Skip to main content
SpringerLink
Log in

Diagnostic value of asymmetric striatal D2 receptor upregulation in Parkinson’s disease: an [123I]IBZM and [123I]FP-CIT SPECT study

  • Original article
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Introduction

Striatal postsynaptic D2 receptors in Parkinson’s disease (PD) are thought to be upregulated in the first years of the disease, especially contralateral to the clinically most affected side. The aim of this study was to evaluate whether the highest striatal D2 binding is found contralateral to the most affected side in PD, and whether this upregulation can be used as a diagnostic tool.

Methods

Cross-sectional survey was undertaken of 81 patients with clinically asymmetric PD, without antiparkinsonian drugs and with a disease duration of ≤5 years and 26 age-matched controls. Striatal D2 binding was assessed with [123I]IBZM SPECT, and severity of the presynaptic dopaminergic lesion with [123I]FP-CIT SPECT.

Results

The mean striato-occipital ratio of [123I]IBZM binding was significantly higher in PD patients (1.56 ±0.09) than in controls (1.53 ±0.06). In PD patients, higher values were found contralateral to the clinically most affected side (1.57 ±0.09 vs 1.55 ±0.10 ipsilaterally), suggesting D2 receptor upregulation, and the reverse was seen using [123I]FP-CIT SPECT. However, on an individual basis only 56% of PD patients showed this upregulation.

Conclusion

Our study confirms asymmetric D2 receptor upregulation in PD. However, the sensitivity of contralateral higher striatal [123I]IBZM binding is only 56%. Therefore, the presence of contralateral higher striatal IBZM binding has insufficient diagnostic accuracy for PD, and PD cannot be excluded in patients with parkinsonism and no contralateral upregulation of D2 receptors, assessed with [123I]IBZM SPECT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Fahn S. Description of Parkinson’s disease as a clinical syndrome. Ann NY Acad Sci 2003;991:1–14.

    Article  PubMed  CAS  Google Scholar 

  2. Piccini P, Whone A. Functional brain imaging in the differential diagnosis of Parkinson’s disease. Lancet Neurol 2004;3:284–90.

    Article  PubMed  Google Scholar 

  3. Elsworth JD, Brittan MS, Taylor JR, Sladek JR Jr, Redmond DE Jr, Innis RB, et al. Upregulation of striatal D2 receptors in the MPTP- treated vervet monkey is reversed by grafts of fetal ventral mesencephalon: an autoradiographic study. Brain Res 1998;795:55–62.

    Article  PubMed  CAS  Google Scholar 

  4. Bezard E, Dovero S, Prunier C, Ravenscroft P, Chalon S, Guilloteau D, et al. Relationship between the appearance of symptoms and the level of nigrostriatal degeneration in a progressive 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-lesioned macaque model of Parkinson’s disease. J Neurosci 2001;21:6853–61.

    PubMed  CAS  Google Scholar 

  5. Schwarz J, Tatsch K, Arnold G, Ott M, Trenkwalder C, Kirsch CM, et al.123I-iodobenzamide-SPECT in 83 patients with de novo parkinsonism. Neurology 1993;43(Suppl 6):S17–20.

    PubMed  CAS  Google Scholar 

  6. Kaasinen V, Ruottinen HM, Nagren K, Lehikoinen P, Oikonen V, Rinne JO. Upregulation of putaminal dopamine D2 receptors in early Parkinson’s disease: a comparative PET study with [11C]raclopride and [11C]N-methylspiperone. J Nucl Med 2000;41:65–70.

    PubMed  CAS  Google Scholar 

  7. Wenning GK, Donnemiller E, Granata R, Riccabona G, Poewe W. 123I-β-CIT and 123I-IBZM-SPECT scanning in levodopa-naïve Parkinson’s disease. Mov Disord 1998;13:438–45.

    Article  PubMed  CAS  Google Scholar 

  8. Ichise M, Kim YJ, Ballinger JR, Vines D, Erami SS, Tanaka F, et al. SPECT imaging of pre- and postsynaptic dopaminergic alterations in l-dopa-untreated PD. Neurology 1999;52:1206–14.

    PubMed  CAS  Google Scholar 

  9. Antonini A, Schwarz J, Oertel WH, Pogarell O, Leenders KL. Long-term changes of striatal dopamine D2 receptors in patients with Parkinson’s disease: a study with positron emission tomography and [11C]raclopride. Mov Disord 1997;12:33–8.

    Article  PubMed  CAS  Google Scholar 

  10. Rinne UK, Laihinen A, Rinne JO, Nagren K, Bergman J, Ruotsalainen U. Positron emission tomography demonstrates dopamine D2 receptor supersensitivity in the striatum of patients with early Parkinson’s disease. Mov Disord 1990;5:55–9.

    Article  PubMed  CAS  Google Scholar 

  11. Knable MB, Jones DW, Coppola R, Hyde TM, Lee KS, Gorey J, et al. Lateralized differences in iodine-123-IBZM uptake in the basal ganglia in asymmetric Parkinson’s disease. J Nucl Med 1995;36:1216–25.

    PubMed  CAS  Google Scholar 

  12. Kim YJ, Ichise M, Ballinger JR, Vines D, Erami SS, Tatschida T, et al. Combination of dopamine transporter and D2 receptor SPECT in the diagnostic evaluation of PD, MSA, and PSP. Mov Disord 2002;17:303–12.

    Article  PubMed  Google Scholar 

  13. Narrang N, Wamsley JK. Time dependent changes in DA uptake sites, D1 and D2 receptor binding and mRNA after 6-OHDA lesions of the medial forebrain bundle in the rat brain. J Chem Neuroanatomy 1995;9:41–53.

    Article  Google Scholar 

  14. Horstink MWIM, Strijks FE, Oyen WJ. [123I]IBZM-SPECT in extrapyramidal disorders. In: Wolters EC, Tolosa E, editors. Current issues in neurodegenerative diseases, vol 13. New tools in the diagnosis of parkinsonism. Utrecht, The Netherlands: Academic Pharmaceutical Productions; 2001; p. 45–55.

    Google Scholar 

  15. Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 1992;55:181–4.

    Article  PubMed  CAS  Google Scholar 

  16. Vingerhoets FJ, Schulzer M, Calne DB, Snow BJ. Which clinical sign of Parkinson’s disease best reflects the nigrostriatal lesion? Ann Neurol 1997;41:58–64.

    Article  PubMed  CAS  Google Scholar 

  17. Pirker W. Correlation of dopamine transport imaging with parkinsonian motor handicap: how close is it? Mov Disord 2003;18(Suppl 7):S43–51.

    Article  PubMed  Google Scholar 

  18. Horstink MW, Morrish PK. Preclinical diagnosis of Parkinson’s disease. Adv Neurol 1999;80:327–33.

    PubMed  CAS  Google Scholar 

  19. van Royen E, Verhoeff NF, Speelman JD, Wolters EC, Kuiper MA, Janssen AG. Multiple system atrophy and progressive supranuclear palsy. Diminished striatal D2 dopamine receptor activity demonstrated by 123I-IBZM single photon emission computed tomography. Arch Neurol 1993;50:513–6.

    PubMed  Google Scholar 

  20. Hierholzer J, Cordes M, Venz S, Schelosky L, Harisch C, Richter W, et al. Loss of dopamine-D2 receptor binding sites in parkinsonian plus syndromes. J Nucl Med 1998;39:954–60.

    PubMed  CAS  Google Scholar 

  21. Fields JZ, Wichlinski L, Drucker GE, Eng K, Gordon JH. Long-lasting dopamine receptor up-regulation in amphetamine-treated rats following amphetamine neurotoxicity. Pharmacol Biochem Behav 1991;40:881–6.

    Article  PubMed  CAS  Google Scholar 

  22. Larisch R, Meyer W, Klimke A, Kehren F, Vosberg H, Muller-Gartner HW. Left-right asymmetry of striatal dopamine D2 receptors. Nucl Med Commun 1998;19:781–7.

    Article  PubMed  CAS  Google Scholar 

  23. Raz N, Torres IJ, Acker JD. Age, gender, and hemispheric differences in human striatum: a quantitative review and new data from in vivo MRI morphometry. Neurobiol Learn Mem 1995;63:133–42.

    Article  PubMed  CAS  Google Scholar 

  24. Brabec J, Krasensky J, Petrovicky P. Volumetry of striatum and pallidum in man—anatomy, cytoarchitecture, connections, MRI and aging Sb. Lek 2003;104:13–65.

    CAS  Google Scholar 

  25. van Dyck CH, Seibyl JP, Malison RT, Laruelle M, Zoghbi SS, Baldwin RM, et al. Age-related decline in dopamine transporters: analysis of striatal subregions, nonlinear effects, and hemispheric asymmetries. Am J Geriatr Psychiatry 2002;10:36–43.

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

This study was supported by a grant from the Alkemade Stichting, The Netherlands.

Author information

Authors and Affiliations

  1. Department of Neurology (935), Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands

    C. C. P. Verstappen, B. R. Bloem, C. A. Haaxma & M. W. I. M. Horstink

  2. Nuclear Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands

    W. J. G. Oyen

Authors
  1. C. C. P. Verstappen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B. R. Bloem
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. A. Haaxma
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. W. J. G. Oyen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. W. I. M. Horstink
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. C. P. Verstappen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Verstappen, C.C.P., Bloem, B.R., Haaxma, C.A. et al. Diagnostic value of asymmetric striatal D2 receptor upregulation in Parkinson’s disease: an [123I]IBZM and [123I]FP-CIT SPECT study. Eur J Nucl Med Mol Imaging 34, 502–507 (2007). https://doi.org/10.1007/s00259-006-0258-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-006-0258-4

Keywords

Search

Navigation