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Loss of Dopamine Transporter Binding in Parkinson’s Disease Follows a Single Exponential Rather Than Linear Decline

¹ Department of Neurology, University of Leipzig, Leipzig, Germany
² Department of Neurology, University of Ulm, Ulm, Germany
³ Department of Nuclear Medicine, Ludwig-Maximilians-University, Munich, Germany
⁴ Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
⁵ Imaging Research, Sunnybrook and Women’s College Health Sciences Centre, Toronto, Ontario, Canada

Imaging of L-dopa uptake or dopamine transporter binding can monitor the progression of Parkinson’s disease. Most follow-up studies have provided data best fitted by a linear decline of their outcome measure. However, in these studies, patients were repeatedly scanned during their first years after a diagnosis had been established. Methods: We followed 6 patients with early Parkinson’s disease for 7.5 y using ¹²³I-labeled N-(3-iodopropene-2-yl)-2ß-carbomethoxy-3ß-(4-chlorophenyl) tropane and SPECT. Results: Loss of dopamine transporter binding was best fitted using a single exponential approximation. A 63% loss ( [time constant tau]) was calculated as 5.18 ± 7.62 y in the putamen and 10.62 ± 31.4 y in the caudate nucleus when a 3-parameter fit was used. Conclusion: These data approximate, for what is to our knowledge the first time, the decline of dopamine transporter binding as expected in biologic systems and may allow for models that correct for exponential decline to be developed and for disease-modifying effects in patients with advanced disease to be determined.

Key Words: Parkinson’s disease • dopamine transporter • SPECT • rate of decline

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