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Levente Kerenyi, MD; George A. Ricaurte, MD, PhD; David J. Schretlen, PhD; Una McCann, MD; Jozsef Varga, PhD; William B. Mathews, PhD; Hayden T. Ravert, PhD; Robert F. Dannals, PhD; John Hilton, PhD; Dean F. Wong, MD, PhD; Zsolt Szabo, MD, PhD

Arch Neurol. 2003;60:1223-1229.

Background  Little is known about serotonin neurons in Parkinson disease (PD).

Objective  To study the serotonin system in PD with positron emission tomography, using the serotonin transporter radioligand [¹¹C](+)McN5652.

Design and Patients  We measured the density of the serotonin transporter and the density of [¹¹C]WIN35 428–labeled dopamine transporters in the striatum of 13 adults with PD and 13 age- and sex-matched controls. To assess the effects of possible differences in blood flow or brain atrophy, we also measured regional cerebral blood flow and the size of the regions of interest for the caudate nucleus and putamen.

Results  Patients with PD showed reductions in the specific distribution volumes of [¹¹C](+)McN5652 in the caudate (P<.01) and putamen (P<.01), along with the expected reductions in striatal [¹¹C]WIN35 428 binding (P<.01). There were no reductions in regional cerebral blood flow or the sizes of the regions of interest, mitigating against potential confounding effects of blood flow, brain atrophy, or partial volume effects. Reductions in serotonin transporter binding correlated with ratings of disease staging.

Conclusions  These results suggest that the density of serotonin transporters, like that of dopamine transporters, is reduced in the striatum of patients with PD and that these changes are related to disease stage.

From the Department of Neurology, Medical School Debrecen (Dr Kerenyi); Department of Nuclear Medicine, University of Debrecen (Dr Varga), Debrecen, Hungary; the Department of Radiology, Johns Hopkins Medical Institutions (Drs Ricaurte, Ravert, Dannals, Hilton, Wong, and Szabo), Baltimore Md; the Department of Psychiatry and Behavioral Sciences, School of Medicine (Dr Schretlen and McCann), and the Division of Nuclear Medicine (Dr Mathews), Johns Hopkins University, Baltimore.

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