Abstract
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Objectives Parkinson's disease (PD) is a neurodegenerative disorder with deterioration of motor functions, featured by characteristic symptoms such as resting tremor, bradykinesia, and rigidity. These symptoms mainly result from the death of dopamine secreting neuronal cells in the substantia nigra 1. Ceruloplasmin, which is normally known as a copper binding protein in the blood, is a glycosylphosphatidylinositol (GPI)- anchored protein in the brain which effluxes iron 2,3. In PD, it has been reported that both the serum ceruloplasmin concentration and ceruloplasmin ferroxidase activity were decreased, compared with age- and gender- matched healthy controls 4. The low serum ceruloplasmin concentration and ferroxidase activity also appears to have a positive correlation with iron deposition in the brain of PD patients 5,6. The present study was conducted to correlate the significance of serum marker levels with 123I-FP-CIT uptake in PD patients.
Methods We analyzed 66 patients (M:F = 31:35, age 65.5 ± 10.0 years) who were diagnosed with PD. Serum ceruloplasmin, copper, iron, TIBC, and ferritin level tests were done. 123I-FP-CIT single positron emission tomography (SPECT) images were taken, and specific binding ratios (SBRs) of the striatum, caudate nucleus, and putamen were obtained. Correlation between serum tests and SBRs of 123I-FP-CIT SPECT images were evaluated using Pearson’s linear regression analysis.
Results Linear regression analysis was used to evaluate the correlation between serum tests and SBRs of 123I-FP-CIT SPECT images. The minimum SBR value among the bilateral corpa striata, caudate nuclei, and putamina was used for analysis. Significant correlation existed between serum ceruloplasmin levels and SBRs of striatum (r = 0.32, p < 0.01) and putamen (r = 0.35, p < 0.01). Serum copper levels showed significant correlation with SBRs of putamen (r = 0.33, p < 0.01). Serum levels of NCC, iron, TIBC, and ferritin did not have any significant correlation with SBRs of striatum, putamen, and caudate nucleus.
Conclusions Our study demonstrated that the decreases of serum ceruloplasmin and copper have a positive correlation with decreased dopaminergic activity. To our knowledge, this is the first study to demonstrate the relationship between serum ceruloplasmin levels and 123I-FP-CIT uptake in PD patients. It is possible that low serum ceruloplasmin levels can be an indicator for decreased striatal dopaminergic activity.