Extrastriatal SPECT-DAT uptake correlates with clinical and biological features of de novo Parkinson's disease

Striatal dopamine transporter (DAT) uptake assessment through I-123-Ioflupane Single-Pphoton Emission Computed Tomography (SPECT) provides valuable information about the dopaminergic denervation occurring in Parkinson's disease (PD). However, little is known about the clinical or biological relevance of extrastriatal DAT uptake in PD. Here, from the Parkinson's Progression Markers Initiative, we studied 623 participants (431 PD and 192 healthy controls) with available SPECT data. Even though striatal denervation was undoubtedly the imaging hallmark of PD, extrastriatal DAT uptake was also reduced in patients with PD. Topographically, widespread frontal but also temporal and posterior cortical regions showed lower DAT uptake in PD patients with respect to healthy controls. Importantly, a longitudinal voxelwise analysis confirmed an active one-year loss of extrastriatal DAT uptake within the PD group. Extrastriatal DAT uptake also correlated with the severity of motor symptoms, cognitive performance, and cerebrospinal fluid alpha-synuclein levels. In addition, we found an association between the Catechol-O-methyltransferase val158met genotype and extrastriatal DAT uptake. These results highlight the clinical and biological relevance of extrastriatal SPECT-DAT uptake in PD. (C) 2020 Elsevier Inc. All rights reserved.

Automated summary

Striatal dopamine transporter (DAT) uptake assessment through I-123-Ioflupane Single-Photon Emission Computed Tomography (SPECT) provides valuable information about dopaminergic denervation in Parkinson's disease (PD). Although striatal denervation is the imaging hallmark of PD, extrastriatal DAT uptake is also reduced in patients with PD. Longitudinal analysis confirmed an active one-year loss of extrastriatal DAT uptake within the PD group.