Striatal dopamine transporter binding does not correlate with clinical severity in dementia with Lewy bodies

J Nucl Med. 2013 Jul;54(7):1072-6. doi: 10.2967/jnumed.112.114025. Epub 2013 May 1.

Abstract

Patients who have dementia with Lewy bodies (DLB) show both clinical and histopathologic overlap with Alzheimer disease patients and Parkinson disease patients. In this study, we correlated the core features of DLB (dementia, parkinsonism, hallucinations, and fluctuations) with striatal dopamine transporter (DAT) availability as assessed with SPECT and (123)I-N-(3-iodoprop-2E-enyl)-2-β-carbomethoxy-3β-(4-methylphenyl) nortropane ((123)I-PE2I) in patients with newly diagnosed DLB.

Methods: Two hundred eighty-eight patients were consecutively included in the study as they were referred for diagnostic SPECT scanning of DAT with (123)I-PE2I. Of those patients, 51 had, on the basis of clinical guideline criteria, a probable-DLB diagnosis at follow-up 16 ± 11.6 mo later. Before or on the day of the SPECT scan, DLB patients had a routine neurologic examination including Hoehn and Yahr grading and were cognitively evaluated with the Mini Mental State Examination.

Results: There was no correlation between Mini Mental State Examination, Hoehn and Yahr score, fluctuations or hallucinations, and striatal DAT availability as measured with (123)I-PE2I and SPECT.

Conclusion: In patients with newly diagnosed DLB, symptoms are not associated with a reduction in striatal DAT despite its firm involvement in DLB pathology.

Keywords: DLB; SPECT; dopamine transporter.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers / metabolism
  • Brain / diagnostic imaging
  • Brain / metabolism*
  • Corpus Striatum / diagnostic imaging
  • Corpus Striatum / metabolism*
  • Denmark / epidemiology
  • Dopamine Plasma Membrane Transport Proteins / metabolism*
  • Female
  • Humans
  • Lewy Body Disease / diagnostic imaging
  • Lewy Body Disease / epidemiology*
  • Lewy Body Disease / metabolism*
  • Male
  • Nortropanes / pharmacokinetics*
  • Prevalence
  • Protein Binding
  • Radionuclide Imaging
  • Radiopharmaceuticals / pharmacokinetics
  • Reproducibility of Results
  • Risk Assessment
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Statistics as Topic

Substances

  • Biomarkers
  • Dopamine Plasma Membrane Transport Proteins
  • N-(3-iodoprop-2-enyl)-2-beta-carbomethoxy-3-(4-methylphenyl)nortropane
  • Nortropanes
  • Radiopharmaceuticals