Brain, Vol 120, Issue 12 2187-2195, Copyright © 1997 by Oxford University Press
A Antonini, KL Leenders, P Vontobel, RP Maguire, J Missimer, M Psylla and I Gunther
We used PET with the tracers [18F]fluorodeoxyglucose (FDG), [18F]fluorodopa
(FDOPA) and [11C]raclopride (RACLO) to study striatal glucose and dopa
metabolism, and dopamine D2 receptor binding, respectively, in nine
patients with multiple system atrophy. Ten patients with classical
Parkinson's disease were investigated with the same three PET tracers' and
three separate groups, each of 10 healthy subjects, served as control
populations. We found that striatal FDOPA values separated all healthy
subjects from patients with parkinsonism but they were not useful in
distinguishing multiple system atrophy from Parkinson's disease.
Conversely, striatal RACLO as well as FDG values discriminated all multiple
system atrophy from Parkinson's disease patients as well as from healthy
control subjects. Metabolic and receptor binding decrements in the putamen
of multiple system atrophy patients were significantly correlated. Stepwise
regression analysis revealed that a linear combination of putamen RACLO and
FDOPA values accurately predicted clinical measures of disease severity in
the multiple system atrophy group. Our findings suggest that striatal FDG
and particularly RACLO are sensitive and effective measures of striatal
function and may help characterizing patients with multiple system atrophy.
In contrast, FDOPA measurements are accurate in detecting abnormalities of
the nigrostriatal dopaminergic system but may not distinguish among
different forms of parkinsonism.
ARTICLES
Complementary PET studies of striatal neuronal function in the differential diagnosis between multiple system atrophy and Parkinson's disease
PET Department, Paul Scherrer Institute, Villigen, Switzerland.
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