Striatal Dopaminergic Depletion Pattern Reflects Pathological Brain Perfusion Changes in Lewy Body Diseases

Mol Imaging Biol. 2022 Dec;24(6):950-958. doi: 10.1007/s11307-022-01745-x. Epub 2022 Jun 14.

Abstract

Purpose: In Lewy body diseases (LBD), various symptoms occur depending on the distribution of Lewy body in the brain, and the findings of brain perfusion and dopamine transporter single-photon emission computed tomography (DAT-SPECT) also change accordingly. We aimed to evaluate the correlation between brain perfusion SPECT and quantitative indices calculated from DAT-SPECT in patients with LBD.

Procedures: We retrospectively enrolled 35 patients with LBD who underwent brain perfusion SPECT with N-isopropyl-p-[123I] iodoamphetamine and DAT-SPECT with 123I-ioflupane. Mini-mental state examination (MMSE) data were also collected from 19 patients. Quantitative indices (specific binding ratio [SBR], putamen-to-caudate ratio [PCR], and caudate-to-putamen ratio [CPR]) were calculated using DAT-SPECT. These data were analysed by the statistical parametric mapping procedure.

Results: In patients with LBD, decreased PCR index correlated with hypoperfusion in the brainstem (medulla oblongata and midbrain) (uncorrected p < 0.001, k > 100), while decreased CPR index correlated with hypoperfusion in the right temporoparietal cortex (family-wise error corrected p < 0.05), right precuneus (uncorrected p < 0.001, k > 100), and bilateral temporal cortex (uncorrected p < 0.001, k > 100). However, there was no significant correlation between decreased SBR index and brain perfusion. Additionally, the MMSE score was correlated with hypoperfusion in the left temporoparietal cortex (uncorrected p < 0.001).

Conclusions: This study suggests that regional changes in striatal 123I-ioflupane accumulation on DAT-SPECT are related to brain perfusion changes in patients with LBD.

Keywords: 123I-FP-CIT; Parkinsonian syndrome; Parkinsonism; SPM; α-synuclein; α-synucleinopathy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain / metabolism
  • Dopamine / metabolism
  • Dopamine Plasma Membrane Transport Proteins / metabolism
  • Humans
  • Lewy Bodies* / metabolism
  • Lewy Bodies* / pathology
  • Lewy Body Disease* / diagnostic imaging
  • Lewy Body Disease* / metabolism
  • Lewy Body Disease* / pathology
  • Perfusion
  • Retrospective Studies
  • Tomography, Emission-Computed, Single-Photon / methods
  • Tropanes

Substances

  • ioflupane
  • Iodine-123
  • Dopamine Plasma Membrane Transport Proteins
  • Dopamine
  • Tropanes