Skip to main content
Top
Published in: European Journal of Nuclear Medicine and Molecular Imaging 6/2005

01-06-2005 | Original Article

Early-stage [123I]β-CIT SPECT and long-term clinical follow-up in patients with an initial diagnosis of Parkinson’s disease

Authors: Diederick Stoffers, Jan Booij, Lisette Bosscher, Ania Winogrodzka, Erik C. Wolters, Henk W. Berendse

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 6/2005

Login to get access

Abstract

Purpose

Previous studies using dopamine transporter single-photon emission computed tomography (SPECT) to try and distinguish between patients with idiopathic Parkinson’s disease (IPD) and patients with atypical parkinsonian syndromes (APS) have mainly focussed on patients with an already established clinical diagnosis of several years’ duration. Differences in the pattern of striatal involvement between IPD and APS have been found in only few studies. We hypothesized that distinguishing SPECT features might be most pronounced at an early disease stage, and the purpose of the present study was to investigate this hypothesis.

Methods

The study included 72 patients with an initial clinical diagnosis of IPD, supported by decreased striatal [123I]β-CIT binding on baseline SPECT. In ten patients, the diagnosis was changed to APS over a mean follow-up period of 62 months. We retrospectively compared the patterns of striatal involvement on the baseline SPECT scans between the group of patients (re)diagnosed with APS and the remaining 62 patients in whom a diagnosis of IPD was maintained.

Results

In the group of patients with APS, baseline [123I]β-CIT binding in both caudate nuclei was lower than in the group of patients with IPD. In addition, putamen to caudate binding ratios were higher in the group of APS patients. In spite of these differences, individual binding values showed considerable overlap between the groups.

Conclusion

[123I]β-CIT SPECT scanning in early-stage, untreated parkinsonian patients revealed a relative sparing of the caudate nucleus in patients with IPD as compared to patients later (re)diagnosed with APS. Nevertheless, the pattern of striatal involvement appears to have little predictive value for a later re-diagnosis of APS in individual cases.
Literature
1.
go back to reference 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. 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.
2.
go back to reference Rajput AH, Rozdilsky B, Rajput A. Accuracy of clinical diagnosis in parkinsonism—a prospective study. Can J Neurol Sci 1991;18:275–8.PubMed Rajput AH, Rozdilsky B, Rajput A. Accuracy of clinical diagnosis in parkinsonism—a prospective study. Can J Neurol Sci 1991;18:275–8.PubMed
3.
go back to reference Hughes AJ, Daniel SE, Lees AJ. Improved accuracy of clinical diagnosis of Lewy body Parkinson’s disease. Neurology 2001;57:1497–9.PubMed Hughes AJ, Daniel SE, Lees AJ. Improved accuracy of clinical diagnosis of Lewy body Parkinson’s disease. Neurology 2001;57:1497–9.PubMed
4.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
5.
go back to reference Tissingh G, Bergmans P, Booij J, Winogrodzka A, van Royen EA, Stoof JC, et al. Drug-naive patients with Parkinson’s disease in Hoehn and Yahr stages I and II show a bilateral decrease in striatal dopamine transporters as revealed by [123I]β-CIT SPECT. J Neurol 1998;245:14–20.CrossRef Tissingh G, Bergmans P, Booij J, Winogrodzka A, van Royen EA, Stoof JC, et al. Drug-naive patients with Parkinson’s disease in Hoehn and Yahr stages I and II show a bilateral decrease in striatal dopamine transporters as revealed by [123I]β-CIT SPECT. J Neurol 1998;245:14–20.CrossRef
6.
go back to reference Marek KL, Seibyl JP, Zoghbi SS, Zea-Ponce Y, Baldwin RM, Fussell B, et al. [123I]β-CIT/SPECT imaging demonstrates bilateral loss of dopamine transporters in hemi-Parkinson’s disease. Neurology 1996;46:231–7.PubMed Marek KL, Seibyl JP, Zoghbi SS, Zea-Ponce Y, Baldwin RM, Fussell B, et al. [123I]β-CIT/SPECT imaging demonstrates bilateral loss of dopamine transporters in hemi-Parkinson’s disease. Neurology 1996;46:231–7.PubMed
7.
go back to reference 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 USA 1993;90:11965–9. 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 USA 1993;90:11965–9.
8.
go back to reference Pirker W, Djamshidian S, Asenbaum S, Gerschlager W, Tribl G, Hoffmann M, et al. Progression of dopaminergic degeneration in Parkinson’s disease and atypical parkinsonism: a longitudinal β-CIT SPECT study. Mov Disord 2002;17:45–53.CrossRef Pirker W, Djamshidian S, Asenbaum S, Gerschlager W, Tribl G, Hoffmann M, et al. Progression of dopaminergic degeneration in Parkinson’s disease and atypical parkinsonism: a longitudinal β-CIT SPECT study. Mov Disord 2002;17:45–53.CrossRef
9.
go back to reference Asenbaum S, Brücke T, Pirker W, Podreka I, Angelberger P, Wenger S, et al. Imaging of dopamine transporters with iodine-123-β-CIT and SPECT in Parkinson’s disease. J Nucl Med 1997;38:1–6. Asenbaum S, Brücke T, Pirker W, Podreka I, Angelberger P, Wenger S, et al. Imaging of dopamine transporters with iodine-123-β-CIT and SPECT in Parkinson’s disease. J Nucl Med 1997;38:1–6.
10.
go back to reference Seibyl JP, Marek KL, Quinlan D, Sheff K, Zoghbi S, Zea-Ponce Y, et al. Decreased single-photon emission computed tomographic [123I]β-CIT striatal uptake correlates with symptom severity in Parkinson’s disease. Ann Neurol 1995;38:589–98.PubMed Seibyl JP, Marek KL, Quinlan D, Sheff K, Zoghbi S, Zea-Ponce Y, et al. Decreased single-photon emission computed tomographic [123I]β-CIT striatal uptake correlates with symptom severity in Parkinson’s disease. Ann Neurol 1995;38:589–98.PubMed
11.
go back to reference Varrone A, Marek KL, Jennings D, Innis RB, Seibyl JP. [123I]β-CIT SPECT imaging demonstrates reduced density of striatal dopamine transporters in Parkinson’s disease and multiple system atrophy. Mov Disord 2001;16:1023–32.CrossRefPubMed Varrone A, Marek KL, Jennings D, Innis RB, Seibyl JP. [123I]β-CIT SPECT imaging demonstrates reduced density of striatal dopamine transporters in Parkinson’s disease and multiple system atrophy. Mov Disord 2001;16:1023–32.CrossRefPubMed
12.
go back to reference Antonini A, Benti R, De Notaris R, Tesei S, Zecchinelli A, Sacilotto G, et al. 123I-Ioflupane/SPECT binding to striatal dopamine transporter (DAT) uptake in patients with Parkinson’s disease, multiple system atrophy, and progressive supranuclear palsy. Neurol Sci 2003;24:149–50.CrossRef Antonini A, Benti R, De Notaris R, Tesei S, Zecchinelli A, Sacilotto G, et al. 123I-Ioflupane/SPECT binding to striatal dopamine transporter (DAT) uptake in patients with Parkinson’s disease, multiple system atrophy, and progressive supranuclear palsy. Neurol Sci 2003;24:149–50.CrossRef
13.
go back to reference Messa C, Volonte MA, Fazio F, Zito F, Carpinelli A, d’Amico A, et al. Differential distribution of striatal [123I]β-CIT in Parkinson’s disease and progressive supranuclear palsy, evaluated with single-photon emission tomography. Eur J Nucl Med 1998;25:1270–6.CrossRef Messa C, Volonte MA, Fazio F, Zito F, Carpinelli A, d’Amico A, et al. Differential distribution of striatal [123I]β-CIT in Parkinson’s disease and progressive supranuclear palsy, evaluated with single-photon emission tomography. Eur J Nucl Med 1998;25:1270–6.CrossRef
14.
go back to reference Brücke T, Asenbaum S, Pirker W, Djamshidian S, Wenger S, Wober C, et al. 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 progressive supranuclear palsy. J Neural Transm Suppl 1997;50:9–24. Brücke T, Asenbaum S, Pirker W, Djamshidian S, Wenger S, Wober C, et al. 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 progressive supranuclear palsy. J Neural Transm Suppl 1997;50:9–24.
15.
go back to reference Pirker W, Asenbaum S, Bencsits G, Prayer D, Gerschlager W, Deecke L, et al. [123I]β-CIT SPECT in multiple system atrophy, progressive supranuclear palsy, and corticobasal degeneration. Mov Disord 2000;15:1158–67.CrossRefPubMed Pirker W, Asenbaum S, Bencsits G, Prayer D, Gerschlager W, Deecke L, et al. [123I]β-CIT SPECT in multiple system atrophy, progressive supranuclear palsy, and corticobasal degeneration. Mov Disord 2000;15:1158–67.CrossRefPubMed
16.
go back to reference Kim YJ, Ichise M, Ballinger JR, Vines D, Erami SS, Tatschida T, et al. Combination of dopamine transporter and D2 receptor SPECT in the diagnostic evaluation of PD, MSA, and PSP. Mov Disord 2002;17:303–12.CrossRefPubMed Kim YJ, Ichise M, Ballinger JR, Vines D, Erami SS, Tatschida T, et al. Combination of dopamine transporter and D2 receptor SPECT in the diagnostic evaluation of PD, MSA, and PSP. Mov Disord 2002;17:303–12.CrossRefPubMed
17.
go back to reference Nurmi E, Bergman J, Eskola O, Solin O, Vahlberg T, Sonninen P, et al. Progression of dopaminergic hypofunction in striatal subregions in Parkinson’s disease using [18F]CFT PET. Synapse 2003;48:109–15.CrossRef Nurmi E, Bergman J, Eskola O, Solin O, Vahlberg T, Sonninen P, et al. Progression of dopaminergic hypofunction in striatal subregions in Parkinson’s disease using [18F]CFT PET. Synapse 2003;48:109–15.CrossRef
18.
go back to reference Innis RB, Marek KL, Sheff K, Zoghbi S, Castronuovo J, Feigin A, et al. Effect of treatment with L-dopa/carbidopa or L-selegiline on striatal dopamine transporter SPECT imaging with [123I]β-CIT. Mov Disord 1999;14:436–42.CrossRefPubMed Innis RB, Marek KL, Sheff K, Zoghbi S, Castronuovo J, Feigin A, et al. Effect of treatment with L-dopa/carbidopa or L-selegiline on striatal dopamine transporter SPECT imaging with [123I]β-CIT. Mov Disord 1999;14:436–42.CrossRefPubMed
19.
go back to reference Ahlskog JE, Uitti RJ, O’Connor MK, Maraganore DM, Matsumoto JY, Stark KF, et al. The effect of dopamine agonist therapy on dopamine transporter imaging in Parkinson’s disease. Mov Disord 1999;14:940–6.CrossRef Ahlskog JE, Uitti RJ, O’Connor MK, Maraganore DM, Matsumoto JY, Stark KF, et al. The effect of dopamine agonist therapy on dopamine transporter imaging in Parkinson’s disease. Mov Disord 1999;14:940–6.CrossRef
20.
go back to reference Gibb WR, Lees AJ. The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson’s disease. J Neurol Neurosurg Psychiatry 1988;51:745–52. Gibb WR, Lees AJ. The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson’s disease. J Neurol Neurosurg Psychiatry 1988;51:745–52.
21.
go back to reference Fahn S, Elthon RL, and members of the UPDRS Development Committee. The Unified Parkinson’s Disease Rating Scale. Recent developments in Parkinson’s disease, Vol 2. Florham Park, NY: Macmillan Healthcare Information, 1987, pp 153–163. Fahn S, Elthon RL, and members of the UPDRS Development Committee. The Unified Parkinson’s Disease Rating Scale. Recent developments in Parkinson’s disease, Vol 2. Florham Park, NY: Macmillan Healthcare Information, 1987, pp 153–163.
22.
go back to reference 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.PubMed 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.PubMed
23.
go back to reference 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 Auton Nerv Syst 1998;74:189–92. 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 Auton Nerv Syst 1998;74:189–92.
24.
go back to reference Litvan I, Agid Y, Calne D, Campbell G, Dubois B, Duvoisin RC, et al. Clinical research criteria for the diagnosis of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome): report of the NINDS-SPSP international workshop. Neurology 1996;47:1–9.PubMed Litvan I, Agid Y, Calne D, Campbell G, Dubois B, Duvoisin RC, et al. Clinical research criteria for the diagnosis of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome): report of the NINDS-SPSP international workshop. Neurology 1996;47:1–9.PubMed
25.
go back to reference 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.PubMed 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.PubMed
26.
go back to reference Tissingh G, Bergmans P, Booij J, Winogrodzka A, Stoof JC, Wolters EC, et al. [123I]β-CIT single-photon emission tomography in Parkinson’s disease reveals a smaller decline in dopamine transporters with age than in controls. Eur J Nucl Med 1997;24:1171–4.CrossRef Tissingh G, Bergmans P, Booij J, Winogrodzka A, Stoof JC, Wolters EC, et al. [123I]β-CIT single-photon emission tomography in Parkinson’s disease reveals a smaller decline in dopamine transporters with age than in controls. Eur J Nucl Med 1997;24:1171–4.CrossRef
27.
go back to reference Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology 1967;17:427–42.PubMed Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology 1967;17:427–42.PubMed
28.
go back to reference Bernheimer H, Birkmayer W, Hornykiewicz O, Jellinger K, Seitelberger F. Brain dopamine and the syndromes of Parkinson and Huntington. Clinical, morphological and neurochemical correlations. J Neurol Sci 1973;20:415–55.CrossRefPubMed Bernheimer H, Birkmayer W, Hornykiewicz O, Jellinger K, Seitelberger F. Brain dopamine and the syndromes of Parkinson and Huntington. Clinical, morphological and neurochemical correlations. J Neurol Sci 1973;20:415–55.CrossRefPubMed
29.
go back to reference Kish SJ, Shannak K, Hornykiewicz O. Uneven pattern of dopamine loss in the striatum of patients with idiopathic Parkinson’s disease. Pathophysiologic and clinical implications. N Engl J Med 1988;318:876–80. Kish SJ, Shannak K, Hornykiewicz O. Uneven pattern of dopamine loss in the striatum of patients with idiopathic Parkinson’s disease. Pathophysiologic and clinical implications. N Engl J Med 1988;318:876–80.
30.
go back to reference Kish SJ, Chang LJ, Mirchandani L, Shannak K, Hornykiewicz O. Progressive supranuclear palsy: relationship between extrapyramidal disturbances, dementia, and brain neurotransmitter markers. Ann Neurol 1985;18:530–6.CrossRef Kish SJ, Chang LJ, Mirchandani L, Shannak K, Hornykiewicz O. Progressive supranuclear palsy: relationship between extrapyramidal disturbances, dementia, and brain neurotransmitter markers. Ann Neurol 1985;18:530–6.CrossRef
31.
go back to reference Ruberg M, Javoy-Agid F, Hirsch E, Scatton B, LHeureux R, Hauw JJ, et al. Dopaminergic and cholinergic lesions in progressive supranuclear palsy. Ann Neurol 1985;18:523–9.CrossRef Ruberg M, Javoy-Agid F, Hirsch E, Scatton B, LHeureux R, Hauw JJ, et al. Dopaminergic and cholinergic lesions in progressive supranuclear palsy. Ann Neurol 1985;18:523–9.CrossRef
32.
go back to reference Goto S, Hirano A, Matsumoto S. Subdivisional involvement of nigrostriatal loop in idiopathic Parkinson’s disease and striatonigral degeneration. Ann Neurol 1989;26:766–70.CrossRef Goto S, Hirano A, Matsumoto S. Subdivisional involvement of nigrostriatal loop in idiopathic Parkinson’s disease and striatonigral degeneration. Ann Neurol 1989;26:766–70.CrossRef
33.
go back to reference Tissingh G, Booij J, Bergmans P, Winogrodzka A, Janssen AG, van Royen EA, et al. Iodine-123-N-Ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)tropane SPECT in healthy controls and early-stage, drug-naive Parkinson’s disease. J Nucl Med 1998;39:1143–8. Tissingh G, Booij J, Bergmans P, Winogrodzka A, Janssen AG, van Royen EA, et al. Iodine-123-N-Ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)tropane SPECT in healthy controls and early-stage, drug-naive Parkinson’s disease. J Nucl Med 1998;39:1143–8.
34.
go back to reference Ilgin N, Zubieta J, Reich SG, Dannals RF, Ravert HT, Frost JJ. PET imaging of the dopamine transporter in progressive supranuclear palsy and Parkinson’s disease. Neurology 1999;52:1221–6. Ilgin N, Zubieta J, Reich SG, Dannals RF, Ravert HT, Frost JJ. PET imaging of the dopamine transporter in progressive supranuclear palsy and Parkinson’s disease. Neurology 1999;52:1221–6.
35.
go back to reference Schwarz J, Tatsch K, Gasser T, Arnold G, Pogarell O, Kunig G, et al. 123I-IBZM binding compared with long-term clinical follow up in patients with de novo parkinsonism. Mov Disord 1998;13:16–9. Schwarz J, Tatsch K, Gasser T, Arnold G, Pogarell O, Kunig G, et al. 123I-IBZM binding compared with long-term clinical follow up in patients with de novo parkinsonism. Mov Disord 1998;13:16–9.
Metadata
Title
Early-stage [123I]β-CIT SPECT and long-term clinical follow-up in patients with an initial diagnosis of Parkinson’s disease
Authors
Diederick Stoffers
Jan Booij
Lisette Bosscher
Ania Winogrodzka
Erik C. Wolters
Henk W. Berendse
Publication date
01-06-2005
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 6/2005
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-004-1733-4

Other articles of this Issue 6/2005

European Journal of Nuclear Medicine and Molecular Imaging 6/2005 Go to the issue

Letter to the Editor

Reply