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Jessica J. van der Zande

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YNICL Journal 2019 Journal Article

Striatal DAT and extrastriatal SERT binding in early-stage Parkinson's disease and dementia with Lewy bodies, compared with healthy controls: An 123I-FP-CIT SPECT study

  • Merijn Joling
  • Chris Vriend
  • Pieter G.H.M. Raijmakers
  • Jessica J. van der Zande
  • Afina W. Lemstra
  • Henk W. Berendse
  • Jan Booij
  • Odile A. van den Heuvel

Parkinson's disease (PD) and dementia with Lewy bodies (DLB) are thought to be part of a spectrum: both have a clinical profile including symptoms associated with dopaminergic and serotonergic loss, yet few imaging studies have focused on serotonergic neurodegeneration in both disorders. We aimed to study degeneration of terminals with dopamine and serotonin transporter (DAT and SERT, respectively) in patients with early-stage PD and DLB relative to healthy controls, using 123I-N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane (123I-FP-CIT) single photon emission computed tomography (SPECT). We conducted region of interest (ROI) and voxel-based analyses on 123I-FP-CIT SPECT scans. Using the cerebellum as a reference region, we determined binding ratios (BRs) for bilateral ROIs in the DAT-rich striatum (head of the caudate nucleus and posterior putamen) and SERT-rich extrastriatal brain regions (thalamus, hypothalamus and hippocampus). We compared BRs in PD and DLB patients with BRs in healthy controls (all groups: n = 16). Both PD and DLB patients had lower striatal 123I-FP-CIT BRs than healthy controls for the bilateral caudate head (PD—left: F(1, 29) = 28. 778, P <. 001, ω 2 = 0. 35; right: F(1, 29) = 35. 338, P <. 001, ω 2 = 0. 42; DLB—left: F(1, 29) = 28. 241, P <. 001, ω 2 = 0. 31; right: F(1, 29) = 18. 811, P <. 001, ω 2 = 0. 26) and bilateral posterior putamen (PD—left: F(1, 29) = 107. 531, P <. 001, ω 2 = 0. 77; right: F(1, 29) = 87. 525, P <. 001, ω 2 = 0. 72; DLB—left: F(1, 29) = 39. 910, P <. 001, ω 2 = 0. 48; right: F(1, 29) = 26. 882, P <. 001, ω 2 = 0. 38). DLB patients had lower hypothalamic 123I-FP-CIT BRs than healthy controls (F(1, 29) = 6. 059, P =. 020, ω 2 = 0. 12). In the voxel-based analysis, PD and DLB patients had significantly lower striatal binding than healthy controls. Both PD patients in the early disease stages and DLB patients have reduced availability of striatal DAT, and DLB patients lower hypothalamic SERT compared with healthy controls. These observations add to the growing body of evidence that PD and DLB are not merely dopaminergic diseases, thereby providing additional clinicopathological insights.

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YNICL Journal 2018 Journal Article

Lower 123I-FP-CIT binding to the striatal dopamine transporter, but not to the extrastriatal serotonin transporter, in Parkinson's disease compared with dementia with Lewy bodies

  • Merijn Joling
  • Chris Vriend
  • Jessica J. van der Zande
  • Afina W. Lemstra
  • Odile A. van den Heuvel
  • Jan Booij
  • Henk W. Berendse

In this retrospective cross-sectional study we compared 123I‑N‑ω‑fluoropropyl‑2β‑carbomethoxy‑3β‑(4‑iodophenyl)nortropane (123I-FP-CIT) binding to the striatal dopamine and the extrastriatal serotonin transporter (DAT and SERT, respectively) between Parkinson's disease (PD) and dementia with Lewy bodies (DLB) to gain more insight in the pathophysiology of the two diseases. We compared 123I-FP-CIT single photon emission computed tomography scans of, age-, gender matched patients with cognitive decline in same range of severity with PD (n = 53) or DLB (n = 53) using a regions of interest (ROIs) approach. We derived ROIs anatomically from individual magnetic resonance imaging brain scans. To corroborate the ROI findings, we performed additional whole-brain voxel-based analyses. In both ROI and voxel-based analyses, 123I-FP-CIT binding in PD patients was significantly lower in the bilateral posterior putamen than in DLB patients (left: F(1, 103) = 18. 363, P < 0. 001, ω 2 = 0. 14; right: F(1, 103) = 20. 434, P < 0. 001, ω 2 = 0. 15) (P corr < 0. 033). Caudate/putamen ratios were also significantly lower in DLB than in PD (U(105) = 724. 0, P < 0. 001). Extrastriatal SERT binding showed no difference between PD and DLB. These results suggest similar involvement of serotonergic structures in the degenerative process in PD and DLB.

Details DOI
v2026.09.13