Tc-99m TRODAT-1 SPECT is a Potential Biomarker for Restless Leg Syndrome in Patients with End-Stage

Yi-Chou Hou^{1

2

3}, Yu-Ming Fan^{3

4}, Ya-Ching Huang^{5

6}, Ruei-Ming Chen⁷, Cheng-Hsu Wang^{4

8}, Yi-Te Lin^{2

3

9}, Tzung-Hai Yen^{10

11}, Kuo-Cheng Lu^{3

12

13}, Yuh-Feng Lin^{1

14

15}

Affiliations

¹ Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
² Department of Internal Medicine, Cardinal Tien Hospital, New Taipei City 231,Taiwan.
³ School of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan.
⁴ Department of Nuclear Medicine, Cardinal Tien Hospital, New Taipei City 231,Taiwan.
⁵ Department of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan.
⁶ Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
⁷ Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
⁸ School of Biomedical Engineering and Environmental Science, National Tsing Hua University, Hsinchu City 300, Taiwan.
⁹ Departments of Hyperbaric Medicine and Neurology, Cardinal Tien Hospital, New Taipei City 231, Taiwan.
¹⁰ Division of Nephrology, Chang Gung Memorial Hospital, Taipei 105, Taiwan.
¹¹ College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
¹² Department of Nephrology, Fu Jen Catholic University Hospital, New Taipei City 243, Taiwan.
¹³ Department of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan.
¹⁴ Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan.
¹⁵ Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 114, Taiwan.

PMID: 32213981
PMCID: PMC7141514
DOI: 10.3390/jcm9030889

Tc-99m TRODAT-1 SPECT is a Potential Biomarker for Restless Leg Syndrome in Patients with End-Stage

Yi-Chou Hou et al. J Clin Med. 2020.

. 2020 Mar 24;9(3):889.

doi: 10.3390/jcm9030889.

Authors

Affiliations

¹ Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
² Department of Internal Medicine, Cardinal Tien Hospital, New Taipei City 231,Taiwan.
³ School of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan.
⁴ Department of Nuclear Medicine, Cardinal Tien Hospital, New Taipei City 231,Taiwan.
⁵ Department of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan.
⁶ Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
⁷ Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
⁸ School of Biomedical Engineering and Environmental Science, National Tsing Hua University, Hsinchu City 300, Taiwan.
⁹ Departments of Hyperbaric Medicine and Neurology, Cardinal Tien Hospital, New Taipei City 231, Taiwan.
¹⁰ Division of Nephrology, Chang Gung Memorial Hospital, Taipei 105, Taiwan.
¹¹ College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
¹² Department of Nephrology, Fu Jen Catholic University Hospital, New Taipei City 243, Taiwan.
¹³ Department of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan.
¹⁴ Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan.
¹⁵ Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 114, Taiwan.

PMID: 32213981
PMCID: PMC7141514
DOI: 10.3390/jcm9030889

Abstract

Rationales: Restless leg syndrome (RLS) is a common complication in patients with end-stage renal disease (ESRD). However, there is a lack of biomarkers linking uremic RLS to dopaminergic neurons. Previous studies demonstrated that Tc-99m TRODAT-1 SPECT was a biomarker for RLS but the correlation between the physiologic parameter was lacking.

Methods: Overall, 32 patients were enrolled in the study and divided into the following 3 groups: (1) control (n = 13), (2) ESRD without RLS (n = 8) and (3) ESRD with RLS (n = 11). All patients had a clinical diagnosis of RLS and received Tc-99m TRODAT-1 SPECT. A subgroup analysis was performed to compare differences between the control and ESRD with RLS groups. Tc-99m TRODAT-1 SPECT was performed and activities in the striatum and occipital areas were measured using manually delineated regions of interest (ROIs) by an experienced nuclear medicine radiologist who was blinded to clinical data.

Results: The total ratio of Tc-99m TRODAT SPECT was lower in the ESRD with RLS group (p = 0.046). The uptake ratio of TRODAT negatively correlated with serum parathyroid hormone (r = -0.577, p = 0.015) and ferritin (r = -0.464, p = 0.039) concentrations. However, the uptake positively correlated with the hemoglobin concentration (r = 0.531, p = 0.011). The sensitivity and specificity of the total TRODAT ratio for predicting RLS in the overall population were 95.0% and 67.7%, respectively, at a cutoff value of 0.980 (area under the curve of receiver operating characteristic curve was 0.767, p = 0.024).

Conclusion: In patients with ESRD and RLS, Tc-99m TRODAT might be a potential biomarker. Dysregulated hemoglobin, serum parathyroid hormone and serum ferritin concentrations might influence the uptake of the TRODAT ratio.

Keywords: ESRD; TRODAT-1; restless leg syndrome.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
TRODAT ratio of the control (A), end stage renal disease (ESRD) without restless leg syndrome (RLS) (B) and ESRD with RLS (C) groups.

**Figure 2**
Comparative TRODAT ratio between the control and ESRD with RLS groups.

**Figure 3**
Receiver operating characteristic (ROC) curve for total TRODAT ratio as a predictor of RLS in the entire study population (A) and in the population including the control and ESRD with RLS groups (B).

**Figure 4**
The linear regression of the caudate nucleus (A), putamen (B) and striatum (C) of the control group and the distribution of the ESRD with RLS group according to the age and the TRODAT ratio.

See this image and copyright information in PMC

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Tc-99m TRODAT-1 SPECT is a Potential Biomarker for Restless Leg Syndrome in Patients with End-Stage

Affiliations

Tc-99m TRODAT-1 SPECT is a Potential Biomarker for Restless Leg Syndrome in Patients with End-Stage

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources