Involvement of nigrostriatal pathway in Japanese encephalitis with movement disorders: evidence from 99mTc-TRODAT-1 and 123I-IBZM SPECT imagings.
OBJECTIVE
The purpose of this study was to evaluate molecular evidence of nigrostriatal pathway involvement in Japanese encephalitis (JE) survivors with movement complications.


METHODS
Three JE patients were recruited. All had cranial magnetic resonance imaging (MRI) and single-photon emission computed tomography (SPECT) studies with (99m)Tc-TRODAT-1 and (123)I-IBZM.


RESULTS
Cranial MRI revealed involvement of bilateral thalami, substantia nigra, and medial temporal lobes in all three patients, but only case 1 had additional bilateral basal ganglia involvement. The (99m)Tc-TRODAT-1 SPECT for presynaptic dopamine transporter imaging disclosed asymmetrical decreases in bilateral striatal uptake in all three patients. However, the (123)I-IBZM SPECT imaging for postsynaptic D2 dopamine receptors (D2Rs) revealed inconsistent abnormalities including asymmetrical bilateral decreases (case 1), unilateral decrease (case 2), and bilateral increases (case 3) in striatal uptakes.


CONCLUSIONS
Data have suggested that presynaptic dopaminergic neurons in JE patients are more susceptible to JE virus than postsynaptic striatal neurons. The degree of movement impairment was more closely correlated to the degree of D2Rs disruption seen in (123)I-IBZM SPECT imaging.
Liao
Chang-Hsu
CH
Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Cheng-Kung Rd Section 2, Taipei, 114, Taiwan, Republic of China.
Ling
Zaodung
Z
Chou
Chung-Hsing
CH
Huang
Wen-Sheng
WS
Denq
Jong-Chyou
JC
Lin
Jiann-Chyun
JC
Chen
Cheng-Yu
CY
Chang
Chia-Jung
CJ
Peng
Giia-Sheun
GS
D000328:Adult; D001549:Benzamides; D004569:Electroencephalography; D004672:Encephalitis, Japanese / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007564:Japan; D008279:Magnetic Resonance Imaging; D008297:Male; D009069:Movement Disorders / Q000150:complications* / Q000000981:diagnostic imaging; D017072:Neostriatum / Q000000981:diagnostic imaging* / Q000473:pathology; D015609:Organotechnetium Compounds; D011759:Pyrrolidines; D013378:Substantia Nigra / Q000000981:diagnostic imaging* / Q000473:pathology; D015899:Tomography, Emission-Computed, Single-Photon; D014326:Tropanes; D055815:Young Adult
D001549:Benzamides; D015609:Organotechnetium Compounds; D011759:Pyrrolidines; D014326:Tropanes; C104196:technetium Tc 99m TRODAT-1; C055743:3-iodo-2-hydroxy-6-methoxy-N-((1-ethyl-2-pyrrolidinyl)methyl)benzamide