Der Nuklearmediziner 2007; 30(3): 195-203
DOI: 10.1055/s-2007-981214
Nuklearmedizinische Gehirndiagnostik

© Georg Thieme Verlag Stuttgart · New York

Dopamin-Transporter- und Dopamin-D2-Rezeptor-SPECT bei Erkrankungen der Basalganglien

Dopamine-Transporter SPECT and Dopamine-D2-Receptor SPECT in Basal Ganglia DiseasesS. Hesse1 , H. Barthel1 , A. Seese1 , O. Sabri1
  • 1Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum Leipzig
Further Information

Publication History

Publication Date:
31 August 2007 (online)

Zusammenfassung

Bei den Basalganglien handelt es sich um eine Gruppe von subkortikalen Kernen des extrapyramidalmotorischen Systems, die bei der Ausgestaltung von Bewegungsabläufen eine zentrale Rolle spielen. Zu den Erkrankungen, die mit einer Funktionsstörung der Basalganglien, insbesondere der dopaminergen Neurotransmission, einhergehen, gehören zum Beispiel der Morbus Parkinson, die Chorea Huntington und der Morbus Wilson. Die Positronen-Emissions-Tomografie beziehungsweise Single-Photonen-Emissions-Computer-Tomografie (SPECT) haben nicht nur zum Verständnis der Pathophysiologie dieser Erkrankungen beigetragen, sondern bieten mittlerweile in Fällen schwieriger differenzialdiagnostischer Entscheidungen eine valide Hilfe in der klinischen Routine, so zum Beispiel in der Abgrenzung der Parkinson-Krankheit vom essenziellen Tremor beziehungsweise in der Differenzialdiagnostik atypischer Parkinson-Syndrome. Der vorliegende Artikel fasst die wichtigsten Befunde der Dopamin-Transporter- und Dopamin-Rezeptor-SPECT bei Erkrankungen der Basalganglien zusammen.

Abstract

The basal ganglia comprise a group of subcortical nuclei, which are essential for motor control. Dysfunction of these areas, especially in dopaminergic transmission, results in disordered movement and neurological diseases such as Parkinson's disease, Wilson's disease, or Huntington disease. Positron emission tomography and single photon emission computed tomography (SPECT) have enhanced the understanding of the underlying pathophysiology, but they much more contribute to the early differential diagnosis of patients suffering from Parkinsonian syndrome in routine care. The present article provides dopamine transporter and D2 receptor SPECT findings in selected movement disorders.

Literatur

  • 1 Ballard C G, Aarsland D, McKeith I. et al . Fluctuations in attention: PD dementia vs DLB with parkinsonism.  Neurology. 2002;  59 1714-1720
  • 2 Barthel H, Hermann W, Kluge R. et al . Concordant pre- and postsynaptic deficits of dopaminergic neurotransmission in neurologic Wilson disease.  AJNR Am J Neuroradiol. 2003;  24 234-238
  • 3 Barthel H, Müller U, Wächter T. et al . Multimodale SPECT- und MRT-Bilddatenanalyse zur Verbesserung der Diagnostik des idiopathischen Parkinson-Syndroms.  Radiologe. 2000;  40 863-869
  • 4 Barthel H, Sorger D, Kühn H J. et al . Differential alteration of the nigrostriatal dopaminergic system in Wilson's disease investigated with [123I]β-CIT and high-resolution SPET.  Eur J Nucl Med. 2001;  28 1656-1663
  • 5 Benamer T S, Patterson J, Grosset D G. et al . Accurate differentiation of parkinsonism and essential tremor using visual assessment of [123I]-FP-CIT SPECT imaging: the [123I]-FP-CIT study group.  Mov Disord. 2000;  15 503-510
  • 6 Benamer H T, Patterson J, Wyper D J. et al . Correlation of Parkinson's disease severity and duration with 123I-FP-CIT SPECT striatal uptake.  Mov Disord. 2000;  15 692-698
  • 7 Catafau A M, Tolosa E. DaTSCAN Clinically Uncertain Parkinsonian Syndromes Study Group . Impact of dopamine transporter SPECT using 123I-Ioflupane on diagnosis and management of patients with clinically uncertain parkinsonian syndromes.  Mov Disord. 2004;  19 1175-1182
  • 8 Dengler I, Leukel N, Meuser T, Jost W H. Prospektive Erfassung der direkten und indirekten Kosten des idiopathischen Parkinson-Syndroms.  Nervenarzt. 2006;  77 1204-1209
  • 9 Dodel R C, Höffken H, Möller J C. et al . Dopamine transporter imaging and SPECT in diagnostic work-up of Parkinson's disease: a decision-analytic approach.  Mov Disord. 2003;  18 (Suppl 7) S52-S62
  • 10 Fahn S. Parkinson disease, the effect of levodopa, and the ELLDOPA trial. Earlier vs Later L-DOPA.  Arch Neurol. 1999;  56 529-535
  • 11 Ghaemi M, Rudolf J, Schmulling S. et al . FDG- and Dopa-PET in postencephalitic parkinsonism.  J Neural Transm. 2000;  107 1289-1295
  • 12 Ginovart N, Lundin A, Farde L. et al . PET study of the pre- and post-synaptic dopaminergic markers for the neurodegenerative process in Huntington's disease.  Brain. 1997;  120 503-514
  • 13 Günther P, Storch A, Schwarz J. et al . Basal ganglia involvement of a patient with SCA 17 - a new form of autosomal dominant spinocerebellar ataxia.  J Neurol. 2004;  251 896-897
  • 14 Hesse S, Oehlwein C, Barthel H. et al . Possible impact of dopamine SPECT on decision-making for drug treatment in Parkinsonian syndrome.  J Neural Transm. 2006;  113 1177-1190
  • 15 Hierholzer J, Cordes M, Venz S. et al . Loss of dopamine-D2 receptor binding sites in Parkinsonian plus syndromes.  J Nucl Med. 1998;  39 954-960
  • 16 Holler I, Dirnberger G, Pirker W. et al . Camptocormia in idiopathic Parkinson's disease: [123I ]β-CIT SPECT and clinical characteristics.  Eur Neurol. 2003;  50 118-120
  • 17 Holloway R G, Shoulson I, Fahn S. et al., Parkinson Study Group . Pramipexole vs levodopa as initial treatment for Parkinson disease: a 4-year randomized controlled trial.  Arch Neurol. 2004;  61 1044-1053
  • 18 Hozumi I, Piao Y S, Inuzuka T. et al . Marked asymmetry of putaminal pathology in an MSA-P patient with Pisa syndrome.  Mov Disord. 2004;  19 470-472
  • 19 Ichise M, Ballinger J R, Tanaka F. et al . Age-related changes in D2 receptor binding with iodine-123-iodobenzofuran SPECT.  J Nucl Med. 1998;  39 1511-1518
  • 20 Im J H, Chung S J, Kim J S, Lee M C. Differential patterns of dopamine transporter loss in the basal ganglia of progressive supranuclear palsy and Parkinson's disease: analysis with [123I]IPT single photon emission computed tomography.  J Neurol Sci. 2006;  244 103-139
  • 21 Jain S, Lo S E, Louis E D. Common misdiagnosis of a common neurological disorder: how are we misdiagnosing essential tremor?.  rch Neurol. 2006;  63 1100-1104
  • 22 Jennings D L, Seibyl J P, Oakes D. et al . 123I-β-CIT and single-photon emission computed tomographic imaging vs clinical evaluation in Parkinsonian syndrome: unmasking an early diagnosis.  Arch Neurol. 2004;  61 1224-1229
  • 23 Jeon B, Kim J M, Jeong J M. et al . Dopamine transporter density measured by [123I ]β-CIT single-photon emission computed tomography is normal in dopa-responsive dystonia.  Ann Neurol. 1998;  43 792-800
  • 24 Kishore A, Nygaard T G, de la Fuente-Fernandez R. et al . Striatal D2 receptors in symptomatic and asymptomatic carriers of dopa-responsive dystonia measured with [11C]-raclopride and positron-emission tomography.  Neurology. 1998;  50 1028-1032
  • 25 Kivi A, Trottenberg T, Kupsch A. et al . Levodopa-responsive posttraumatic parkinsonism is not associated with changes of echogenicity of the substantia nigra.  Mov Disord. 2005;  20 258-260
  • 26 Klaffke S, Kuhn A A, Plotkin M. et al . Dopamine transporters, D2 receptors, and glucose metabolism in corticobasal degeneration.  Mov Disord. 2006;  21 1724-1727
  • 27 Knudsen G M, Karlsborg M, Thomsen G. et al . Imaging of dopamine transporters and D2 receptors in patients with Parkinson's disease and multiple system atrophy.  Eur J Nucl Med Mol Imaging. 2004;  31 1631-1638
  • 28 Koch W, Hamann C, Radau P E, Tatsch K. Does combined imaging of the pre- and postsynaptic dopaminergic system increase the diagnostic accuracy in the differential diagnosis of parkinsonism?.  Eur J Nucl Med Mol Imaging. 2007;  , DOI 10.1007/s00259-007-0375-8
  • 29 Koch W, Hamann C, Welsch J. et al . Is iterative reconstruction an alternative to filtered backprojection in routine processing of dopamine transporter SPECT studies?.  J Nucl Med. 2005;  46 1804-1811
  • 30 Koch W, Hornung J, Hamann C. et al . Equipment-indepedent reference values for dopamine transporter imaging with 123I-FP-CIT.  Nuklearmedizin. 2007;  46 107-111
  • 31 Koch W, Radau P E, Hamann C, Tatsch K. Clinical testing of an optimized software solution for an automated, observer-independent evaluation of dopamine transporter SPECT studies.  J Nucl Med. 2005;  46 1109-1118
  • 32 Künstler U, Hohdorf K, Regenthal R. et al . Verkleinerung der Handschriftfläche und D2-Dopaminrezeptorblockade. Ergebnisse unter Behandlung mit typischen und atypischen Neuroleptika.  Nervenarzt. 2000;  71 373-379
  • 33 Leenders K L. Neuroimaging methods applied in Parkinson's disease.  J Neurol. 2004;  251 Suppl 6 VI/7-12
  • 34 Lorberboym M, Djaldetti R, Melamed E. et al . 123I-FP-CIT SPECT imaging of dopamine transporters in patients with cerebrovascular disease and clinical diagnosis of vascular parkinsonism.  J Nucl Med. 2004;  45 1688-1693
  • 35 Louis E D, Levy G, Cote L J. et al . Clinical correlates of action tremor in Parkinson disease.  Arch Neurol. 2001;  58 1630-1634
  • 36 Marek K L, Seibyl J P, Zoghbi S S. et al . [123I]β-CIT/SPECT imaging demonstrates bilateral loss of dopamine transporters in hemi-Parkinson's disease.  Neurology. 1996;  46 231-237
  • 37 Marshall V, Grosset D G. Role of dopamine transporter imaging in the diagnosis of atypical tremor disorders.  Mov Disord. 2003;  18 Suppl 7 S22-S27
  • 38 McKeith I, O'Brien J, Walker Z. et al . Sensitivity and specificity of dopamine transporter imaging with (123)I-FP-CIT SPECT in dementia with Lewy bodies: a phase III, multicentre study.  Lancet Neurol. 2007;  6 305-313
  • 39 McKeith I, Mintzer J, Aarsland D. et al . International Psychogeriatric Association Expert Meeting on DLB. Dementia with Lewy bodies.  Lancet Neurol. 2004;  3 19-28
  • 40 Meara J, Bhowmick B K, Hobson P. Accuracy of diagnosis in patients with presumed Parkinson's disease.  Age Ageing. 1999;  28 99-102
  • 41 Meyer J H, Kruger S, Wilson A A. et al . Lower dopamine transporter binding potential in striatum during depression.  Neuroreport. 2001;  12 4121-4125
  • 42 Meyer P T, Sattler B, Lincke T. et al . Investigating dopaminergic neurotransmission with 123I-FP-CIT SPECT: comparability of modern SPECT systems.  J Nucl Med. 2003;  44 839-845
  • 43 Morton R J, Guy M J, Clauss R. et al . Comparison of different methods of DatSCAN quantification.  Nucl Med Commun. 2005;  26 1139-1146
  • 44 O'Brien J T, Colloby S, Fenwick J. et al . Dopamine transporter loss visualized with FP-CIT SPECT in the differential diagnosis of dementia with Lewy bodies.  Arch Neurol. 2004;  61 919-925
  • 45 O'Sullivan J D, Costa D C, Gacinovic S, Lees A J. SPECT imaging of the dopamine transporter in juvenile-onset dystonia.  Neurology. 2001;  56 266-267
  • 46 Ottaviani S, Tinazzi M, Pasquin I. et al . Comparative analysis of visual and semi-quantitative assessment of striatal [123I]FP-CIT-SPET binding in Parkinson's disease.  Neurol Sci. 2006;  27 397-401
  • 47 Ouchi Y, Nakayama T, Kanno T. et al . In vivo presynaptic and postsynaptic striatal dopamine functions in idiopathic normal pressure hydrocephalus.  J Cereb Blood Flow Metab. 2007;  27 803-810
  • 48 Parkinson's Disease Society .DaTSCAN-SPECT Diagnostic Imaging in the Management of Parkinson's Disease. (A consensus report from the Parkinson's Disease Society.) Darwin Medical Communications Limited, Oxford 2002
  • 49 Pirker W, Djamshidian S, Asenbaum S. et al . Progression of dopaminergic degeneration in Parkinson's disease and atypical parkinsonism: a longitudinal β-CIT SPECT study.  Mov Disord. 2002;  17 45-53
  • 50 Plotkin M, Amthauer H, Klaffke S. et al . Combined 123I-FP-CIT and 123I-IBZM SPECT for the diagnosis of parkinsonian syndromes: study on 72 patients.  J Neural Transm. 2005;  112 677-692
  • 51 Rajput A, Robinson C A, Rajput A H. Essential tremor course and disability: A clinicopathologic study of 20 cases.  Neurology. 2004;  62 932-936
  • 52 Ransmayr G, Seppi K, Donnemiller E. et al . Striatal dopamine transporter function in dementia with Lewy bodies and Parkinson's disease.  Eur J Nucl Med. 2001;  28 1523-1528
  • 53 Scherfler C, Seppi K, Donnemiller E. et al . Voxel-wise analysis of [123I]β-CIT SPECT differentiates the Parkinson variant of multiple system atrophy from idiopathic Parkinson's disease.  Brain. 2005;  128 1605-1612
  • 54 Schrag A, Ben-Shlomo Y, Quinn N. How valid is the clinical diagnosis of Parkinson's disease in the community?.  J Neurol Neurosurg Psychiatry. 2002;  73 529-534
  • 55 Schwarz J, Storch A, Koch W. et al . Loss of dopamine transporter binding in Parkinson's disease follows a single exponential rather than a linear decline.  J Nucl Med. 2004;  45 1694-1697
  • 56 Schwarz J, Tatsch K, Gasser T. et al . [123]IBZM binding predicts dopaminergic responsiveness in patients with parkinsonism and previous dopaminomimetic therapy.  Mov Disord. 1997;  12 898-902
  • 57 Sperfeld A D, Collatz M B, Baier H. et al . FTDP-17: an early-onset phenotype with parkinsonism and epileptic seizures caused by a novel mutation.  Ann Neurol. 1999;  46 708-715
  • 58 Thobois S, Vingerhoets F, Fraix V. et al . Role of dopaminergic treatment in dopamine receptor down-regulation in advanced Parkinson disease: a positron emission tomographic study.  Arch Neurol. 2004;  61 1705-1709
  • 59 Tolosa E, Coelho M, Gallardo M. DAT imaging in drug-induced and psychogenic parkinsonism.  Mov Disord. 2003;  18 Suppl 7 S28-S33
  • 60 van Dyck C H, Seibyl J P, Malison R T. et al . Age-related decline in dopamine transporters: analysis of striatal subregions, nonlinear effects, and hemispheric asymmetries.  Am J Geriatr Psychiatry. 2002;  10 36-43
  • 61 Varrone A, Marek K L, Jennings D. et al . [123I]β-CIT SPECT imaging demonstrates reduced density of striatal dopamine transporters in Parkinson's disease and multiple system atrophy.  Mov Disord. 2001;  16 1023-1032
  • 62 Verstappen C C, Bloem B R, Haaxma C A. et al . Diagnostic value of asymmetric striatal D2 receptor upregulation in Parkinson's disease: an [123I]IBZM and [123I]FP-CIT SPECT study.  Eur J Nucl Med Mol Imaging. 2007;  34 502-507
  • 63 Walker Z, Costa D C, Walker R W. et al . Differentiation of dementia with Lewy bodies from Alzheimer's disease using a dopaminergic presynaptic ligand.  J Neurol Neurosurg Psychiatry. 2002;  73 134-140
  • 64 Walker Z, Jaros E, Walker R W. et al . Dementia with lewy bodies: A comparison of clinical diagnosis, FP-CIT SPECT imaging and autopsy.  J Neurol Neurosurg Psychiatry. 2007;  , Doi:10.1136/jnnp.2006.110122
  • 65 Yeh C B, Lee C H, Chou Y H. et al . Evaluating dopamine transporter activity with 99mTc-TRODAT-1 SPECT in drug-naive Tourette's adults.  Nucl Med Commun. 2006;  27 779-784

Dr. S. Hesse

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