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Dopaminergic denervation using [123I]-FPCIT and pain in Parkinson’s disease: a correlation study

  • Neurology and Preclinical Neurological Studies - Original Article
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Abstract

In patients with Parkinson’s disease (PD), abnormal activations of nociceptive brain areas and lowered pain thresholds were reported, probably reflecting a central modification of pain processing. The aim of this study was to investigate the possible correlation between the striatal and extrastriatal dopaminergic system and pain threshold in PD patients. We included 25 PD patients with various intensities of central pain (visual analog scale). Subjective pain threshold (thermotest) and a motor examination (UPDRS III) were performed. Patients underwent SPECT imaging with [123I]-FP-CIT. We analyzed the correlation between [123I]-FP-CIT binding and subjective pain threshold, using a simple linear regression model for striatal uptake and a voxel-based approach for extrastriatal uptake. The covariables were age, sex, duration of PD, and UPDRS motor score. A pain matrix mask was also used to identify clusters in relation with pain matrix. Striatal analysis revealed that [123I]-FP-CIT binding was negatively correlated with age (p = 0.02), duration of PD (p = 0.0002) and UPDRS motor score (p = 0.006), but no correlation with pain threshold was observed. The extrastriatal analysis showed a positive correlation between [123I]-FP-CIT binding and subjective heat pain threshold for the left posterior cingulate cortex (PCC) (p < 0.001) and negative correlations for the right secondary visual cortex (p < 0.001) and left insula (p < 0.001). When applying the pain matrix mask, correlations remained significant only in the left PCC and the left insula. We suggest that pain perception abnormalities in PD are not directly related to striatal dopaminergic dysfunction. Painful sensations may be related to extrastriatal monoaminergic systems.

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Acknowledgements

This work was supported by a Toulouse University Hospital grant.

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Authors and Affiliations

  1. ToNIC, Toulouse Neuroimaging Center, University of Toulouse, Inserm, UPS, Toulouse, France

    Estelle Dellapina, Jean Pellaprat, Djilali Adel, Jerome Llido, Anne Sophie Salabert, Fabienne Ory-Magne, Pierre Payoux & Christine Brefel-Courbon

  2. Department of Neurology, University Hospital of Toulouse, Toulouse, France

    Estelle Harroch, Fabienne Ory-Magne & Christine Brefel-Courbon

  3. CATI, Paris, France

    Jean Baptiste Martini

  4. INSERM, U 1146 LIB, Paris, France

    Jean Baptiste Martini & Aurélie Kas

  5. Department of Nuclear Medicine, Pitié-Salpêtrière Hospital, APHP, Paris, France

    Aurélie Kas

  6. Department of Nuclear Medicine, University Hospital of Toulouse, Toulouse, France

    Anne Sophie Salabert & Pierre Payoux

  7. Department of Clinical Pharmacology, Service de Pharmacologie Médicale et Clinique, Faculty of Medicine, Toulouse, France

    Christine Brefel-Courbon

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  1. Estelle Dellapina
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  2. Jean Pellaprat
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  3. Djilali Adel
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  4. Jerome Llido
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  7. Aurélie Kas
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  8. Anne Sophie Salabert
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  9. Fabienne Ory-Magne
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  10. Pierre Payoux
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  11. Christine Brefel-Courbon
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Correspondence to Christine Brefel-Courbon.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of the national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Dellapina, E., Pellaprat, J., Adel, D. et al. Dopaminergic denervation using [123I]-FPCIT and pain in Parkinson’s disease: a correlation study. J Neural Transm 126, 279–287 (2019). https://doi.org/10.1007/s00702-019-01974-5

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  • DOI: https://doi.org/10.1007/s00702-019-01974-5

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