Objective: As a pilot study, this study was aimed to perform the detailed analysis of the striatal DAT density in patients with early-onset Parkinson’s disease (PD) using N-(3-[(18)F]fluoropropyl)-2-carbomethoxy-3-(4-iodophenyl) nortropane (FP-CIT) PET scans.

Background: In vivo study of the striatonigral dopaminergic system provides helpful information, including the differential diagnosis of parkinsonism, in clinical as well as scientific fields. However, a majority of research using the DAT scans for striatal dopaminergic integrity was focused on elderly or late-onset PD patients. Accordingly, positron emission tomography (PET) imaging with high resolution in early-onset PD remains little known.

Methods: We reviewed clinical data of all early-onset PD patients with [18F] FP-CIT PET in our hospital. Early-onset PD was defined as the onset age of parkinsonian motor symptom was below 45 years old. Blinded to the clinical diagnosis of each patient, one movement disorder specialist (K-Y.K.) performed a visual analysis for PET/CT scans. For control analysis of DAT density in the striatum, we selected [18F] FP-CIT PET scans of a patient diagnosed with classic essential tremor (ET).

Results: Among all 98 patients performing [18F] FP-CIT PET scans in the hospital, only 5 patients were diagnosed and compatible with early-onset PD. Two patients with parkin mutation showed more symmetric decrease of dopamine transporter (DAT) density in the putamen, whereas others displayed asymmetric reduction of DAT density in the putamen. Notably, only those with parkin mutation revealed more severe dopaminergic deficits in the anteroventral putamen rather than the posterodoral putamen.

Conclusions: We observed a distinct pattern of dopaminergic depletion in parkin positive patients exhibiting more symmetric loss in anteroventral putamen. This suggests, among PD patients, patients with parkin mutation may exhibit the different pattern of striatal dopaminergic depletion.

References: 1.         Varrone A, Pellecchia MT, Amboni M, et al. Imaging of dopaminergic dysfunction with [123I]FP-CIT SPECT in early-onset parkin disease. Neurology. 2004;63(11):2097-2103.

2.         Thobois S, Ribeiro MJ, Lohmann E, et al. Young-onset Parkinson disease with and without parkin gene mutations: a fluorodopa F 18 positron emission tomography study. Arch Neurol. 2003;60(5):713-718.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/distinct-pattern-of-striatal-dopaminergic-depletion-in-patients-with-parkin-mutation/