, MI, USA
| | - Peter J H Scott
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Kirk A Frey
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA; Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Roger L Albin
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA; University of Michigan, Morris K. Udall Center of Excellence for Parkinson's Disease, Ann Arbor, MI, USA; Neurology Service and GRECC, VAAAHS, Ann Arbor, MI, USA
| | - Nicolaas I Bohnen
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA; Department of Radiology, University of Michigan, Ann Arbor, MI, USA; University of Michigan, Morris K. Udall Center of Excellence for Parkinson's Disease, Ann Arbor, MI, USA; Neurology Service and GRECC, VAAAHS, Ann Arbor, MI, USA.
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Bannon D, Landau AM, Doudet DJ. How Relevant Are Imaging Findings in Animal Models of Movement Disorders to Human Disease? Curr Neurol Neurosci Rep 2015; 15:53. [DOI: 10.1007/s11910-015-0571-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Molinet-Dronda F, Gago B, Quiroga-Varela A, Juri C, Collantes M, Delgado M, Prieto E, Ecay M, Iglesias E, Marín C, Peñuelas I, Obeso JA. Monoaminergic PET imaging and histopathological correlation in unilateral and bilateral 6-hydroxydopamine lesioned rat models of Parkinson's disease: A longitudinal in-vivo study. Neurobiol Dis 2015; 77:165-72. [DOI: 10.1016/j.nbd.2015.01.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 12/25/2014] [Accepted: 01/30/2015] [Indexed: 10/24/2022] Open
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Differential Alterations of Dopamine Transporter in the Striatum and Midbrain in Patients With Parkinsonian Syndrome. Clin Nucl Med 2015; 40:191-4. [DOI: 10.1097/rlu.0000000000000638] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Perlmutter JS, Norris SA. Neuroimaging biomarkers for Parkinson disease: facts and fantasy. Ann Neurol 2014; 76:769-83. [PMID: 25363872 PMCID: PMC4245400 DOI: 10.1002/ana.24291] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 09/30/2014] [Accepted: 10/05/2014] [Indexed: 11/12/2022]
Abstract
In this grand rounds, we focus on development, validation, and application of neuroimaging biomarkers for Parkinson disease (PD). We cover whether such biomarkers can be used to identify presymptomatic individuals (probably yes), provide a measure of PD severity (in a limited fashion, but frequently done poorly), investigate pathophysiology of parkinsonian disorders (yes, if done carefully), play a role in differential diagnosis of parkinsonism (not well), and investigate pathology underlying cognitive impairment (yes, in conjunction with postmortem data). Along the way, we clarify several issues about definitions of biomarkers and surrogate endpoints. The goal of this lecture is to provide a basis for interpreting current literature and newly proposed clinical tools in PD. In the end, one should be able to critically distinguish fact from fantasy.
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Affiliation(s)
- Joel S. Perlmutter
- Neurology, Washington University, St. Louis, MO, USA
- Radiology, Washington University, St. Louis, MO, USA
- Anatomy & Neurobiology, Washington University, St. Louis, MO, USA
- Occupational Therapy, Washington University, St. Louis, MO, USA
- Physical Therapy, Washington University, St. Louis, MO, USA
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Diabetes mellitus is independently associated with more severe cognitive impairment in Parkinson disease. Parkinsonism Relat Disord 2014; 20:1394-8. [PMID: 25454317 DOI: 10.1016/j.parkreldis.2014.10.008] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 09/28/2014] [Accepted: 10/07/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND There is increasing interest in interactions between metabolic syndromes and neurodegeneration. Diabetes mellitus (DM) contributes to cognitive impairment in the elderly but its effect in Parkinson disease (PD) is not well studied. OBJECTIVE To investigate effects of comorbid DM on cognition in PD independent from PD-specific primary neurodegenerations. METHODS Cross-sectional study. Patients with PD (n = 148); age 65.6 ± 7.4 years, Hoehn and Yahr stage 2.4 ± 0.6, with (n = 15) and without (n = 133) comorbid type II DM, underwent [(11)C]methyl-4-piperidinyl propionate (PMP) acetylcholinesterase (AChE) PET imaging to assess cortical cholinergic denervation, [(11)C]dihydrotetrabenazine (DTBZ) PET imaging to assess nigrostriatal denervation, and neuropsychological assessments. A global cognitive Z-score was calculated based on normative data. Analysis of covariance was performed to determine cognitive differences between subjects with and without DM while controlling for nigrostriatal denervation, cortical cholinergic denervation, levodopa equivalent dose and education covariates. RESULTS There were no significant differences in age, gender, Hoehn and Yahr stage or duration of disease between diabetic and non-diabetic PD subjects. There was a non-significant trend toward lower years of education in the diabetic PD subjects compared with non-diabetic PD subjects. PD diabetics had significantly lower mean (±SD) global cognitive Z-scores (-0.98 ± 1.01) compared to the non-diabetics (-0.36 ± 0.91; F = 7.78, P = 0.006) when controlling for covariate effects of education, striatal dopaminergic denervation, and cortical cholinergic denervation (total model F = 8.39, P < 0.0001). CONCLUSION Diabetes mellitus is independently associated with more severe cognitive impairment in PD likely through mechanisms other than disease-specific neurodegenerations.
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Dugan LL, Tian L, Quick KL, Hardt JI, Karimi M, Brown C, Loftin S, Flores H, Moerlein SM, Polich J, Tabbal SD, Mink JW, Perlmutter JS. Carboxyfullerene neuroprotection postinjury in Parkinsonian nonhuman primates. Ann Neurol 2014; 76:393-402. [PMID: 25043598 PMCID: PMC4165715 DOI: 10.1002/ana.24220] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 07/02/2014] [Accepted: 07/02/2014] [Indexed: 11/10/2022]
Abstract
OBJECTIVE We evaluated the efficacy of the potent antioxidant C3 to salvage nigrostriatal neuronal function after 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) exposure in nonhuman primates. C3 is a first-in-class functionalized water-soluble fullerene that reduces oxygen radical species associated with neurodegeneration in in vitro studies. However, C3 has not been evaluated as a neuroprotective agent in a Parkinson model in vivo. METHODS Macaque fascicularis monkeys were used in a double-blind, placebo-controlled study design. MPTP-lesioned primates were given systemic C3 (n = 8) or placebo (n = 7) for 2 months starting 1 week after MPTP. Outcomes included in vivo behavioral measures of motor parkinsonism using a validated nonhuman primate rating scale, kinematic analyses of peak upper extremity velocity, positron emission tomography imaging of 6-[(18) F]fluorodopa (FD; reflects dopa decarboxylase) and [(11) C]dihydrotetrabenazine (DTBZ; reflects vesicular monoamine transporter type 2), ex vivo quantification of striatal dopamine, and stereologic counts of tyrosine hydroxylase-immunostained neurons in substantia nigra. RESULTS After 2 months, C3 -treated monkeys had significantly improved parkinsonian motor ratings, greater striatal FD and DTBZ uptake, and higher striatal dopamine levels. None of the C3 -treated animals developed any toxicity. INTERPRETATION Systemic treatment with C3 reduced striatal injury and improved motor function despite administration after the MPTP injury process had begun. These data strongly support further development of C3 as a promising therapeutic agent for Parkinson disease.
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Affiliation(s)
- Laura L. Dugan
- Department of Medicine, University of California, San Diego, CA
- Department of Neurosciences, University of California, San Diego, CA
- Department of Neurology, Washington University, St. Louis, MO
| | - LinLin Tian
- Department of Neurology, Washington University, St. Louis, MO
| | - Kevin L. Quick
- Department of Medicine, University of California, San Diego, CA
- Department of Neurology, Washington University, St. Louis, MO
| | - Josh I. Hardt
- Department of Neurology, Washington University, St. Louis, MO
| | - Morvarid Karimi
- Department of Neurology, Washington University, St. Louis, MO
| | - Chris Brown
- Department of Neurology, Washington University, St. Louis, MO
| | - Susan Loftin
- Department of Neurology, Washington University, St. Louis, MO
| | - Hugh Flores
- Department of Neurology, Washington University, St. Louis, MO
| | - Stephen M. Moerlein
- Department of Radiology, Washington University, St. Louis, MO
- Department of Biochemistry and Molecular Biophysics, Washington University, St. Louis, MO
| | - John Polich
- Biostastics Department, The Scripps Research Institute, La Jolla, CA
| | - Samer D. Tabbal
- Department of Neurology, Washington University, St. Louis, MO
| | - Jonathan W. Mink
- Department of Pediatric Neurology, Rochester University, Rochester, NY
| | - Joel S. Perlmutter
- Department of Neurology, Washington University, St. Louis, MO
- Department of Radiology, Washington University, St. Louis, MO
- Department of Neurobiology, Washington University, St. Louis, MO
- Department of Physical Therapy and Occupational Therapy, Washington University, St. Louis, MO
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Vezoli J, Dzahini K, Costes N, Wilson CRE, Fifel K, Cooper HM, Kennedy H, Procyk E. Increased DAT binding in the early stage of the dopaminergic lesion: a longitudinal [11C]PE2I binding study in the MPTP-monkey. Neuroimage 2014; 102 Pt 2:249-61. [PMID: 25108180 DOI: 10.1016/j.neuroimage.2014.07.059] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Revised: 07/24/2014] [Accepted: 07/30/2014] [Indexed: 12/13/2022] Open
Abstract
The delayed appearance of motor symptoms in PD poses a crucial challenge for early detection of the disease. We measured the binding potential of the selective dopamine active transporter (DAT) radiotracer [(11)C]PE2I in MPTP-treated macaque monkeys, thus establishing a detailed profile of the nigrostriatal DA status following MPTP intoxication and its relation to induced motor and non-motor symptoms. Clinical score and cognitive performance were followed throughout the study. We measured longitudinally in vivo the non-displaceable binding potential to DAT in premotor, motor-recovered (i.e. both non-symptomatic) and symptomatic MPTP-treated monkeys. Results show an unexpected and pronounced dissociation between clinical scores and [(11)C]PE2I-BP(ND) during the premotor phase i.e. DAT binding in the striatum of premotor animals was increased around 20%. Importantly, this broad increase of DAT binding in the caudate, ventral striatum and anterior putamen was accompanied by i) deteriorated cognitive performance, showing a likely causal role of the observed hyperdopaminergic state (Cools, 2011; Cools and D'Esposito, 2011) and ii) an asymmetric decrease of DAT binding at a focal point of the posterior putamen, suggesting that increased DAT is one of the earliest, intrinsic compensatory mechanisms. Following spontaneous recovery from motor deficits, DAT binding was greatly reduced as recently shown in-vivo with other radiotracers (Blesa et al., 2010, 2012). Finally, high clinical scores were correlated to considerably low levels of DAT only after the induction of a stable parkinsonian state. We additionally show that the only striatal region which was significantly correlated to the degree of motor impairments is the ventral striatum. Further research on this period should allow better understanding of DA compensation at premature stages of PD and potentially identify new diagnosis and therapeutic index.
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Affiliation(s)
- Julien Vezoli
- INSERM U846, Stem Cell and Brain Research Institute, Bron, France; Université de Lyon, Université Lyon1, Lyon, France.
| | - Kwamivi Dzahini
- INSERM U846, Stem Cell and Brain Research Institute, Bron, France; Université de Lyon, Université Lyon1, Lyon, France; Primastem (LifeStemCells), Bron, France
| | | | - Charles R E Wilson
- INSERM U846, Stem Cell and Brain Research Institute, Bron, France; Université de Lyon, Université Lyon1, Lyon, France
| | - Karim Fifel
- INSERM U846, Stem Cell and Brain Research Institute, Bron, France; Université de Lyon, Université Lyon1, Lyon, France
| | - Howard M Cooper
- INSERM U846, Stem Cell and Brain Research Institute, Bron, France; Université de Lyon, Université Lyon1, Lyon, France
| | - Henry Kennedy
- INSERM U846, Stem Cell and Brain Research Institute, Bron, France; Université de Lyon, Université Lyon1, Lyon, France
| | - Emmanuel Procyk
- INSERM U846, Stem Cell and Brain Research Institute, Bron, France; Université de Lyon, Université Lyon1, Lyon, France
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Howes OD, Williams M, Ibrahim K, Leung G, Egerton A, McGuire PK, Turkheimer F. Midbrain dopamine function in schizophrenia and depression: a post-mortem and positron emission tomographic imaging study. ACTA ACUST UNITED AC 2013; 136:3242-51. [PMID: 24097339 DOI: 10.1093/brain/awt264] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Elevated in vivo markers of presynaptic striatal dopamine activity have been a consistent finding in schizophrenia, and include a large effect size elevation in dopamine synthesis capacity. However, it is not known if the dopaminergic dysfunction is limited to the striatal terminals of dopamine neurons, or is also evident in the dopamine neuron cell bodies, which mostly originate in the substantia nigra. The aim of our studies was therefore to determine whether dopamine synthesis capacity is altered in the substantia nigra of people with schizophrenia, and how this relates to symptoms. In a post-mortem study, a semi-quantitative analysis of tyrosine hydroxylase staining was conducted in nigral dopaminergic cells from post-mortem tissue from patients with schizophrenia (n = 12), major depressive disorder (n = 13) and matched control subjects (n = 13). In an in vivo imaging study, nigral and striatal dopaminergic function was measured in patients with schizophrenia (n = 29) and matched healthy control subjects (n = 29) using (18)F-dihydroxyphenyl-L-alanine ((18)F-DOPA) positron emission tomography. In the post-mortem study we found that tyrosine hydroxylase staining was significantly increased in nigral dopaminergic neurons in schizophrenia compared with both control subjects (P < 0.001) and major depressive disorder (P < 0.001). There was no significant difference in tyrosine hydroxylase staining between control subjects and patients with major depressive disorder, indicating that the elevation in schizophrenia is not a non-specific indicator of psychiatric illness. In the in vivo imaging study we found that (18)F-dihydroxyphenyl-L-alanine uptake was elevated in both the substantia nigra and in the striatum of patients with schizophrenia (effect sizes = 0.85, P = 0.003 and 1.14, P < 0.0001, respectively) and, in the voxel-based analysis, was elevated in the right nigra (P < 0.05 corrected for family wise-error). Furthermore, nigral (18)F-dihydroxyphenyl-L-alanine uptake was positively related with the severity of symptoms (r = 0.39, P = 0.035) in patients. However, whereas nigral and striatal (18)F-dihydroxyphenyl-L-alanine uptake were positively related in control subjects (r = 0.63, P < 0.001), this was not the case in patients (r = 0.30, P = 0.11). These findings indicate that elevated dopamine synthesis capacity is seen in the nigral origin of dopamine neurons as well as their striatal terminals in schizophrenia, and is linked to symptom severity in patients.
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Affiliation(s)
- Oliver D Howes
- 1 King's College London, Department of Psychosis Studies, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
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