Effects of subthalamic nucleus stimulation on striatal dopaminergic transmission in patients with Parkinson's disease within one-year follow-up.
The mechanisms by which deep brain stimulation (DBS) of the subthalamic nucleus (STN) leads to clinical benefit in Parkinson's disease (PD), especially with regard to dopaminergic transmission, remain unclear. Therefore, the objective of our study was to evaluate alterations of synaptic dopaminergic signaling following bilateral STN-DBS in advanced PD within a one-year follow-up. We used [(123)I]FP-CIT single-photon emission computed tomography (SPECT) to measure dopamine transporter (DAT) availability and [(123)I]IBZM SPECT to assess dopamine D(2) receptor (D2R) availability (stimulator ON condition).Patients (n=18) showed a tendency towards a better suppression of symptoms after STN-DBS (Unified Parkinson's Disease Rating Scale motor score with medication decreased from 24.1+/-16.1 to 15.4+/-7.45; p=0. 002) while medication was strongly reduced (61% reduction of levodopa equivalent units; p<0. 0001). No changes of striatal [(123)I]FP-CIT binding and an increase of [(123)I]IBZM binding up to 16% (p<0. 05) between pre-surgery and follow-up investigations were noticed. These data show that clinical improvement and reduction of dopaminergic drugs in patients with advanced PD undergoing bilateral STN-DBS are paralleled by stable DAT and recovery of striatal D2R availability 12 months after surgery.
Hesse
Swen
S
Dept. of Nuclear Medicine, University of Leipzig, Stephanstrasse 11, 04103 Leipzig, Germany. swen.hesse@medizin.uni-leipzig.de
Strecker
Karl
K
Winkler
Dirk
D
Luthardt
Julia
J
Scherfler
Christoph
C
Reupert
Annegret
A
Oehlwein
Christian
C
Barthel
Henryk
H
Schneider
Jens-Peter
JP
Wegner
Florian
F
Meyer
Philipp
P
Meixensberger
Jürgen
J
Sabri
Osama
O
Schwarz
Johannes
J
D000368:Aged; D001549:Benzamides / Q000378:metabolism; D001931:Brain Mapping; D003342:Corpus Striatum / Q000000981:diagnostic imaging / Q000378:metabolism*; D046690:Deep Brain Stimulation / Q000379:methods*; D004298:Dopamine / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D006801:Humans; D007456:Iodine Isotopes / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D011759:Pyrrolidines / Q000378:metabolism; D011877:Radionuclide Imaging; D020531:Subthalamic Nucleus / Q000502:physiology / Q000528:radiation effects*; D014326:Tropanes / Q000378:metabolism
D001549:Benzamides; D007456:Iodine Isotopes; D011759:Pyrrolidines; D014326:Tropanes; C087552:2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane; C055743:3-iodo-2-hydroxy-6-methoxy-N-((1-ethyl-2-pyrrolidinyl)methyl)benzamide; D004298:Dopamine