Advertisement

Annals of Nuclear Medicine

, Volume 31, Issue 5, pp 390–398 | Cite as

Correlation between clinical symptoms and striatal DAT uptake in patients with DLB

  • Soichiro Shimizu
  • Disuke Hirose
  • Nayuta Namioka
  • Hidekazu Kanetaka
  • Kentaro Hirao
  • Hirokuni Hatanaka
  • Naoto Takenoshita
  • Yoshitsugu Kaneko
  • Yusuke Ogawa
  • Takahiko Umahara
  • Hirofumi Sakurai
  • Haruo Hanyu
Original Article

Abstract

Objective

It is widely known that there is low striatal 123I-FP-CIT dopamine transporter-single photon emission tomography (DAT-SPECT) uptake in patients with dementia with Lewy bodies (DLB). We assessed the correlation between symptom and regional low DAT uptake in the striatum.

Methods

Patients with Alzheimer’s disease (AD) (n = 95) and patients with DLB (n = 133) who underwent DAT-SPECT were enrolled. We examined the correlation between symptoms [cognitive function decline, fluctuations, visual hallucinations, parkinsonism, and REM sleep behavior disorder (RBD)] and regional striatal DAT uptake in the patients with DLB.

Results

When comparing the DLB patients with or without fluctuations, visual hallucinations, or RBD, there were no significant differences in DAT uptake in any regions of the striatum. DLB patients with parkinsonism had significantly lower DAT uptake in entire striatum, entire putamen, and anterior putamen compared to DLB patients without parkinsonism. Moreover, there was weak but significant correlation between severity of parkinsonism and DAT uptake in entire regions of the striatum in patients with DLB. There was no significant correlation between cognitive function and DAT uptake in any regions of the striatum in patients with DLB.

Conclusions

In patients with DLB, only parkinsonism is associated with a reduction in striatal DAT uptake.

Keywords

Dementia with Lewy bodies Parkinsonism 123I-FP-CIT DAT scan Alzheimer’s disease 

Notes

Acknowledgements

We thank M. Takahashi, D. Hakamada, T. Aida, K. Uchida, and H. Hirose of the Department of Nuclear Medicine of Tokyo Medical University for their support and technical assistance. We are also grateful to the medical editors from the Department of International Medical Communications of Tokyo Medical University for editing and reviewing the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Financial Disclosures

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

References

  1. 1.
    McKeith IG, Dickson DW, Lowe J, Emre M, O’Brien JT, Feldman H, et al. Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology. 2005;65:1863–72.CrossRefPubMedGoogle Scholar
  2. 2.
    Benamer TS, Patterson J, Grosset DG, Booij J, de Bruin K, van Royen E, 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;15:503–10.CrossRefGoogle Scholar
  3. 3.
    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.CrossRefPubMedGoogle Scholar
  4. 4.
    Ashkan K, Wallace BA, Mitrofanis J, Pollo C, Brard PY, Fagret D, et al. SPECT imaging, immunohistochemical and behavioural correlations in the primate models of Parkinson’s disease. Parkinsonism Relat Disord. 2007;13:266–75.CrossRefPubMedGoogle Scholar
  5. 5.
    Sossi V, Dinelle K, Topping GJ, Holden JE, Doudet D, Schulzer M, et al. Dopamine transporter relation to levodopa-derived synaptic dopamine in a rat model of Parkinson’s: an in vivo imaging study. J Neurochem. 2009;109:85–92.CrossRefPubMedGoogle Scholar
  6. 6.
    Walker Z, Costa DC, Walker RW, 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.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    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.CrossRefPubMedGoogle Scholar
  8. 8.
    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.CrossRefPubMedGoogle Scholar
  9. 9.
    Papathanasiou ND, Boutsiadis A, Dickson J, Bomanji JB. Diagnostic accuracy of ¹²³I-FP-CIT (DaTSCAN) in dementia with Lewy bodies: a meta-analysis of published studies. Parkinsonism Relat Disord. 2012;18:225–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Tofaris GK, Spillantini MG. Alpha-synuclein dysfunction in Lewy body diseases. Mov Disord. 2005;20(Suppl 12):S37–44.CrossRefPubMedGoogle Scholar
  11. 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.CrossRefPubMedGoogle Scholar
  12. 12.
    Ziebell M, Andersen BB, Thomsen G, Pinborg LH, Karlsborg M, Hasselbalch SG, et al. Predictive value of dopamine transporter SPECT imaging with [¹²³I]PE2I in patients with subtle parkinsonian symptoms. Eur J Nucl Med Mol Imaging. 2012;39:242–50.CrossRefPubMedGoogle Scholar
  13. 13.
    Walker Z, Moreno E, Thomas A, Inglis F, Tabet N, Rainer M, et al. Clinical usefulness of dopamine transporter SPECT imaging with 123I-FP-CIT in patients with possible dementia with Lewy bodies: randomised study. Br J Psychiatry. 2015;206:145–52.CrossRefPubMedGoogle Scholar
  14. 14.
    Brücke T, Asenbaum S, Pirker W, Djamshidian S, Wenger S, Wöber C, et al. Measurement of the dopaminergic degeneration in Parkinson’s disease with [123I] beta-CIT and SPECT. Correlation with clinical findings and comparison with multiple system atrophy and progressive supranuclear palsy. J Neural Transm Suppl. 1997;50:9–24.CrossRefPubMedGoogle Scholar
  15. 15.
    Brooks DJ. PET and SPECT studies in Parkinson’s disease. Baillieres Clin Neurol. 1997;6:69–87.PubMedGoogle Scholar
  16. 16.
    Benamer HT, Patterson J, Wyper DJ, Hadley DM, Macphee GJ, Grosset DG. Correlation of Parkinson’s disease severity and duration with 123I-FP-CIT SPECT striatal uptake. Mov Disord. 2000;15:692–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Morrish PK. How valid is dopamine transporter imaging as a surrogate marker in research trials in Parkinson’s disease? Mov Disord. 2003;18(Suppl 7):S63–70.CrossRefPubMedGoogle Scholar
  18. 18.
    Roselli F, Pisciotta NM, Perneczky R, Pennelli M, Aniello MS, De Caro MF, et al. Severity of neuropsychiatric symptoms and dopamine transporter levels in dementia with Lewy bodies: a 123I-FP-CIT SPECT study. Mov Disord. 2009;24:2097–103.CrossRefPubMedGoogle Scholar
  19. 19.
    Ziebell M, Andersen BB, Pinborg LH, Knudsen GM, Stokholm J, Thomsen G, et al. Striatal dopamine transporter binding does not correlate with clinical severity in dementia with Lewy bodies. J Nucl Med. 2013;54:1072–6.CrossRefPubMedGoogle Scholar
  20. 20.
    Kasanuki K, Iseki E, Ota K, Kondo D, Ichimiya Y, Sato K, et al. (123)I-FP-CIT SPECT findings and its clinical relevance in prodromal dementia with Lewy bodies. Eur J Nucl Med Mol Imaging. 2017;44:358–65.CrossRefPubMedGoogle Scholar
  21. 21.
    Siepel FJ, Dalen I, Grüner R, Booij J, Brønnick KS, Buter TC, et al. Loss of dopamine transporter binding and clinical symptoms in dementia with Lewy bodies. Mov Disord. 2016;31:118–25.CrossRefPubMedGoogle Scholar
  22. 22.
    Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia. Br J Psychiatry. 1982;140:566–72.CrossRefPubMedGoogle Scholar
  23. 23.
    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.CrossRefPubMedGoogle Scholar
  24. 24.
    McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology. 1984;34:939–44.CrossRefPubMedGoogle Scholar
  25. 25.
    Djang DS, Janssen MJ, Bohnen N, Booij J, Henderson TA, Herholz K, et al. SNM practice guideline for dopamine transporter imaging with 123I-ioflupane SPECT 1.0. J Nucl Med. 2012;53:154–63.CrossRefPubMedGoogle Scholar
  26. 26.
    Hachinski VC, Iliff LD, Zilhka E, Du Boulay GH, McAllister VL, Marshall J, et al. Cerebral blood flow in dementia. Arch Neurol. 1975;32:632–7.CrossRefPubMedGoogle Scholar
  27. 27.
    Daniel SE, Lees AJ. Parkinson’s Disease Society Brain Bank, London: overview and research. J Neural Transm Suppl. 1993;39:165–72.PubMedGoogle Scholar
  28. 28.
    Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology. 1967;17:427–42.CrossRefPubMedGoogle Scholar
  29. 29.
    Papathanasiou N, Rondogianni P, Chroni P, Themistocleous M, Boviatsis E, Pedeli X, et al. Interobserver variability, and visual and quantitative parameters of (123)I-FP-CIT SPECT (DaTSCAN) studies. Ann Nucl Med. 2012;26:234–40.CrossRefPubMedGoogle Scholar
  30. 30.
    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.CrossRefPubMedGoogle Scholar
  31. 31.
    Fearnley JM, Lees AJ. Ageing and Parkinson’s disease: substantia nigra regional selectivity. Brain. 1991;114(Pt 5):2283–301.CrossRefPubMedGoogle Scholar
  32. 32.
    Nobili F, Naseri M, De Carli F, Asenbaum S, Booij J, Darcourt J, et al. Automatic semi-quantification of [123I]FP-CIT SPECT scans in healthy volunteers using BasGan version 2: results from the ENC-DAT database. Eur J Nucl Med Mol Imaging. 2013;40:565–73.CrossRefPubMedGoogle Scholar
  33. 33.
    Ala TA, Yang KH, Sung JH, Frey WH. Clinical parkinsonism in dementia patients with substantia nigra Lewy bodies. J Neural Transm (Vienna). 1999;106:47–57.CrossRefGoogle Scholar
  34. 34.
    Costa DC, Walker Z, Walker RW, Fontes FR. Dementia with Lewy bodies versus Alzheimer’s disease: role of dopamine transporter imaging. Mov Disord. 2003;18(Suppl 7):S34–8.CrossRefPubMedGoogle Scholar
  35. 35.
    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.CrossRefPubMedGoogle Scholar
  36. 36.
    Burruss JW, Hurley RA, Taber KH, Rauch RA, Norton RE, Hayman LA. Functional neuroanatomy of the frontal lobe circuits. Radiology. 2000;214:227–30.CrossRefPubMedGoogle Scholar
  37. 37.
    Perneczky R, Drzezga A, Boecker H, Wagenpfeil S, Förstl H, Kurz A, et al. Right prefrontal hypometabolism predicts delusions in dementia with Lewy bodies. Neurobiol Aging. 2009;30:1420–9.CrossRefPubMedGoogle Scholar
  38. 38.
    Rinne JO, Laine M, Kaasinen V, Norvasuo-Heilä MK, Någren K, Helenius H. Striatal dopamine transporter and extrapyramidal symptoms in frontotemporal dementia. Neurology. 2002;58:1489–93.CrossRefPubMedGoogle Scholar
  39. 39.
    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.CrossRefPubMedGoogle Scholar
  40. 40.
    Morgan S, Kemp P, Booij J, Costa DC, Padayachee S, Lee L, et al. Differentiation of frontotemporal dementia from dementia with Lewy bodies using FP-CIT SPECT. J Neurol Neurosurg Psychiatry. 2012;83:1063–70.CrossRefPubMedGoogle Scholar
  41. 41.
    Braak H, Braak E. Neuropathological stageing of Alzheimer-related changes. Acta Neuropathol. 1991;82:239–59.CrossRefPubMedGoogle Scholar
  42. 42.
    Song IU, Kim YD, Cho HJ, Chung SW, Chung YA. An FP-CIT PET comparison of the differences in dopaminergic neuronal loss between idiopathic Parkinson disease with dementia and without dementia. Alzheimer Dis Assoc Disord. 2013;27:51–5.CrossRefPubMedGoogle Scholar
  43. 43.
    Ferman TJ, Smith GE, Boeve BF, Ivnik RJ, Petersen RC, Knopman D, et al. DLB fluctuations: specific features that reliably differentiate DLB from AD and normal aging. Neurology. 2004;62:181–7.CrossRefPubMedGoogle Scholar
  44. 44.
    Kim YK, Yoon IY, Kim JM, Jeong SH, Kim KW, Shin YK, et al. The implication of nigrostriatal dopaminergic degeneration in the pathogenesis of REM sleep behavior disorder. Eur J Neurol. 2010;17:487–92.CrossRefPubMedGoogle Scholar
  45. 45.
    Stoessl AJ. Positron emission tomography in premotor Parkinson’s disease. Parkinsonism Relat Disord. 2007;13(Suppl 3):S421–4.CrossRefPubMedGoogle Scholar
  46. 46.
    Knopman DS, DeKosky ST, Cummings JL, Chui H, Corey-Bloom J, Relkin N, et al. Practice parameter: diagnosis of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2001;56:1143–53.CrossRefPubMedGoogle Scholar
  47. 47.
    McKeith IG, Ballard CG, Perry RH, Ince PG, O’Brien JT, Neill D, et al. Prospective validation of consensus criteria for the diagnosis of dementia with Lewy bodies. Neurology. 2000;54:1050–8.CrossRefPubMedGoogle Scholar

Copyright information

© The Japanese Society of Nuclear Medicine 2017

Authors and Affiliations

  • Soichiro Shimizu
    • 1
  • Disuke Hirose
    • 1
  • Nayuta Namioka
    • 1
  • Hidekazu Kanetaka
    • 1
  • Kentaro Hirao
    • 1
  • Hirokuni Hatanaka
    • 1
  • Naoto Takenoshita
    • 1
  • Yoshitsugu Kaneko
    • 1
  • Yusuke Ogawa
    • 1
  • Takahiko Umahara
    • 1
  • Hirofumi Sakurai
    • 1
  • Haruo Hanyu
    • 1
  1. 1.Department of Geriatric MedicineTokyo Medical UniversityTokyoJapan

Personalised recommendations