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16.05.2019 | Original Article

Extrastriatal dopaminergic and serotonergic pathways in Parkinson’s disease and in dementia with Lewy bodies: a 123I-FP-CIT SPECT study

Zeitschrift:
European Journal of Nuclear Medicine and Molecular Imaging
Autoren:
Andrea Pilotto, Francesca Schiano di Cola, Enrico Premi, Roberto Grasso, Rosanna Turrone, Stefano Gipponi, Andrea Scalvini, Elisabetta Cottini, Barbara Paghera, Valentina Garibotto, Maria Cristina Rizzetti, Laura Bonanni, Barbara Borroni, Silvia Morbelli, Flavio Nobili, Ugo Paolo Guerra, Daniela Perani, Alessandro Padovani
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00259-019-04324-5) contains supplementary material, which is available to authorized users.

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Abstract

Purpose

The aim of the study was to evaluate extrastriatal dopaminergic and serotonergic pathways in patients with Parkinson’s disease (PD) and dementia with Lewy bodies (DLB) using 123I-FP-CIT SPECT imaging.

Methods

The study groups comprised 56 PD patients without dementia, 41 DLB patients and 54 controls. Each patient underwent a standardized neurological examination and 123I-FP-CIT SPECT. Binding in nigrostriatal and extrastriatal regions of interest was calculated in each patient from spatially normalized images. The occipital-adjusted specific to nondisplaceable binding ratio (SBR) in the different regions was compared among the PD patients, DLB patients and controls adjusting for the effects of age, sex, disease duration and serotonergic/dopaminergic treatment. Covariance analysis was used to determine the correlates of local and long-distance regions with extrastriatal 123I-FP-CIT deficits.

Results

Both PD and DLB patients showed lower 123I-FP-CIT SPECT SBR in several regions beyond the nigrostriatal system, especially the insula, cingulate and thalamus. DLB patients showed significantly lower 123I-FP-CIT SBR in the thalamus than controls and PD patients. Thalamic and cingulate 123I-FP-CIT SBR deficits were correlated, respectively, with limbic serotonergic and widespread cortical monoaminergic projections only in DLB patients but exhibited only local correlations in PD patients and controls.

Conclusion

PD and DLB patients both showed insular dopamine deficits, whereas impairment of thalamic serotonergic pathways was specifically associated with DLB. Longitudinal studies are necessary to determine the clinical value of the assessment of extrastriatal 123I-FP-CIT SPECT.

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Zusatzmaterial
High resolution image (TIF 3944 kb)
259_2019_4324_MOESM1_ESM.tif
ESM 2 (DOCX 17 kb)
259_2019_4324_MOESM2_ESM.docx
Literatur
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