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Progression of dopaminergic degeneration in dementia with Lewy bodies and Parkinson’s disease with and without dementia assessed using 123I-FP-CIT SPECT

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Abstract

Purpose

The objective of this study was to investigate the rate of progression of nigrostriatal dopaminergic loss in subjects with dementia with Lewy bodies (DLB), Parkinson’s disease (PD) and PD with dementia (PDD) using serial 123I-FP-CIT SPECT imaging. We hypothesised that striatal rates of decline in patients would be greater than in controls, and that DLB and PDD would show similar rates, reflecting the similarity in neurobiological mechanisms of dopaminergic loss between the two disorders.

Methods

We studied 20 patients with DLB, 20 with PD, 15 with PDD and 22 healthy age-matched controls. Semi-automated region of interest (ROI) analysis was performed on both baseline and repeat scans for each subject and mean striatal uptake ratios (caudate, anterior and posterior putamen) were calculated.

Results

Rates of decline in striatal binding between groups were assessed using ANCOVA. Significant differences between patients and controls were observed in caudate (DLB, PD, PDD, p≤0.01), anterior putamen (DLB, PDD, p≤0.05; PD, p=0.07) and posterior putamen (DLB, PD, PDD, p<0.006). Rates of decline were similar between DLB, PD and PDD.

Conclusion

In conclusion, this is the first study to show that significant progressive dopaminergic loss occurs in DLB and PDD using serial 123I-FP-CIT SPECT. Dementia severity and motor impairment were correlated with decline, suggesting that dopaminergic loss may play an important role in cognitive as well as motor features.

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References

  1. Rahkonen T, Eloniemi-Sulkava U, Rissanen S, Vatanen A, Viramo P, Sulkava R. Dementia with Lewy bodies according to the consensus criteria in a general population aged 75 years or older. J Neurol Neurosurg Psychiatry 2003;74:720–4

    Google Scholar 

  2. Rabins P, Blacker D, Bland W, BrightLong L, Cohen E, Katz I, et al. Practice guideline for the treatment of patients with Alzheimer’s disease and other dementias of late life. Am J Psychiatr 1997;154:1–39

    Google Scholar 

  3. de Rijk MC, Tzourio C, Breteler MM, Dartigues JF, Amaducci L, Lopez-Pousa S, et al. Prevalence of parkinsonism and Parkinson’s disease in Europe: the EUROPARKINSON collaborative study. European community concerted action on the epidemiology of Parkinson’s disease. J Neurol Neurosurg Psychiatry 1997;62:10–5

    Google Scholar 

  4. Aarsland D, Andersen K, Larsen JP, Lolk A, Nielsen H, Kragh-Sorensen P. Risk of dementia in Parkinson’s disease: a community-based, prospective study. Neurology 2001;56:730–6

    CAS  PubMed  Google Scholar 

  5. Aarsland D, Litvan I, Salmon D, Galasko D, Wentzel-Larsen T, Larsen JP. Performance on the dementia rating scale in Parkinson’s disease with dementia and dementia with Lewy bodies: comparison with progressive supranuclear palsy and Alzheimer’s disease. J Neurol Neurosurg Psychiatry 2003;74:1215–20

    Google Scholar 

  6. Noe E, Marder K, Bell KL, Jacobs DM, Manly JJ, Stern Y. Comparison of dementia with Lewy bodies to Alzheimer’s disease and Parkinson’s disease with dementia. Mov Disord 2004;19:60–7

    Article  PubMed  Google Scholar 

  7. Burn DJ, Rowan EN, Minett T, Sanders J, Myint P, Richardson J, Thomas A, Newby J, Reid J, O’Brien JT, McKeith IG. Extrapyramidal features in Parkinson’s disease with and without dementia and dementia with Lewy bodies: a cross-sectional comparative study. Mov Disord 2003;18:884–9

    Article  PubMed  Google Scholar 

  8. Bonelli SB, Ransmayr G, Steffelbauer M, Lukas T, Lampl C, Deibl M. l-Dopa responsiveness in dementia with Lewy bodies, Parkinson disease with and without dementia. Neurology 2004;63:376–8

    CAS  PubMed  Google Scholar 

  9. O’Brien JT, Colloby S, Fenwick J, Williams ED, Firbank M, Burn D, et al. Dopamine transporter loss visualized with FP-CIT SPECT in the differential diagnosis of dementia with Lewy bodies. Arch Neurol 2004;61:919–25

    Google Scholar 

  10. Donnemiller E, Heilmann J, Wenning GK, Berger W, Decristoforo C, Moncayo R, et al. Brain perfusion scintigraphy with 99mTc-HMPAO orv99mTc-ECD and 123I-beta-CIT single-photon emission tomography in dementia of the Alzheimer-type and diffuse Lewy body disease. Eur J Nucl Med 1997;24:320–5

    Google Scholar 

  11. Walker Z, Costa DC, Walker RW, Lee L, Livingston G, Jaros E, et al. Striatal dopamine transporter in dementia with Lewy bodies and Parkinson disease: a comparison. Neurology 2004;62:1568–72

    CAS  PubMed  Google Scholar 

  12. Walker Z, Costa DC, Walker RWH, Shaw K, Gacinovic S, Stevens T, et al. Differentiation of dementia with Lewy bodies from Alzheimer’s disease using a dopaminergic presynaptic ligand. J Neurol Neurosurg Psychiatry 2002;73:134–40

    Google Scholar 

  13. Morrish PK, Rakshi JS, Bailey DL, Sawle GV, Brooks DJ. Measuring the rate of progression and estimating the preclinical period of Parkinson’s disease with [18F]dopa PET. J Neurol Neurosurg Psychiatry 1998;64:314–9

    Google Scholar 

  14. Nurmi E, Bergman J, Eskola O, Solin O, Vahlberg T, Sonninen P, et al. Progression of dopaminergic hypofunction in striatal subregions in Parkinson’s disease using [18F]CFT PET. Synapse 2003;48:109–15

    Article  CAS  PubMed  Google Scholar 

  15. Nurmi E, Ruottinen HM, Bergman J, Haaparanta M, Solin O, Sonninen P, Rinne JO. Rate of progression in Parkinson’s disease: a 6-F-18 fluoro-l-dopa PET study. Mov Disord 2001;16:608–15

    Article  CAS  PubMed  Google Scholar 

  16. Nurmi E, Ruottinen HM, Kaasinen V, Bergman J, Haaparanta M, Solin O, et al. Progression in Parkinson’s disease: a positron emission tomography study with a dopamine transporter ligand [18F]CFT. Ann Neurol 2000;47:804–8

    Article  CAS  PubMed  Google Scholar 

  17. Morrish PK, Rakshi JS, Bailey DL, Sawle GV, Brooks DJ. Measuring the rate of progression and estimating the preclinical period of Parkinson’s disease with [18F]dopa PET. J Neurol Neurosurg Psychiatry 1998;64:314–9

    Google Scholar 

  18. Chouker M, Tatsch K, Linke R, Pogarell O, Hahn K, Schwarz J. Striatal dopamine transporter binding in early to moderately advanced Parkinson’s disease: monitoring of disease progression over 2 years. Nucl Med Commun 2001;22:721–5

    Article  CAS  PubMed  Google Scholar 

  19. Marek K, Innis R, van Dyck C, Fussell B, Early M, Eberly S, et al. I-123 beta-CIT SPECT imaging assessment of the rate of Parkinson’s disease progression. Neurology 2001;57:2089–94

    CAS  PubMed  Google Scholar 

  20. Winogrodzka A, Bergmans P, Booij J, van Royen EA, Stoof JC, Wolters EC. I-123 beta-CIT SPECT is a useful method for monitoring dopaminergic degeneration in early stage Parkinson’s disease. J Neurol Neurosurg Psychiatry 2003;74:294–8

    Google Scholar 

  21. Pirker W, Djamshidian S, Asenbaum S, Gerschlager W, Tribl G, Hoffmann M, et al. Progression of dopaminergic degeneration in Parkinson’s disease and atypical parkinsonism: a longitudinal beta-CIT SPECT study. Mov Disord 2002;17:45–53

    Article  PubMed  Google Scholar 

  22. Staffen W, Mair A, Unterrainer J, Trinka E, Ladurner G. Measuring the progression of idiopathic Parkinson’s disease with [123I]beta-CIT SPECT. J Neural Transm 2000;107:543–52

    Article  CAS  PubMed  Google Scholar 

  23. Colloby SJ, O’Brien JT, Fenwick JD, Firbank MJ, Burn DJ, McKeith IG, et al. The application of statistical parametric mapping to 123I-FP-CIT SPECT in dementia with Lewy bodies, Alzheimer’s disease and Parkinson’s disease. Neuroimage 2004;23:956–66

    Article  PubMed  Google Scholar 

  24. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–98

    Article  CAS  PubMed  Google Scholar 

  25. Roth M, Tym E, Mountjoy CQ, Huppert FA, Hendrie H, Verma S, Goddard R. CAMDEX. A standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. Br J Psychiatry 1986;149:698–709

    CAS  PubMed  Google Scholar 

  26. Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994;44:2308–14

    Google Scholar 

  27. Fahn S, Elton RL, Marsden CD, Goldstein M. Unified Parkinson’s disease rating scale. In: Fahn S, Marsden C, Calne D, editors. Recent developments in Parkinson’s disease. New York: Macmillan; 1987. p. 153–63

  28. McKeith IG, Galasko D, Kosaka K, Perry EK, Dickson DW, Hansen LA, et al. Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology 1996;47:1113–24

    CAS  PubMed  Google Scholar 

  29. Gibb WRG, Lees AJ. The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson’s disease. J Neurol Neurosurg Psychiatry 1988;51:745–52

    Google Scholar 

  30. Innis RB, Marek KL, Sheff K, Zoghbi S, Castronuovo J, Feigin A, et al. Effect of treatment with l-dopa/carbidopa or l-selegiline on striatal dopamine transporter SPECT imaging with [123I]beta-CIT. Mov Disord 1999;14:436–42

    Article  CAS  PubMed  Google Scholar 

  31. Ahlskog JE, Uitti RJ, O’Connor MK, Maraganore DM, Matsumoto JY, Stark KF, et al. The effect of dopamine agonist therapy on dopamine transporter imaging in Parkinson’s disease. Mov Disord 1999;14:940–6

    Article  CAS  PubMed  Google Scholar 

  32. Collins DL, Neelin P, Peters TM, Evans AC. Automatic 3D intersubject registration of MR volumetric data in standardized Talairach space. J Comput Assist Tomogr 1994;18:192–205

    CAS  PubMed  Google Scholar 

  33. Whone AL, Watts RL, Stoessl AJ, Davis M, Reske S, Nahmias C, et al. Slower progression of Parkinson’s disease with ropinirole versus levodopa: the REAL-PET study. Ann Neurol 2003;54:93–101

    Article  CAS  PubMed  Google Scholar 

  34. Marek K, Innis R, van Dyck C, Fussell B, Early M, Eberly S, et al. I-123 beta-CIT SPECT imaging assessment of the rate of Parkinson’s disease progression. Neurology 2001;57:2089–94

    CAS  PubMed  Google Scholar 

  35. Winogrodzka A, Bergmans P, Booij J, van Royen EA, Stoof JC, Wolters EC. I-123 beta-CIT SPECT is a useful method for monitoring dopaminergic degeneration in early stage Parkinson’s disease. J Neurol Neurosurg Psychiatry 2003;74:294–8

    Google Scholar 

  36. Nurmi E, Ruottinen HM, Bergman J, Haaparanta M, Solin O, Sonninen P, et al. Rate of progression in Parkinson’s disease: a 6- F-18 fluoro-l-dopa PET study. Mov Disord 2001;16:608–15

    Article  CAS  PubMed  Google Scholar 

  37. Pirker W, Holler I, Gerschlager W, Asenbaum S, Zettinig G, Brucke T. Measuring the rate of progression of Parkinson’s disease over a 5-year period with beta-CIT SPECT. Mov Disord 2003;18:1266–72

    Article  PubMed  Google Scholar 

  38. Seibyl JP, Laruelle M, van Dyck CH, Wallace E, Baldwin RM, Zoghbi S, et al. Reproducibility of iodine-123-beta-CIT SPECT brain measurement of dopamine transporters. J Nucl Med 1996;37:222–8

    CAS  PubMed  Google Scholar 

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Acknowledgements

We would like to express gratitude to the Medical Research Council for financial support and Amersham plc (GE Healthcare, formerly Amersham Health) for provision of the FP-CIT ligand used in this study. We thank staff at the Regional Medical Physics Department, Newcastle General Hospital for undertaking SPECT scanning and all members of the Lewy body research team who helped with patient recruitment and assessment.

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Authors and Affiliations

  1. Institute for Ageing and Health, Wolfson Research Centre, Newcastle General Hospital, Newcastle University, Westgate Road, Newcastle upon Tyne, NE4 6BE, UK

    Sean J. Colloby, Ian G. McKeith & John T. O’Brien

  2. Regional Medical Physics Department, Sunderland Royal Hospital, Sunderland, UK

    E. David Williams

  3. Department of Neurology, Newcastle General Hospital, Newcastle upon Tyne, UK

    David J. Burn

  4. Regional Medical Physics Department, Royal Victoria Infirmary, Newcastle upon Tyne, UK

    Jim J. Lloyd

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  1. Sean J. Colloby
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  2. E. David Williams
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  6. John T. O’Brien
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Correspondence to Sean J. Colloby.

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Colloby, S.J., Williams, E.D., Burn, D.J. et al. Progression of dopaminergic degeneration in dementia with Lewy bodies and Parkinson’s disease with and without dementia assessed using 123I-FP-CIT SPECT. Eur J Nucl Med Mol Imaging 32, 1176–1185 (2005). https://doi.org/10.1007/s00259-005-1830-z

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  • DOI: https://doi.org/10.1007/s00259-005-1830-z

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