Objective: To evaluate the ability of DAT SPECT quantification to track disease progression in subjects with idiopathic Parkinson’s disease (PD) by comparing baseline scans to those obtained 12 months later. The quantified DAT SPECT data will be clinically correlated to UPDRS motor scores obtained at baseline and at 12 months.

Background: The major clinical uncertainty with DAT SPECT imaging is whether or not quantitative analysis can be utilized to determine progressive degeneration over time and serve as a quantitative biomarker for changes in striatal dopaminergic integrity in correlation with clinical worsening in patients with idiopathic PD. Current analytical methodologies have focused on establishing differences between the PD and control groups, but have not explored the technology for tracking disease progression with Ioflupane I123, using patients as their own controls. As there are no current biomarkers for PD progression, it is critical to evaluate the potential for DAT SPECT to serve as an analytical tool for the quantification of dopaminergic functional integrity. As an example we are investigating the ability of autologous sural nerve grafts, implanted in PD subjects undergoing deep brain stimulation (DBS), to restore dopaminergic cell function.

Method: Twelve subjects with a clinical diagnosis of PD have been enrolled. Inclusion criteria were subjects aged 40 to 75, a Hoehn and Yahr score of 1-3, with demonstrated positive response to carbidopa/levodopa treatment. The subjects will undergo two DAT SPECT scans, one at baseline and one 12 months later. UPDRS (Unified Parkinson’s Disease Rating Scale) testing in the on and off state will be acquired at baseline and at 12 months. Disease severity will be correlated to DAT SPECT imaging results. DAT SPECT scan analysis will be performed using software for visual evaluation and quantification of Ioflupane I123 images.

Results: Eight subjects to date have completed baseline and 12 month DAT SPECT scans and UPDRS testing. Data analysis will be performed when all 12 subjects complete testing.

Conclusion: DAT SPECT may be an effective methodology for tracking disease progression in PD and serve as an analytical tool for the quantification of dopaminergic functional integrity in translational research strategies to restore dopaminergic cell function in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/exploring-dopamine-transporter-single-photon-emission-computed-tomography-quantification-as-a-measure-of-disease-progression-in-idiopathic-parkinsons-disease/