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Brain Advance Access published online on March 30, 2007
Brain, doi:10.1093/brain/awm044
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© The Author (2007). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Microglial activation in presymptomatic Huntington's disease gene carriers

Yen F. Tai1, Nicola Pavese1, Alexander Gerhard1,4, Sarah J. Tabrizi2, Roger A. Barker3, David J. Brooks1,5 and Paola Piccini1

1MRC Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, 2Department of Neurodegenerative Disease, Institute of Neurology, London, 3Cambridge Centre for Brain Repair, Forvie Site, Cambridge, UK, 4Department of Psychiatry, Mainz University, Mainz, Germany and 5Hammersmith Imanet, GE Healthcare

Correspondence to: Dr Paola Piccini, Cyclotron Building, MRC Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK E-mail: paola.piccini{at}csc.mrc.ac.uk

Microglial activation may play a role in the pathogenesis of Huntington's disease (HD). Using 11C-(R)-PK11195 (PK) positron emission tomography (PET), we investigated microglial activation in HD presymptomatic gene carriers (PGCs), its relationship with striatal neuronal dysfunction measured with 11C-raclopride (RAC) PET, and the role of PK PET as a possible marker of subclinical disease progression in PGCs. Eleven HD PGCs underwent PK and RAC PET. Their results were compared with those of healthy controls. PK and RAC binding was measured using region-of-interest analysis. Regional increases in PK binding were also localized with voxel-based statistical parametric mapping. HD PGCs had lower striatal RAC binding than the controls but significantly higher striatal and cortical PK binding. Individual levels of higher striatal PK binding in PGCs correlated with lower striatal RAC binding and, after excluding one outlier, with a higher probability of developing HD in 5 years. The inverse association between striatal PK and RAC binding in PGCs continues into early to moderate stages of HD. This study demonstrated for the first time in vivo widespread microglial activation in preclinical HD which correlated with striatal neuronal dysfunction. These findings indicate that microglial activation is an early event in the pathogenic processes of HD and is associated with subclinical progression of disease. PK PET may be a useful marker of active subclinical disease and a means of investigating the efficacy of neuroprotection strategies in PGCs.

Key Words: Huntington's disease; presymptomatic; microglial activation; positron emission tomography; PK11195

Abbreviations: BP, binding potential; HD, Huntington's disease; PET, positron emission tomography; PGCs, presymptomatic gene carriers; SPM, statistical parametric mapping

Received October 10, 2006. Revised February 13, 2007. Accepted February 16, 2007.


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