SPECT molecular imaging in Parkinson's disease

Abstract

Parkinson's disease (PD) is a common disorder, and the diagnosis of Parkinson's disease is clinical and relies on the presence of characteristic motor symptoms. The accuracy of the clinical diagnosis of PD is still limited. Functional neuroimaging using SPECT technique is helpful in patients with first signs of parkinsonism. The changes detected may reflect the disease process itself and/or compensatory responses to the disease, or they may arise in association with disease- and/or treatment-related complications. This paper addresses the value of SPECT in early differential diagnosis of PD and its potential as a sensitive tool to assess the pathophysiology and progression, as well as the therapeutic efficacy of PD.

Figure 1

TRODAT-1 SPECT images of a healthy control (a) and a patient with early PD (b). The patient with early PD shows decreased TRODAT-1 uptake in the striatum compared to the control, particularly in the posterior putamen [45].

Figure 2

Transverse ¹²³I-β-CIT images. (a) The image from a healthy control. (b) in PD patient the uptake is markedly reduced, with putamen more affected than caudate, and the right striatum (opposite to the side of more severe symptoms) showing the largest dopamine transporter (DAT) loss. (c) In MSA-striatonigral degeneration (MSA-SND) patient, the uptake is significantly reduced in both caudate and putamen and indicates more symmetric loss of DAT. (d) In the MSA-Shy-Drager syndrome (SDS) patient, the uptake is also significantly reduced, with putamen more affected than caudate; the loss of DAT appears to be symmetric [64].