Image: Susanna Jakobsson Mo
Image: Susanna Jakobsson Mo
Research project Brain imaging of the dopamine function with 18F FE-PE2I PET/CT in Lewy Body Dementa and Atypical Parkinsonian syndromes.
The goal of the research project is to contribute to improved diagnostic accuracy in Lewy body dementia and atypical parkinsonian syndromes through better knowledge about the cerebral dopamine transporter (DAT) availability in patients with neurodegenerative disorders by using detailed PET/CT brain imaging with a highly DAT-selective tracer, 18F FE-PE2I
Background
Lewy Body Dementia (LBD) resembles both Alzheimer´s disease (AD) and Parkinson´s disease (PD). LBD is often categorized to either the dementias or the so called atypical parkinsonian syndromes (APS). The less common diseases Progressive Supranukleär Palsy and Corticobasal Degeneration are also classified as APS, with some features similar to PD, but also with the frontotemporal dementias. Another rare disease among the APS´s is Multi System Atrophy, which resembles PD but which, with time, develops with symptoms not typical for PD.
Thus, all these diseases have shared features, with Parkinson-like symptoms and disturbances in the cerebral dopamine function. The diagnosis is based on clinical criteria, but the similarities makes the differential diagnosis difficult in early stages.
Nuclear medicine techniques for brain imaging of the dopamine function through targeting of the dopamine transporter protein (DAT) and the glucose metabolism or blood-flow can add important diagnostic information to the diagnostic work-up.
Brain imaging of the dopamine function
An isotope-labelled tracer is used for brain imaging of the DAT. Imaging may be done in a gamma-camera with SPECT (e.g. DaTSCAN™). For even more specific and highly detailed DAT-imaging, PET-camera imaging with a very DAT-selective DAT-tracer, 18F FE-PE2I, can be used.
Earlier published data imply that the extent and pattern of dopamine reduction may be different between PS, LBD and APS in early stages. This is, however, not previously studied with 18F FE-PE2I PET.
The superior DAT-selectivity and high resolution in 18F FE-PE2I PET imaging should have all the requirements to detect such differences between these neurodegenerative diseases, which could improve the early differential diagnosis.
The study
In this prospective research study, we will evaluate the distribution of DAT-activity in the basal ganglia in patients with early stage LBD and APS with 18F FE-PE2I PET/CT. We will compare images to previously collected image data from early stage PD-patients and healthy volunteers. We will also assess the correlation between DAT-activity and glucose metabolism in the striatum. The study will include 20 patients with clinical criteria for LBD and 20 patients with clinical criteria for APS in 60-80 years of age.
