帕金森病不同亚型患者的多巴胺转运体正电子发射断层显像研究

Dopamine Transporter PET Imaging in Patients with Different Subtypes of Parkinson's Disease

目的探讨帕金森病(PD)不同亚型患者多巴胺转运体(DAT)正电子发射断层显像(PET)的特点。方法回顾性分析年龄、运动症状严重程度匹配的45例有明显震颤型(TDT组)和60例无明显震颤型(n TDT组)PD患者的临床和11C-CFT PET显像资料;另选择年龄匹配的健康对照者40名为对照组。对上述PD不同亚型患者的临床和影像学特征进行对比和相关性研究。结果与对照组比较,TDT组和n TDT组在尾状核、前壳核和后壳核11C-CFT的摄取值均显著减低(P<0.001)。与n TDT组比较,TDT组患者的病程更长而进展更慢(P<0.05),但两组在纹状体各部位11C-CFT的摄取值差异无显著性。前壳核和后壳核11C-CFT的摄取值与UPDRSⅢ运动评分、非震颤评分均呈显著负相关(P≤0.005),而震颤评分仅在TDT组与后壳核11C-CFT的摄取值呈显著负相关(P=0.018)。结论 DAT PET显像有助于PD诊断和病情严重度评估,但不能用于PD不同临床亚型的鉴别。

AimThe study investigated striatal dopamine transporter （DAT） binding characteristics in the patients with different subtypes of Parkinson’s disease （PD） by performing positron emission tomography （PET） imaging.Methods The clinical and11C-CFT PET imaging data of age and motor severity-matched two groups of idiopathic PD patients were studied retrospectively： 45 with a tremor-dominant type （TDT） and 60 with a non-tremor-dominant type （nTDT）. Clinical characteristics and11C-CFT uptake were compared among groups and their correlations were evaluated.Results11C-CFT uptake were＆amp;nbsp;signiifcantly decreased in the caudate, anterior putamen and posterior putamen in PD patients relative to those in the healthy controls （P〈0.01）. Although TDT patients had a longer duration and slower progression when compared with the nTDT patients,11C-CFT uptake was similar in the two groups and correlated negatively with the uniifed Parkinson’s disease rating scale motor score （UPDRSⅢ） and non-tremor score in the anterior putamen and posterior putamen （P≤0.005）. Only in TDT patients the tremor score correlated 11C-CFT uptake in the posterior putamen （P=0.018）.ConclusionDAT PET imaging could serve as a sensitive biomarker in the diagnosis and assessment of disease severity of PD. However, it was not helpful in discriminating the subtypes of PD.