Journal
EUROPEAN JOURNAL OF NEUROLOGY
Volume 10, Issue 3, Pages 257-264Publisher
BLACKWELL PUBLISHING LTD
DOI: 10.1046/j.1468-1331.2003.00571.x
Keywords
inflammation; microglia; multiple sclerosis; peripheral benzodiazepine receptor; PK11195; positron emission tomography
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Activated microglia are involved in the immune response of multiple sclerosis (MS). The peripheral benzodiazepine receptor (PBR) is expressed on microglia and up-regulated after neuronal injury. [(11) C]PK11195 is a positron emission tomography (PET) radioligand for the PBR. The objective of the present study was to investigate [(11) C]PK11195 imaging in MS patients and its additional value over magnetic resonance imaging (MRI) concerning the immuno-pathophysiological process. Seven healthy and 22 MS subjects were included. Semiquantitative [(11) C]PK11195 uptake values were assessed with normalization on cortical grey matter. Uptake in Gadolinium-lesions was significantly increased compared with normal white matter. Uptake in T2-lesions was generally decreased, suggesting a PBR down-regulation. However, uptake values increased whenever a clinical or MR-relapse was present, suggestive for a dynamic process with a transient PBR up-regulation. During disease progression, an increase of normal-appearing white matter (NAWM) uptake was found, propagating NAWM as the possible real burden of disease. In conclusion, [(11) C]PK11195 and PET are able to demonstrate inflammatory processes with microglial involvement in MS.
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