1. Quantitative analysis of striatal dopamine D2 receptors with 123 I-iodolisuride SPECT in degenerative extrapyramidal diseases.
- Author
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Prunier C, Tranquart F, Cottier JP, Giraudeau B, Chalon S, Guilloteau D, De Toffol B, Chossat F, Autret A, Besnard JC, and Baulieu JL
- Subjects
- Aged, Aged, 80 and over, Diagnosis, Differential, False Positive Reactions, Female, Humans, Lisuride pharmacokinetics, Male, Middle Aged, Multiple System Atrophy diagnostic imaging, Parkinsonian Disorders diagnostic imaging, Supranuclear Palsy, Progressive diagnostic imaging, Basal Ganglia Diseases diagnostic imaging, Corpus Striatum diagnostic imaging, Iodine Radioisotopes pharmacokinetics, Lisuride analogs & derivatives, Neurodegenerative Diseases diagnostic imaging, Parkinson Disease diagnostic imaging, Receptors, Dopamine D2 analysis, Tomography, Emission-Computed, Single-Photon
- Abstract
123I-Iodolisuride has high specific affinity for binding on dopamine D2 receptors in the striatum and has been used in a few single photon emission computed tomography (SPECT) studies of extrapyramidal disorders. The diagnosis of Parkinson's disease (PD) is very difficult in the first 5 years of evolution, with 15-25% false positive diagnoses. The aim of this study was therefore to determine the value of iodolisuride SPECT in discriminating Parkinson's from the most frequent Parkinson-plus syndromes (PPS). Seventeen patients with an extrapyramidal syndrome had a SPECT examination 1 h after injection of 180-185 MBq of 123I-iodolisuride. They were followed under dopaminergic treatment for at least 2 years. After 2 years, they were separated in two groups according to specific clinical criteria and sensitivity to dopaminergic treatment: nine patients had PD (age = 59.8+/-8.8 years; Hoehn and Yahr = 1.8+/-0.7; evolution = 4.3+/-3 years) and eight had PPS (age = 71.6+/-7.3 years; Hoehn and Yahr = 2.9+/-2.0; evolution = 4.1+/-1.5 years). The binding potential of iodolisuride in the striatum was assessed by considering the striatum (S)/occipital lobe (O) ratio at the pseudo-equilibrium 1 h after injection. The S/O ratio was statistically different between PD and PPS (1.97+/-0.3 vs. 1.65+/-0.2 (P<0.02)). Iodolisuride SPECT could differentiate both groups with a sensitivity of 88.8% and a specificity of 75%. Iodolisuride is a good specific D2 receptor ligand for SPECT and complements specific clinical criteria for the diagnosis of Parkinson's disease and differentiation between different extrapyramidal disorders.
- Published
- 2001
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