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Rate of 6-[18F]fluorodopa uptake decline in striatal subregions in Parkinson's disease

Authors

  • Catherine L. Gallagher MD,

    Corresponding author
    1. William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
    2. Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
    • William S. Middleton VA Hospital, 6112B, 2500 Overlook Terrace Dr., Madison, WI 53792

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  • Terrence R. Oakes PhD,

    1. Waisman Center Brain Imaging Laboratory, University of Wisconsin, Madison, USA
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  • Sterling C. Johnson PhD,

    1. Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
    2. Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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  • Moo K. Chung PhD,

    1. Waisman Center Brain Imaging Laboratory, University of Wisconsin, Madison, USA
    2. Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin, USA
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  • James E. Holden PhD,

    1. Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
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  • Barbara B. Bendlin PhD,

    1. Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
    2. Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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  • Donald G. McLaren PhD,

    1. Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
    2. Neuroscience Training Program, University of Wisconsin, Madison, Wisconsin, USA
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  • Guofan Xu PhD,

    1. Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
    2. Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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  • Robert J. Nickles PhD,

    1. Neuroscience Training Program, University of Wisconsin, Madison, Wisconsin, USA
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  • Robert Pyzalski PhD,

    1. Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA
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  • Onofre DeJesus PhD,

    1. Neuroscience Training Program, University of Wisconsin, Madison, Wisconsin, USA
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  • W. Douglas Brown MD

    1. Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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  • Relevant conflicts of interest/financial disclosures: Nothing to report. Full financial disclosures and author roles can be found in the online version of this article.

Abstract

Background:

Rate of decline in 6-L-[18F]fluorodopa (FDOPA) uptake within the striatum has been reported as showing regional differences in Parkinson's disease (PD).

Methods:

We acquired longitudinal brain FDOPA positron emission tomography (PET) studies in 26 PD subjects and 11 controls over 4.5 years. We analyzed both spatially normalized voxel-wise maps of radiotracer influx (Kocc) and average Kocc values for six non-overlapping volumes of interest (VOIs) encompassing the striatum.

Results:

The voxel-wise analysis showed that in PD, FDOPA Kocc decline spanned the striatum but was greatest in the posterior putamen ipsilateral and anterior putamen contralateral to initial symptoms. The VOI approached showed that absolute rates of Kocc decline were significantly greater in PD than control subjects, but that the slope of decline did not differ between subregions. In PD, ratios of uptake between subregions did not change during the study with the exception of the ipsilateral putamen/caudate ratio. Decline rates were marginally greater during earlier time segments. Both male gender and advancing age were associated with lower baseline FDOPA uptake, but no difference in decline rates. VOI Kocc values were significantly correlated with disease duration, but only moderately correlated with clinical measures.

Discussion:

We conclude that FDOPA uptake in subregions of the striatum is strongly correlated with disease duration and age, and declines approximately equally from symptom onset in PD. This implies that in idiopathic PD, relative preservation of uptake in the anterior striatum reflects a delay in pathologic involvement of nigrostriatal projections to this region. © 2011 Movement Disorder Society

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