Skip to main content

Advertisement

Log in

Differences in [99mTc]TRODAT-1 SPECT binding to dopamine transporters in patients with multiple system atrophy and Parkinson’s disease

  • Original Article
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Multiple system atrophy (MSA), a disorder causing autonomic dysfunction, parkinsonism, and cerebellar dysfunction, is difficult to differentiate from other movement disorders, particularly early in the course of disease. This study evaluated whether [99mTc]TRODAT-1 binding to the dopamine transporter differentiates MSA from other movement disorders.

Methods

Single-photon emission computed tomographic brain scans were acquired in 25 MSA patients, 48 age-matched controls, and 130 PD patients, 3 h after the injection of 740 MBq (20 mCi) of [99mTc]TRODAT-1. Regions of interest (ROIs) were placed manually on subregions of both basal ganglia and distribution volume ratios (DVRs) were calculated. Regional DVRs were compared between study groups in MSA patients. Student’s t tests were used to compare MSA patients with other study groups. Spearman correlations were used to compare DVRs with NP measures.

Results

Based upon various motor scores, MSA and PD patients had comparable motor impairment, and were significantly impaired compared with controls. Mean DVRs in the basal ganglia of MSA patients were significantly less than those of controls, but generally higher (p<0.05) than in PD patients. In particular, the MSA patients had significantly increased DVRs in the posterior putamen (mean 0.49±0.30) compared with PD patients (0.74±0.25).

Conclusion

Movement disorder patients could be differentiated from controls, but MSA and PD patients could not be easily differentiated from each other. As a group, MSA patients had significantly higher mean [99mTc]TRODAT-1 binding, particularly in the posterior putamen, compared with PD patients and significantly lower binding compared with controls. This may reflect different pathophysiological processes of the two neurodegenerative diseases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Gilman S, Low PA, Quinn N, Albanese A, Ben-Shlomo Y, Fowler CJ, et al. Consensus statement on the diagnosis of multiple system atrophy. J Neurol Sci 1999;163:94–8.

    Article  CAS  PubMed  Google Scholar 

  2. Wenning GK, Braune S. Multiple system atrophy: pathophysiology and management. CNS Drugs 2001;15:839–52.

    CAS  PubMed  Google Scholar 

  3. Tison F, Yekhlef F, Chrysostome V, Balestre E, Quinn NP, Poewe W, Wenning GK. Parkinsonism in multiple system atrophy: natural history, severity (UPDRS-III), and disability assessment compared with Parkinson’s disease. Mov Disord 2002;17:701–92.

    Article  PubMed  Google Scholar 

  4. Lang AE, Lozano AM. Parkinson’s disease. First of two parts. N Engl J Med 1998;339:1044–53.

    Article  CAS  PubMed  Google Scholar 

  5. Lang AE, Lozano AM. Parkinson’s disease. Second of two parts. N Engl J Med 1998;339:1130–43.

    Article  CAS  PubMed  Google Scholar 

  6. Stern MB, Koller WC. Parkinson’s disease. In: Stern MB, Koller WC, editors. Parkinsonian syndromes. New York: Marcel; 1993. p. 3–29.

    Google Scholar 

  7. Jankovic J. Pathophysiology and clinical assessment of motor symptoms in Parkinson’s disease. In: Koller WC, editor. Handbook of Parkinson’s disease. New York: Marcel; 1992. p. 129–57.

    Google Scholar 

  8. Rajput AH, Rozdilsky B, Rajput A. Accuracy of clinical diagnosis in parkinsonism—a prospective study. Can J Neurol Sci 1991;18:275–8.

    CAS  PubMed  Google Scholar 

  9. Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 1992;55:181–4.

    Google Scholar 

  10. Hughes AJ, Daniel SE, Lees AJ. Improved accuracy of clinical diagnosis of Lewy body Parkinson’s disease. Neurology 2001;57:1497–9.

    CAS  PubMed  Google Scholar 

  11. Hughes AJ, Daniel SE, Ben-Shlomo Y, Lees AJ. The accuracy of diagnosis of parkinsonian syndromes in a specialist movement disorder service. Brain 2002;125:861–70.

    Article  PubMed  Google Scholar 

  12. Hughes AJ, Colosimo C, Kleedorfer B, Daniel SE, Lees AJ. The dopaminergic response in multiple system atrophy. Neurol Neurosurg Psychiatry 1992;55:1009–13.

    CAS  Google Scholar 

  13. Mozley PD, Schneider JS, Acton PD, Plossl K, Stern MB, Siderowf A, et al. Binding of [99mTc]TRODAT-1 to dopamine transporters in patients with Parkinson’s disease and in healthy volunteers. J Nucl Med 2000;41:584–9.

    CAS  PubMed  Google Scholar 

  14. Lu CS, Weng YH, Chen MC, Chen RS, Tzen KY, Wey SP, et al. 99mTc-TRODAT-1 imaging of multiple system atrophy. J Nucl Med 2004;45:49–55.

    PubMed  Google Scholar 

  15. Ishikawa T, Dhawan V, Kazumata K, Chaly T, Mandel F, Neumeyer J, et al. Comparative nigrostriatal dopaminergic imaging with iodine-123-βCIT-FP/SPECT and fluorine-18-FDOPA/PET. J Nucl Med 1996;37:1760–5.

    CAS  PubMed  Google Scholar 

  16. Innis RB, Seibyl JP, Scanley BE, Laruelle M, Abi-Dargham A, Wallace E, et al. Single-photon emission computed tomographic imaging demonstrates loss of striatal dopamine transporters in Parkinson’s disease. Proc Natl Acad Sci U S A 1993;90:11965–9.

    CAS  PubMed  Google Scholar 

  17. Kung HF, Kim HJ, Kung MP, Meegala SK, Plossl K, Lee HK. Imaging of dopamine transporters in humans with technetium-99m TRODAT-1. Eur J Nucl Med 1996;23:1527–30.

    CAS  PubMed  Google Scholar 

  18. Mozley PD, Stubbs JB, Plossl K, Dresel SH, Barraclough ED, Alavi A, et al. Biodistribution and dosimetry of TRODAT-1: a technetium-99m tropane for imaging dopamine transporters. J Nucl Med 1998;39:2069–76.

    CAS  PubMed  Google Scholar 

  19. Ward CD, Gibbs WR. Research diagnostic criteria for Parkinson’s disease. In: Streifler MB, Korczyn AD, Melamed E, Youdin MBH, editors. Advances in neurology: anatomy, pathology and therapy. New York: Raven; 1990.

    Google Scholar 

  20. Dresel SH, Kung MP, Plossl K, Meegalla SK, Kung HF. Pharmacological effects of dopaminergic drugs on in vivo binding of [99mTc]TRODAT-1 to the central dopamine transporters in rats. Eur J Nucl Med 1998;25:31–9.

    Article  CAS  PubMed  Google Scholar 

  21. Mozley LH, Gur RC, Mozley PD, Gur RE. Striatal dopamine transporters and cognitive functioning in healthy men and women. Am J Psychiatry 2001;158:1492–9.

    Article  CAS  PubMed  Google Scholar 

  22. Golden CJ, Hammeke TA, Purisch AD. Luria-Nebraska neuropsychological battery manual. Los Angeles: Western Psychological; 1980.

    Google Scholar 

  23. Reitan RM, Wolfson D. The Halstead-Reitan neuropsychological test battery: theory and clinical interpretation. Tuscon: Neuropsychology; 1985.

    Google Scholar 

  24. Harley JP, Leuthold CA, Matthews CG, Bergs LE. Wisconsin neuropsychological test battery t-score norms for older Veterans Administration Medical Center patients. Madison: Matthews; 1980.

    Google Scholar 

  25. Kim HJ, Karp JS, Mozley PD, Yang SO, Moon DH, Kung HF, et al. Stimulating technetium-99m cerebral perfusion studies with a three-dimensional Hoffmann brain phantom: collimator and filter selection in SPECT neuroimaging. Ann Nucl Med 1996;10:153–60.

    CAS  PubMed  Google Scholar 

  26. Chang LT. A method for attenuation correction in radionuclide computed tomography. IEEE Trans Nucl Sci 1978;25:638–43.

    Google Scholar 

  27. Mozley PD, Acton PD, Barraclough ED, Plossl K, Gur RC, Alavi A, et al. Effects of age on dopamine transporters in healthy humans. J Nucl Med 1999;40:1812–7.

    CAS  PubMed  Google Scholar 

  28. Kim YJ, Ichise M, Ballinger JR, Vines D, Erami SS, Tatschida T, Lang AE. Combination of dopamine transporter and D2 receptor SPECT in the diagnostic evaluation of PD, MSA, and PSP. Mov Disord 2002;17:303–2.

    Article  PubMed  Google Scholar 

  29. Berding G, Brucke T, Odin P, Brooks DJ, Kolbe H, Gielow P, et al. [123I]beta-CIT SPECT imaging of dopamine and serotonin transporters in Parkinson’s disease and multiple system atrophy. Nuklearmedizin 2003;42:31–8.

    CAS  PubMed  Google Scholar 

  30. Brooks DJ, Ibanez V, Sawle GV, Quinn N, Lees AJ, Mathias CJ, et al. Differing patterns of striatal 18F-dopa uptake in Parkinson’s disease, multiple system atrophy, and progressive supranuclear palsy. Ann Neurol 1990;28:547–55.

    CAS  PubMed  Google Scholar 

  31. Antonini A, Leenders KL, Vontobel P, Maguire RP, Missimer J, Psylla M, Gunther I. Complementary PET studies of striatal neuronal function in the differential diagnosis between multiple system atrophy and Parkinson’s disease. Brain 1997;120:2187–95.

    Article  PubMed  Google Scholar 

  32. Brooks DJ, Ibanez V, Sawle GV, Playford ED, Quinn N, Mathias CJ, et al. Striatal D2 receptor status in patients with Parkinson’s disease, striatonigral degeneration, and progressive supranuclear palsy. Measured with 11C-raclopride and positron emission tomography. Ann Neurol 1992;31:184–92.

    CAS  PubMed  Google Scholar 

  33. Pirker W, Asenbaum S, Wenger S, Kornhuber J, Angelberger P, Deecke L, et al. Iodine-123-epidepride-SPECT: studies in Parkinson’s disease, multiple system atrophy and Huntington’s disease. J Nucl Med 1997;38:1711–7.

    CAS  PubMed  Google Scholar 

  34. Ghaemi M, Hilker R, Rudolf J, Sobesky J, Heiss WD. Differentiating multiple system atrophy from Parkinson’s disease: contribution of striatal and midbrain MRI volumetry and multi-tracer PET imaging. J Neurol Neurosurg Psychiatry 2002;73:517–23.

    Article  CAS  PubMed  Google Scholar 

  35. Schulz JB, Klockgether T, Petersen D, Jauch M, Muller-Schauenburg W, Spieker S, et al. Multiple system atrophy: natural history, MRI morphology, and dopamine receptor imaging with 123IBZM-SPECT. J Neurol Neurosurg Psychiatry 1994;57:1047–56.

    CAS  PubMed  Google Scholar 

  36. Wenning GK, Tison F, Ben Shlomo Y, Daniel SE, Quinn NP. Multiple system atrophy: a review of 203 pathologically proven cases. Mov Disord 1997;12:133–47.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This research was supported by NIH grant R01 AG-17524. Dr. Siderowf is supported by grant number K-08 HS00004 from the Agency for Healthcare Research and Quality (AHRQ).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Andrew B. Newberg.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Swanson, R.L., Newberg, A.B., Acton, P.D. et al. Differences in [99mTc]TRODAT-1 SPECT binding to dopamine transporters in patients with multiple system atrophy and Parkinson’s disease. Eur J Nucl Med Mol Imaging 32, 302–307 (2005). https://doi.org/10.1007/s00259-004-1667-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-004-1667-x

Keywords

Navigation