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Maria-Joao Ribeiro, MD, PhD; Marie Vidailhet, MD; Christian Loc'h, BS; Corinne Dupel, MD; Jean Paul Nguyen, MD; Michel Ponchant, BS; Frédéric Dollé, PhD; Marc Peschanski, MD, PhD; Philippe Hantraye, PhD; Pierre Cesaro, MD, PhD; Yves Samson, MD; Philippe Remy, MD, PhD

Arch Neurol. 2002;59:580-586.

Background  Measuring progression of Parkinson disease (PD) using positron emission tomography may help demonstrate the efficacy of neuroprotective treatments. To date, ¹⁸F-dopa has been the gold standard to measure presynaptic dopaminergic function in PD, but this tracer might overestimate the rate of neuronal death in PD because its uptake also depends on dopamine turnover rather than exclusively on the density of dopaminergic terminals in the striatum. The latter might be assessed using newly developed ligands of the membrane dopamine transporter.

Objective  To compare the striatal uptakes of ¹⁸F-dopa and ⁷⁶Br-FE-CBT, a dopamine transporter ligand, in patients with PD.

Patients and Methods  The striatal uptakes of ⁷⁶Br-FE-CBT and ¹⁸F-dopa were compared using positron emission tomography in 10 patients with early PD and 8 with advanced PD. Correlation of uptakes with motor performance was investigated.

Results  The reduction in ⁷⁶Br-FE-CBT binding to 43% of control values was more severe than the reduction in ¹⁸F-dopa uptake (63% of control values) in the putamen of patients with early PD. No significant difference was found between either tracer's uptake in the putamen of patients with advanced PD. Motor performance was highly correlated to ¹⁸F-dopa uptake, whereas correlation to ⁷⁶Br-FE-CBT binding was weak.

Conclusions  Uptake of ¹⁸F-dopa may be up-regulated in early PD, suggesting a compensatory increase of dopamine synthesis in surviving dopaminergic terminals. Positron emission tomography dopamine transporter ligands and ¹⁸F-dopa give complementary information on the presynaptic status of the nigrostriatal dopaminergic system and might be associated to investigate the efficacy of neuroprotective treatments in PD.

From Commissariat à l'Energie Atomique (CEA), Service Hospitalier Frédéric Joliot, Orsay, France (Drs Ribeiro, Dupel, Dollé, Samson, and Remy and Messrs Loc'h and Ponchant); Service de Neurologie, Hôpital Saint-Antoine, Paris, France (Dr Vidailhet); Institut National de la Santé et de la Recherche Médicale (INSERM) U289, Paris (Dr Vidailhet); Département de Neurosciences, Centre Hospitalier Universitaire (CHU) Henri Mondor, Assistance Publique-Hôpitaux de Paris & Université Paris 12, Créteil, France (Drs Nguyen, Peschanski, Cesaro, and Remy); INSERM U421, IM3, Faculté de Médecine, Créteil (Drs Nguyen, Peschanski, and Cesaro); Unité de Recherche Associée CEA–Centre National de la Recherche Scientifique 2210, Orsay (Drs Hantraye and Remy); and Urgences Cérébro-Vasculaires, CHU Pitié-Salpétrière, Paris (Dr Samson)

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