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Different loss of dopamine transporter according to subtype of multiple system atrophy

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to evaluate whether striatal dopamine transporter (DAT) loss as measured by 18F-fluorinated-N-3-fluoropropyl-2-b-carboxymethoxy-3-b-(4-iodophenyl) nortropane ([18F]FP-CIT) PET differs according to the metabolic subtype of multiple system atrophy (MSA) as assessed by [18F]FDG PET.

Methods

This retrospective study included 50 patients with clinically diagnosed MSA who underwent [18F]FP-CIT and [18F]FDG brain PET scans. The PET images were analysed using 12 striatal subregional volume-of-interest templates (bilateral ventral striatum, anterior caudate, posterior caudate, anterior putamen, posterior putamen, and ventral putamen). The patients were classified into three metabolic subtypes according to the [18F]FDG PET findings: MSA-Pm (striatal hypometabolism only), MSA-mixedm (both striatal and cerebellar hypometabolism), and MSA-Cm (cerebellar hypometabolism only). The subregional glucose metabolic ratio (MRgluc), subregional DAT binding ratio (BRDAT), and intersubregional ratio (ISRDAT; defined as the BRDAT ratio of one striatal subregion to that of another striatal subregion) were compared according to metabolic subtype.

Results

Of the 50 patients, 13 presented with MSA-Pm, 16 presented with MSA-mixedm, and 21 presented with MSA-Cm. The BRDAT of all striatal subregions in the MSA-Pm and MSA-mixedm groups were significantly lower than those in the MSA-Cm group. The posterior putamen/anterior putamen ISRDAT and anterior putamen/ventral striatum ISRDAT in the MSA-Pm and MSA-mixedm groups were significantly lower than those in the MSA-Cm group.

Conclusion

Patients with MSA-Pm and MSA-mixedm showed more severe DAT loss in the striatum than patients with MSA-Cm. Patients with MSA-Cm had more diffuse DAT loss than patients with MSA-Pm and MSA-mixedm.

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Compliance with ethical standards

ᅟ

Funding

This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korea Government (MSIP) (no. 2014R1A5A2010008) and by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (HI14C2768).

Conflicts of interest

None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and complied with the principles of the 1964 Declaration of Helsinki. No formal consent is required for this type of study.

Informed consent

The institutional review board of Asan Medical Center granted exempt status for this retrospective study and waived the need for informed consent.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea

    Hae Won Kim

  2. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea

    Jae Seung Kim, Minyoung Oh, Jungsu S. Oh, Sang Joo Lee & Seung Jun Oh

  3. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Sun Ju Chung & Chong Sik Lee

  4. Department of Nuclear Medicine, School of Medicine, Keimyung University, 56 Dalseong-ro, Jung-gu, Daegu, 700-712, Republic of Korea

    Hae Won Kim

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  1. Hae Won Kim
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Correspondence to Jae Seung Kim.

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Kim, H.W., Kim, J.S., Oh, M. et al. Different loss of dopamine transporter according to subtype of multiple system atrophy. Eur J Nucl Med Mol Imaging 43, 517–525 (2016). https://doi.org/10.1007/s00259-015-3191-6

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  • DOI: https://doi.org/10.1007/s00259-015-3191-6

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