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Advances in Research on Neurodegeneration pp 9–24Cite as

Measurement of the dopaminergic degeneration in Parkinson’s disease with [123I]β-CIT and SPECT

Correlation with clinical findings and comparison with multiple system atrophy and progessive supranuclear palsy

  • Conference paper

Part of the book series: Journal of Neural Transmission. Supplementa ((NEURAL SUPPL,volume 50))

Summary

The cocaine derivative [123I]β-CIT binds with high affinity to dopamine uptake sites in the striatum and can be used to visualize dopaminergic nerve terminals in vivo in the human brain with SPECT. It has been validated that the calculation of a simple ratio of specific/nondisplaceable binding during a period of binding-equilibrium in the striatum about 20 hrs after bolus injection of the tracer gives a strong and reliable index of the binding potential of dopamine uptake sites. Previous studies have shown that the dopaminergic deficit in patients with Parkinson’s disease (PD) can clearly be visualized and quantified using this method. Our own results in a group of 113 patients with PD demonstrate a 45% loss of striatal [123I]β-CIT binding in comparison to age corrected control values. Highly significant correlations of SPECT findings with clinical data obtained from the UPDRS rating scale such as akinesia, rigidity, axial symptoms and activities of daily living are demonstrated, while no correlation is found with tremor. The signal loss in a region comprising the whole striatum ranges from 35% in Hoehn/Yahr stage I to over 72% in stage V and is highly significantly correlated to the different stages of disease severity. A comparison of [123I]β-CIT binding in the striatum contralaterally and ipsilaterally to the affected body side in 29 patients with hemiparkinson shows a loss of striatal binding of 41% contralaterally and 30% ipsilaterally. Results from subregional analyses in caudate and putamen show relative sparing of the caudate nucleus in PD. Data in 9 patients with multiple system atrophy (MSA) and 4 patients with progressive supranuclear palsy (PSP) are similar to the findings in PD although the differences between caudate and putamen are somewhat less marked.

These data demonstrate that the dopaminergic nerve cell loss in PD and other disorders with a dopaminergic lesion can be quantified with [123I]β-CIT and SPECT and that hopefully a preclinical or very early diagnosis is made possible. Such studies might also open the way for a better evaluation of neuroprotective strategies in PD. It does not seem to be possible however to differentiate PD and MSA or PSP with this method in individual cases.

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  1. Prof. Dr. T. Brücke

    Present address: Universitätsklinik für Neurologie, Währinger Gürtel 18-20, A-1090, Wien, Austria

Authors and Affiliations

  1. University Clinic for Neurology, Vienna, Austria

    Prof. Dr. T. Brücke, S. Asenbaum, W. Pirker, S. Djamshidian, S. Wenger, Ch. Wöber & Ch. Müller

  2. University Clinic for Nuclear Medicine, Vienna, Austria

    Prof. Dr. T. Brücke & S. Asenbaum

  3. University Clinic for Rudolfstiftung Hospital, Vienna, Austria

    I. Podreka

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  1. Prof. Dr. T. Brücke
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Editors and Affiliations

  1. Department of Psychiatry, University of Würzburg, Germany

    P. Riederer

  2. Neurodegenerative Disorders Centre, University of British Columbia, Vancouver, Canada

    D. B. Calne

  3. Clinical Research, Schering AG, Berlin, Germany

    R. Horowski

  4. Department of Neurology, Juntendo University, Tokyo, Japan

    Y. Mizuno

  5. Department of Neurology, University of Innsbruck, Austria

    W. Poewe

  6. Faculty of Medicine, Institute of Pharmacology, Technion — Israel Institute of Technology, Haifa, Israel

    M. B. H. Youdim

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Brücke, T. et al. (1997). Measurement of the dopaminergic degeneration in Parkinson’s disease with [123I]β-CIT and SPECT. In: Riederer, P., Calne, D.B., Horowski, R., Mizuno, Y., Poewe, W., Youdim, M.B.H. (eds) Advances in Research on Neurodegeneration. Journal of Neural Transmission. Supplementa, vol 50. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6842-4_2

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