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Overview of Dopamine Transporter Imaging in Parkinson’s Disease, Dementia with Lewy Bodies and Other Dementias

  • Neurology of Aging (KS Marder, Section Editor)
  • Published:
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Abstract

123I FP-CIT is a radiotracer that is used in conjunction with single photon emission computed tomography (SPECT) scanning to detect dopaminergic neuron pre-synaptic terminal degeneration, in the striatum (caudate nucleus and putamen) of patients with Parkinson’s disease (PD) and dementia with Lewy bodies (DLB), showing a reduced uptake of this ligand by the dopamine transporters (DaT). This is a licensed diagnostic test in Europe (as DaTSCAN) and in the USA (as DaTscan). Recent work on functional imaging in PD and DLB largely uses the FP-CIT SPECT approach, and this is the focus of our paper, whilst noting that other ligands (e.g. beta-CIT) and imaging techniques such as positron emission tomography (PET) have been used in similar settings.

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References

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  1. Soderlund TA, Dickson JC, Prvulovich E, Ben-Haim S, Kemp P, Booij J, et al. Value of semiquantitative analysis for clinical reporting of 123I-2-beta-carbomethoxy-3beta-(4-iodophenyl)-N-(3-fluoropropyl)nortropane SPECT studies. J Nucl Med. 2013;54:714–22.

    Article  CAS  PubMed  Google Scholar 

  2. Booij J, Speelman JD, Horstink MW, Wolters EC. The clinical benefit of imaging striatal dopamine transporters with [123I]FP-CIT SPET in differentiating patients with presynaptic parkinsonism from those with other forms of parkinsonism. Eur J Nucl Med. 2001;28:266–72.

    Article  CAS  PubMed  Google Scholar 

  3. Borre L, Andreassen TF, Shi L, Weinstein H, Gether U. The second sodium site in the dopamine transporter controls cation permeability and is regulated by chloride. The Journal of biological chemistry. 2014.

  4. Andringa G, Drukarch B, Bol JG, de Bruin K, Sorman K, Habraken JB, et al. Pinhole SPECT imaging of dopamine transporters correlates with dopamine transporter immunohistochemical analysis in the MPTP mouse model of Parkinson's disease. NeuroImage. 2005;26:1150–8.

    Article  PubMed  Google Scholar 

  5. Park E. A new era of clinical dopamine transporter imaging using 123I-FP-CIT. J Nucl Med Technol. 2012;40:222–8.

    Article  PubMed  Google Scholar 

  6. Rinne JO. Nigral degeneration in Parkinson's disease in relation to clinical features. Acta Neurol Scand Suppl. 1991;136:87–90.

    Article  CAS  PubMed  Google Scholar 

  7. Lee CS, Samii A, Sossi V, Ruth TJ, Schulzer M, Holden JE, et al. In vivo positron emission tomographic evidence for compensatory changes in presynaptic dopaminergic nerve terminals in Parkinson's disease. Ann Neurol. 2000;47:493–503.

    Article  CAS  PubMed  Google Scholar 

  8. DaTSCAN INN-Ioflupane. European Medicines Agency. http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Scientific_Discussion/human/000266/WC500035350.pdf Downloaded on 07/09/2014.

  9. Marshall V, Grosset D. Role of dopamine transporter imaging in routine clinical practice. Mov Disord : Off J Mov Disord Soc. 2003;18:1415–23.

    Article  Google Scholar 

  10. Samaranch L, Lorenzo-Betancor O, Arbelo JM, Ferrer I, Lorenzo E, Irigoyen J, et al. PINK1-linked parkinsonism is associated with Lewy body pathology. Brain : J Neurol. 2010;133:1128–42.

    Article  Google Scholar 

  11. Benamer HTS, Patterson J, Wyper DJ, Hadley DM, Macphee GJA, Grosset DG. Correlation of Parkinson's disease severity and duration with 123I-FP-CIT SPECT striatal uptake. Mov Disord. 2000;15:692–8.

    Article  CAS  PubMed  Google Scholar 

  12. Sixel-Doring F, Liepe K, Mollenhauer B, Trautmann E, Trenkwalder C. The role of 123I-FP-CIT-SPECT in the differential diagnosis of Parkinson and tremor syndromes: a critical assessment of 125 cases. J Neurol. 2011;258:2147–54.

    Article  PubMed  Google Scholar 

  13. Zijlmans J, Evans A, Fontes F, Katzenschlager R, Gacinovic S, Lees AJ, et al. [123I] FP-CIT spect study in vascular parkinsonism and Parkinson's disease. Mov Disord. 2007;22:1278–85.

    Article  PubMed  Google Scholar 

  14. Contrafatto D, Mostile G, Nicoletti A, Dibilio V, Raciti L, Lanzafame S, et al. [123I]FP-CIT-SPECT asymmetry index to differentiate Parkinson’s disease from vascular parkinsonism. Acta Neurol Scand. 2012;126:12–6.

    Article  CAS  PubMed  Google Scholar 

  15. Kahraman D, Eggers C, Schicha H, Timmermann L, Schmidt M. Visual assessment of dopaminergic degeneration pattern in 123I-FP-CIT SPECT differentiates patients with atypical parkinsonian syndromes and idiopathic Parkinson's disease. J Neurol. 2012;259:251–60.

    Article  PubMed  Google Scholar 

  16. Pencharz DR, Hanlon P, Chakravartty R, Navalkissoor S, Quigley AM, Wagner T, et al. Automated quantification with BRASS reduces equivocal reporting of DaTSCAN (123I-FP-CIT) SPECT studies. Nucl Med Rev Cent East Eur. 2014;17:65–9.

    PubMed  Google Scholar 

  17. Varrone A, Dickson JC, Tossici-Bolt L, Sera T, Asenbaum S, Booij J, et al. European multicentre database of healthy controls for [123I]FP-CIT SPECT (ENC-DAT): age-related effects, gender differences and evaluation of different methods of analysis. Eur J Nucl Med Mol Imaging. 2013;40:213–27. This study provides a large database of [(123)I]FP-CIT SPECT scans in healthy controls as a reference database for nuclear medicine centres and for clinical trials using [(123)I]FP-CIT SPECT as the imaging marker.

    Article  CAS  PubMed  Google Scholar 

  18. Elbaz A, Bower JH, Maraganore DM, McDonnell SK, Peterson BJ, Ahlskog JE, et al. Risk tables for parkinsonism and Parkinson's disease. J Clin Epidemiol. 2002;55:25–31.

    Article  PubMed  Google Scholar 

  19. Pringsheim T, Jette N, Frolkis A, Steeves TD. The prevalence of Parkinson's disease: A systematic review and meta-analysis. Movement disorders : official journal of the Movement Disorder Society. 2014.

  20. Booij J, Tissingh G, Boer GJ, Speelman JD, Stoof JC, Janssen AG, et al. [123I]FP-CIT SPECT shows a pronounced decline of striatal dopamine transporter labelling in early and advanced Parkinson's disease. J Neurol Neurosurg Psychiatry. 1997;62:133–40.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. DATSCAN. FDA approved drug products. http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.DrugDetails. Accessed on 13/09/2014.

  22. DaTSCAN (I-123 Ioflupane). European Medicines Agency. http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/medicines/000266/human_med_000739.jsp&mid=WC0b01ac058001d125&murl=menus/medicines/medicines.jsp. Accessed on 13/09/2014.

  23. Brigo F, Matinella A, Erro R, Tinazzi M. [(1)(2)(3)I]FP-CIT SPECT (DaTSCAN) may be a useful tool to differentiate between Parkinson's disease and vascular or drug-induced parkinsonisms: a meta-analysis. European journal of neurology : the official journal of the European Federation of Neurological Societies. 2014.

  24. Brajkovic LD, Svetel MV, Kostic VS, Sobic-Saranovic DP, Pavlovic SV, Artiko VM, et al. Dopamine transporter imaging (123)I-FP-CIT (DaTSCAN) SPET in differential diagnosis of dopa-responsive dystonia and young-onset Parkinson's disease. Hell J Nucl Med. 2012;15:134–8.

    PubMed  Google Scholar 

  25. Jakobson Mo S, Linder J, Forsgren L, Holmberg H, Larsson A, Riklund K. Pre- and postsynaptic dopamine SPECT in idiopathic Parkinsonian diseases: a follow-up study. BioMed Res Int. 2013;2013:143532.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Kaasinen V, Kinos M, Joutsa J, Seppanen M, Noponen T. Differences in striatal dopamine transporter density between tremor dominant and non-tremor Parkinson's disease. European journal of nuclear medicine and molecular imaging. 2014.

  27. Moccia M, Pappata S, Picillo M, Erro R, Coda AR, Longo K, et al. Dopamine transporter availability in motor subtypes of de novo drug-naive Parkinson's disease. Journal of neurology. 2014.

  28. Hong JY, Oh JS, Lee I, Sunwoo MK, Ham JH, Lee JE, et al. Presynaptic dopamine depletion predicts levodopa-induced dyskinesia in de novo Parkinson disease. Neurology. 2014;82:1597–604.

    Article  CAS  PubMed  Google Scholar 

  29. Vriend C, Raijmakers P, Veltman DJ, van Dijk KD, van der Werf YD, Foncke EM, et al. Depressive symptoms in Parkinson's disease are related to reduced [123I]FP-CIT binding in the caudate nucleus. J Neurol Neurosurg Psychiatry. 2014;85:159–64.

    Article  PubMed  Google Scholar 

  30. Kiferle L, Ceravolo R, Giuntini M, Linsalata G, Puccini G, Volterrani D, et al. Caudate dopaminergic denervation and visual hallucinations: evidence from a (1)(2)(3)I-FP-CIT SPECT study. Parkinsonism Relat Disord. 2014;20:761–5.

    Article  PubMed  Google Scholar 

  31. Nissen T, Malek N, Grosset KA, Newman EJ, Patterson J, Hadley D, et al. Baseline [(123) I]FP-CIT SPECT (DaTSCAN) severity correlates with medication use at 3 years in Parkinson's disease. Acta Neurol Scand. 2014;129:204–8.

    Article  CAS  PubMed  Google Scholar 

  32. Borghammer P, Knudsen K, Ostergaard K, Danielsen EH, Pavese N, Arveschoug A, et al. Combined DaT imaging and olfactory testing for differentiating parkinsonian disorders. Int J Clin Pract. 2014. This study demonstrates combining two different diagnostic tests increases the posterior odds of making a diagnosis of PD/DLB > 90 % in those with hyposmia and an abnormal 123 I FP-CIT SPECT scan compared to those with normosmia and an 123 I FP-CIT SPECT abnormal scan.

  33. Borghammer P, Knudsen K, Danielsen E, Ostergaard K. False-positive 123I-FP-CIT scintigraphy and suggested dopamine transporter upregulation due to chronic modafinil treatment. Clin Nucl Med. 2014;39:e87–8.

    Article  PubMed  Google Scholar 

  34. Booij J, Kemp P. Dopamine transporter imaging with [(123)I]FP-CIT SPECT: potential effects of drugs. Eur J Nucl Med Mol Imaging. 2008;35:424–38.

    Article  CAS  PubMed  Google Scholar 

  35. 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.

    Article  PubMed  Google Scholar 

  36. Walker Z, Jaros E, Walker RW, Lee L, Costa DC, Livingston G, et al. Dementia with Lewy bodies: a comparison of clinical diagnosis, FP-CIT single photon emission computed tomography imaging and autopsy. J Neurol Neurosurg Psychiatry. 2007;78:1176–81.

    Article  PubMed Central  PubMed  Google Scholar 

  37. McKeith I, O'Brien J, Walker Z, Tatsch K, Booij J, Darcourt J, et al. Sensitivity and specificity of dopamine transporter imaging with 123I-FP-CIT SPECT in dementia with Lewy bodies: a phase III, multicentre study. Lancet Neurol. 2007;6:305–13.

    Article  PubMed  Google Scholar 

  38. Filippi L, Manni C, Pierantozzi M, Brusa L, Danieli R, Stanzione P, et al. 123I-FP-CIT in progressive supranuclear palsy and in Parkinson's disease: a SPECT semiquantitative study. Nucl Med Commun. 2006;27:381–6.

    Article  PubMed  Google Scholar 

  39. Filippi L, Manni C, Pierantozzi M, Brusa L, Danieli R, Stanzione P, et al. 123I-FP-CIT semi-quantitative SPECT detects preclinical bilateral dopaminergic deficit in early Parkinson's disease with unilateral symptoms. Nucl Med Commun. 2005;26:421–6.

    Article  CAS  PubMed  Google Scholar 

  40. Gil-Navarro S, Gelpi E, Lomena F, Montagut N, Llado A, Molinuevo JL, et al. In vivo decreased dopamine transporter uptake in corticobasal degeneration presenting with primary progressive aphasia without parkinsonism. Eur J Neurol : Off J Eur Fed Neurol Soc. 2014;21:e56–7.

    Article  CAS  Google Scholar 

  41. Kaasinen V, Gardberg M, Roytta M, Seppanen M, Paivarinta M. Normal dopamine transporter SPECT in neuropathologically confirmed corticobasal degeneration. J Neurol. 2013;260:1410–1. This paper demonstrates the limits of 123 I FP- CIT SPECT imaging and a normal scan can not be used to refute trhe diagnosis of corticobasal degeneration (atypical parkinsonism) when clinic examination findings clearly demonstrate parkinsonian features.

    Article  PubMed  Google Scholar 

  42. Rissanen E, Kaasinen V, Sonninen P, Roytta M, Paivarinta M. Brain dopamine transporter binding and glucose metabolism in progressive supranuclear palsy-like Creutzfeldt-Jakob disease. Case Rep Neurol. 2014;6:28–33.

    Article  PubMed Central  PubMed  Google Scholar 

  43. Sedaghat F, Gotzamani-Psarrakou A, Dedousi E, Arnaoutoglou M, Psarrakos K, Baloyannis I, et al. Evaluation of dopaminergic function in frontotemporal dementia using I-FP-CIT single photon emission computed tomography. Neurodegener Dis. 2007;4:382–5.

    Article  CAS  PubMed  Google Scholar 

  44. Mossa EP, Niccoli Asabella A, Iuele F, Stabile Ianora AA, Giganti M, Rubini G. [Striatal dopamine transporter levels in patients with REM sleep behavior disorder: assessment with 123I-FP-CIT SPECT]. Recenti Prog Med. 2012;103:500–4.

    PubMed  Google Scholar 

  45. Iranzo A, Valldeoriola F, Lomena F, Molinuevo JL, Serradell M, Salamero M, et al. Serial dopamine transporter imaging of nigrostriatal function in patients with idiopathic rapid-eye-movement sleep behaviour disorder: a prospective study. Lancet Neurol. 2011;10:797–805.

    Article  CAS  PubMed  Google Scholar 

  46. Antonini A, Berto P, Lopatriello S, Tamma F, Annemans L, Chambers M. Cost-effectiveness of 123I-FP-CIT SPECT in the differential diagnosis of essential tremor and Parkinson's disease in Italy. Mov Disord : Off J Mov Disord Soc. 2008;23:2202–9.

    Article  Google Scholar 

  47. Van Laere K, Everaert L, Annemans L, Gonce M, Vandenberghe W, Vander Borght T. The cost effectiveness of 123I-FP-CIT SPECT imaging in patients with an uncertain clinical diagnosis of parkinsonism. Eur J Nucl Med Mol Imaging. 2008;35:1367–76.

    Article  PubMed  Google Scholar 

  48. Grosset DG, Tatsch K, Oertel WH, Tolosa E, Bajaj N, Kupsch A, et al. Safety analysis of 10 clinical trials and for 13 years after first approval of ioflupane 123I injection (DaTscan). J Nucl Med : Off Publ, Soc Nucl Med. 2014;55:1281–7. This is the biggest and longest data analysis of the safety aspects of 123 I FP- CIT SPECT imaging demonstrating it is a safe diagnostic modalityin clinical practice.

    Article  CAS  Google Scholar 

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Conflict of Interest

Naveed Malek declares that he has no conflict of interest.

Donald G. Grosset has received research support from Merz Pharmaceuticals; consultancy fees from AbbVie and Civitas; and honoraria from AbbVie, GE Healthcare, and UCB.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to Naveed Malek.

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This article is part of the Topical Collection on Neurology of Aging

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Malek, N., Grosset, D.G. Overview of Dopamine Transporter Imaging in Parkinson’s Disease, Dementia with Lewy Bodies and Other Dementias. Curr Geri Rep 4, 124–130 (2015). https://doi.org/10.1007/s13670-015-0126-9

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