Study of the relation between platelet count and periodontal condition in patients with immune thrombocytopenic purpura

Immune thrombocytopenic purpura (ITP) is a disease associated to the decrease of platelet count in peripheral blood, with repercussion on the oral cavity, due to the potential risk of spontaneous bleeding or provoking it. The aim of this work was evaluate the relation between the platelet count of chronic IPT patients and their periodontal condition. Thereunto, 31 patients were evaluated; 15 with this pathology (group 1) and 16 Dentistry students with no hematologic disease (group 2). Both groups were examined in their periodontal condition through gingival condition index (G), periodontal attachment loss (P) and gingival recession (R), as well as blood tests were performed to verify the platelet count, further a questionnaire on the socioeconomic aspects, access to dentistry services and mouth health self-perception. It was observed that 68.8% of IPT patients' mouth sextants presented some degree of gingivitis, despite some 16.8% manifested loss of periodontal insertion. Gingival retraction occurred in only 2 patients of the group 1, and the average measure for this event in this group was 0.22mm. The questionnaires applied allowed characterizing the sample of the group 1 as low income and low education in relation to the group 2, but with need of dental treatment. We concluded, therefore, there was no direct relation between the platelet count of IPT individuals when the intraoral test was performed, and their periodontal conditions received the indexes "G", "P" e "R".

Malaria Prevalence, the Use of Intermittent Preventive Therapy and Long Lasting Insecticidal Nets among Pregnant Women in Onitsha, Anambra State, Nigeria.

Malaria prevalence, the use of intermittent preventive therapy (IPT) and long lasting insecticidal nets (LLINs) was studied among pregnant women in Onitsha, Anambra State, Nigeria. Peripheral blood were obtained from 204 pregnant women and examined microscopically for malaria parasites. Structured questionnaire was used to determine the use of IPT and LLIN among the pregnant women. The results showed an overall malaria prevalence of 40.5% (99/204) in pregnant women. Prevalence varied markedly within age groups, with ages 15-19 recording a value of 75%. Prevalence among the primigravidae was 55.1% compared to 39.5% for multigravidae. There was a statistical significance in prevalence by age and by parity (P<0.05). Compliance to the use of IPT was 53.9% (110/204). The result also showed that 79.4% (162/204) sleep under LLIN. Malaria was still a problem among pregnant woman and IPT reduced malaria during pregnancy.

Use and Effects of Malaria Control Measures in Pregnancy in Lagos, Nigeria

In Nigeria, malaria causes up to 11% of maternal mortality. Our main aim was to find out the most common mosquito control measures employed by the pregnant women in Lagos and their effects on malaria infection. The study was carried out over a period of 6 months during which trained interviewers administered questionnaires to 400 pregnant women. The prevalence of malaria was 8.4%. There was no significant association between the prevalence of malaria and age, level of education, or occupation of the participants. Pregnant women in the age range 26-30 had the mean parasite density (409.9+/-196.80). Insecticide spray (32.8%), mosquito coil (27.5%), and insecticide-treated nets (ITN) (15.5%) were the major mosquito control measures employed by the participants while the prevalence of infection among them were 2.3%, 6.2%, and 3.2%, respectively (P<0.05). Only 18.3% of the women had taken more than one dose of intermittent preventive treatment (IPT), while another 11.8% had taken a single dose. The infection rate among them was 4.1% and 6.4%, respectively. Malaria prevalence was highest among those who had not received any dose of IPT (10%). This study showed that the use of ITN and IPT among the pregnant women were still unacceptably low. It also showed that the use of insecticide spray which was the most common malaria control measure adopted by the participants was effective despite the fact that it is not a National Malaria Control Policy. We recommend that a sustained integrated mosquito management and public education should be strengthened in Nigeria.

Differentiation of Parkinson's Disease and Essential Tremor on I-123 IPT(I-123-N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta(4-cholorophenyl) tropane) Brain SPECT / 핵의학분자영상

PURPOSE: The study was to assess I-123-N-(3-iodopropen-2-yl)-2[beta]-carbomethoxy-3[beta]-(4-cholorophenyl) tropane (IPT) SPECT in differential diagnosis among early stage of Parkinson's disease(PD) and essential tremor(ET) and normal control(NL) groups quantitatively. MATERIALS AND METHODS: I-123 IPT brain SPECT of 50 NL, 20 early PD, 30 advanced PD, and 20 ET were performed at 20 minutes and 2 hours. Specific/nonspecific binding of striatum was calculated by using right and left striatal specific to occipital non-specific uptake ratio (striatum-OCC/OCC). RESULTS: Mean value of specific/nonspecific binding ratio was significantly different between advanced PD group and NL group. However, significant overlap of striatal specific/nonspecific binding ratio was observed between PD group and ET group. Bilateral striatal specific/nonspecific binding ratios were decreased in advanced PD. Lateralized differences in the striatal uptake of I-123 IPT correlated with asymmetry in clinical findings in PD group. CONCLUSION: I-123 IPT SPECT may be a useful method for the diagnosis of PD and objective evaluation of progress of clinical stages. Care should be made in the differential diagnosis of early stage of PD and other motor disturbances mimicking PD such as ET in view of significant overlap in striatal I-123 specific/nonspecific binding ratio.

Application of SPM for Comparison of Striatal Dopamine Transporter Density between the Early Stage of the Parkinsonian Variant of Multiple System Atrophy and Parkinson's Disease

OBJECTIVE: Nigrostriatal dopaminergic neuronal degeneration is common to idiopathic Parkinson's disease(PD) and multiple system atrophy(MSA); although the topography of the nigral cell loss and striatal dopamine deficiency may differ. Currently, several functional neuroimaging techniques have been developed to differentiate between these two diseases. However, since the basal ganglia are usually poorly delineated in parkinsonian disorders on most functional neuroimaging techniques, most studies have failed to show the different pathologic changes among the parkinsonian disorders. In this study, we investigated alternation in regional loss of dopamine transporter binding using statistical parametric mapping(SPM) in patients with PD and the parkinsonian variant of MSA(MSA-P). METHODS: Ten PD and five MSA-P patients within 3 years of duration were studied with dual isotope brain SPECT following simultaneous injection of 370 MBq [99mTc] HMPAO and 111 MBq [123I] IPT. RESULTS: The basal ganglia were clearly visible on the fusion image, which was possible for quantitative and sta- tistical analysis. MSA-P patients showed significant loss of dopamine transporter binding in the left globus pallidus, anterior putamen and caudate nucleus in comparison to PD patients. CONCLUSION: This result may provide a useful tool to differentiate the pattern of loss of dopamine transporter bin- ding between PD and MSA-P.

Dopamine Transporter Density of the Basal Ganglia Assessed with I-123 IPT SPECT in Methamphetamine Abusers / 대한핵의학회잡지

PURPOSE: Functional imaging of dopamine transporter (DAT) defines integrity of the dopaminergic system, and DAT is the target site of drugs of abuse such as cocaine and methamphetamine. Functional imaging the DAT may be a sensitive and selective indicator of neurotoxic change by the drug. The aim of the present study is to evaluate the clinical implications of qualitative/quantitative analyses of dopamine transporter imaging in methamphetamine abusers. MATERIALS AND METHODS: Six detoxified methamphetamine abusers (abuser group) and 4 volunteers (control group) were enrolled in this study. Brain MRI was performed in all of abuser group. Abuser group underwent psychiatric and depression assessment using brief psychiatric rating scale (BPRS) and Hamilton depression rating scale (HAMD), respectively. All of the subjects underwent I-123 IPT SPECT (IPT SPECT). IPT SPECT image was analysed with visual qualitative method and quantitative method using basal ganglia dopamine transporter (DAT) specific/non-specific binding ratio (SBR). Comparison of DAT SBR between abuser and control groups was performed. We also performed correlation tests between psychiatric and depression assessment results and DAT SBR in abuser group. RESULTS: All of abuser group showed normal MRI finding, but had residual psychiatric and depressive symptoms, and psychiatric and depressive symptom scores were exactly correlated (r=1.0, p=0.005) each other. Five of them showed abnormal finding on qualitative visual I-123 IPT SPECT. Abuser group had lower basal ganglia DAT SBR than that of control (2.38+/-0.20 vs 3.04+/-0.27, p=0.000). Psychiatric and depressive symptoms were negatively well correlated with basal ganglia DAT SBR (r=-0.908, p=0.012, r=-0.924, p=0.009). CONCLUSION: These results suggest that dopamine transporter imaging using I-123 IPT SPECT may be used to evaluate dopaminergic system of the basal ganglia and the clinical status in methamphetamine abusers.

Dopamine Transporter Density Assessed with 123IIPT SPECT Before and After Risperidone Treatment in Children with Tourette's Disorder / 대한핵의학회잡지

PURPOSE: Tourette's disorder (TD), which is characterized by multiple waxing and waning motor tics and one or more vocal tics, is known to be associated with abnormalities in the dopaminergic system. To testify our hypothesis that risperidone would improve tic symptoms of TD patients through the change of the dopaminergic system, we measured the dopamine transporter (DAT) densities between drug-naive children with TD and normal children, and investigated the DAT density before and after treatment with risperidone in drug-naive children with TD, using iodine-123 labelled N- (3-iodopropen-2-yl) -2beta-carbomethoxy -3beta- (4-chlorophenyl) tropane ([123I]IPT) single photon emission computed tomography (SPECT). MATERIALS AND METHODS: [123I]IPT SPECT imaging and Yale Global Tic Severity Scale-Korean version (YGTSS-K) for assessing the tic symptom severity were carried out before and after treatment with risperidone for 8 weeks in nine drug-naive children with TD. Eleven normal children also underwent SPECT imaging 2 hours after an intravenous administration of [123I]IPT. RESULTS: Drug-naive children with TD had a significantly greater increase in the specific/nonspecific DAT binding ratio of both basal ganglia compared with the normal children. However, no significant difference in the specific/nonspecific DAT binding ratio of the basal ganglia before and after treatment with risperidone in children with TD was found, although tic symptoms were significantly improved with risperidone. CONCLUSION: These findings suggest that DAT densities are directly associated with the pathophysiology of TD, however, that the effect of risperidone on tic symptoms in children with TD is not attributed to the change of dopaminergic system.

Correlation between Psychopathology and Dopamine Transporter Density in Striatum before and after Taking Olanzapine Assessed with IPT-SPECT in First Episode Schizophrenia / 대한정신약물학회지

OBJECTIVE: Using [123I]IPT-SPECT, we compared between the dopamine transporter (DAT) density of the basal ganglia in first-episode, patients with schizophrenia and DAT density in normal control subjects. We investigated the change between DAT density before and after taking olanzapine during 4weeks in patients with schizophrenia. We studied correlations between the clinical symptoms of schizophrenia and DAT density. METHODS: Ten patients with schizophrenia and ten healthy control subjects were included in this study. Brief Psychiatric Rating Scale (BPRS) and Montgomery-Asberg Depression Rating Scale (MADRS) were obtained before and after 4-week treatment with olanzapine in schizophrenic group. Nuclear imaging using [123I]IPT-SPECT was obtained in normal control subjects and schizophrenic group before taking olanzapine. After 4-week treatment with olanzapine, Nuclear imaging was obtained in schizophrenic group. RESULTS: There is significant negative correlation between BPRS total score, withdrawal subscale score after treatment and DAT density before treatment. There is significant positive correlation between the age of onset and DAT density after treatment and there is significant negative correlation between the duration of illness and DAT density after treatment. CONCLUSION: The data of this study suggest that DAT density in basal ganglia in patients with schizophrenia would be a predicting factor in treatment response.

Correlation between Psychopathology and Dopamine Transporter Density in Striatum before and after Taking Olanzapine Assessed with IPT-SPECT in First Episode Schizophrenia / 대한정신약물학회지

OBJECTIVE: Using [123I]IPT-SPECT, we compared between the dopamine transporter (DAT) density of the basal ganglia in first-episode, patients with schizophrenia and DAT density in normal control subjects. We investigated the change between DAT density before and after taking olanzapine during 4weeks in patients with schizophrenia. We studied correlations between the clinical symptoms of schizophrenia and DAT density. METHODS: Ten patients with schizophrenia and ten healthy control subjects were included in this study. Brief Psychiatric Rating Scale (BPRS) and Montgomery-Asberg Depression Rating Scale (MADRS) were obtained before and after 4-week treatment with olanzapine in schizophrenic group. Nuclear imaging using [123I]IPT-SPECT was obtained in normal control subjects and schizophrenic group before taking olanzapine. After 4-week treatment with olanzapine, Nuclear imaging was obtained in schizophrenic group. RESULTS: There is significant negative correlation between BPRS total score, withdrawal subscale score after treatment and DAT density before treatment. There is significant positive correlation between the age of onset and DAT density after treatment and there is significant negative correlation between the duration of illness and DAT density after treatment. CONCLUSION: The data of this study suggest that DAT density in basal ganglia in patients with schizophrenia would be a predicting factor in treatment response.

Dopamine Transporter Density of the Basal Ganglia in Children with Attention Deficit Hyperactivity Disorder Assessed with I-123 IPT PECT / 대한핵의학회잡지

PURPOSE: Attention deficit hyperactivity disorder (ADHD) has been known as psychiatric disorder in childhood associated with dopamine dysregulation. In present study, we investigated changes in dopamine transporter (DAT) density of the basal ganglias using I-123 N- (3-iodopropen-2-yl) -2-carbomethoxy-3beta- (4-chlorophenyl) tropane [I-123 IPT] SPECT in children with ADHD before and after methylphenidate treatment. MATERIALS AND METHOD: Nine drug-naive children with ADHD and seven normal children were included in the study. We performed brain SPECT two hours after the intravenous administration of I-123 IPT and made both quantitative and qualitative analyses using the obtained SPECT data, which were reconstructed for the assessment of specific/nonspecific DAT binding ratios in the basal ganglia. All children with ADHD reperformed [123I]IPT SPECT after treatment with methylphenidate (0.7mg/kg/d) during about 8 weeks. SPECT data reconstructed for the assessment of specific/nonspecific DAT binding ratio of the basal ganglia were compared between before and after treatment methylphenidate. We investigated correlation between the change of ADHD symptom severity assessed with ADHD rating scale-IV and specific/nonspecific DAT binding ratio of basal ganglia. RESULTS: Children with ADHD had a significantly greater specific/nonspecific DAT binding ratio of the basal ganglia comparing to normal children (Right: z = 2.057, p = 0.041; Left: z = 2.096, p = 0.032). Under treatment with methylphenidate in all children with ADHD, specific/nonspecific DAT binding ratio of both basal ganglia decreased significantly greater than before treatment with methylphenidate (Right: t = 3.239, p = 0.018; Left: t = 3.133, p = 0.020). However, no significant correlation between the change of ADHD symptom severity scores and specific/nonspecific DAT binding ratio of the basal ganglia were found. CONCLUSIONS: These findings support the complex dysregulation of the dopaminergic neurotransmitter system in children with ADHD.

Dopamine Transporter Density of the Basal Ganglia Assessed with 123IIPT SPECT before and after Methylphenidate Treatment in Children with Attention Deficit Hyperactivity Disorder / 신경정신의학

OBJECTIVES: ADHD has been known as psychiatric disorder in childhood associated with dopamine dysregulation. The symptoms of ADHD can be treated with methylphenidate, a potent blocker of the dopamine transporter (DAT). In present study, we investigated DAT density using I-123N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl) tropane ([123I]IPT SPECT) in children with ADHD before and after treatment with methylphenidate. METHODS: Seven drug-naive children with ADHD and eight normal children were included in the study and performed SPECT 2 hours after an intravenous administration of [123I]IPT. All children with ADHD reperformed [123I]IPT SPECT after treatment with methylphenidate (0.7 mg/kg/d) during about 8 weeks. SPECT data reconstructed for the assessment of specific/ nonspecific DAT binding ratio of the basal ganglia were compared between before and after treatment methylphenidate. We investigated correlation between the change of ADHD symptom severity assessed with ADHD rating scale-IV and specific/ nonspecific DAT binding ratio of basal ganglia. RESULTS: Children with ADHD had a significantly greater increase of specific/nonspecific DAT binding ratio of right basal ganglia than normal children (Right:z=2.085, p=0.037;Left:z=1.506, p=0.132). Under treatment with methylphenidate in all children with ADHD, specific/nonspecific DAT binding ratio of both basal ganglia decreased significantly greater than before treatment with methylphenidate (Right:t=3.239, p=0.018;Left:t=3.133, p=0.020). However, no significant correlation between the change of ADHD symptom severity scores and specific/nonspecific DAT binding ratio of the basal ganglia were found. CONCLUSIONS: The data of this study using methylphenidate in children with ADHD support the complex dysregulation of the dopaminergic neurotransmitter system in children with ADHD.

Levosulpiride-induced Parkinsonim

The present report discusses four cases of chronic renal failure, which developed symptoms of parkinsonism in response to levosulpiride. The temporal relationship between levosulpiride discontinuation and the disappearance of parkinsonism suggests a causal link. In addition, decreased striatal dopamine transporter bindings assessed by [I-123] IPT SPECT were observed in two patients suggesting that a dopamine blocking agent causes the dysfunction of nigrostriatal dopaminergic neurons and that such injury may be involved in the pathogenesis of drug-induced parkinsonism.

Dopamine Transporter Density of the Basal Ganglia Assessed with I-123 IPT SPECT in Patients with Obsessive-Compulsive Disorder / 신경정신의학

OBJECTIVES: It has been suggested that dopamine as well as serotonin were related to the pathophysiology of obsessive-compulsive disorder (OCD). Thus, many studies were performed to nivestigate brain regions and their association with dopamine in OCD patients. Recently, we have been able to monitor the density of the dopamine transporter (DAT) in the basal ganglia using I-123N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl) tropane (I-123 IPT) SPECT, to evaluate the activity of the presynaptic dopamine function. In present study, we investigated the DAT density of the basal ganglia using I-123 IPT SPECT in patients with OCD. METHODS: Fifteen patients with OCD and nineteen normal control group were included in this study. We performed brain SPECT 2 hours after the intravenous administration of I-123N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl) tropane (I-123 IPT) and carried out both quantitative and qualitative analyses using the SPECT, which were reconstructed for the assessment of the specific/nonspecific DAT binding ratio in basal ganglia. We then investigated the correlation between the severity of OCD symptoms assessed with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the specific/nonspecific DAT binding ratio of basal ganglia. RESULTS: Patients with OCD showed a significantly increased specific/nonspecific DAT binding ratio in right basal ganglia compared with normal controls and did not show a significantly increased specific/nonspecific DAT binding ratio, and an increased tendency in the specific/nonspecific DAT binding ratio in left basal ganglia (Rt:Z=2.584, P=0.009, Lt:=1.873, P=0.060). We found no significant correlation between the total scores of the Y-BOCS and the specific/nonspecific DAT binding ratio of basal ganglia. CONCLUSIONS: The data of this study suggest that dopamine in basal ganglia plays an important role in fronto-subcortical circuit, which are already known as a site of the pathophysiological mechanism of OCD.

Clinical Significance of 123I-IPT SPECT for the Diagnosis of the Parkinson's Disease

OBJECTIVE: N-(3-iodopropene-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl)tropane(IPT) is a cocaine analogue which allows the presynaptic dopamine transporters. The aim of this study is to assess the imaging of dopamine transporters using 123I-IPT SPECT and its correlation with several clinical features of Parkinson's disease and Parkinson Plus syndrome. METHODS: Forty-two patients with Parkinson's disease(14 bilateral, 28 unilateral clinical features), three Parkinson Plus syndrome and five normal controls were studied. All patients with Parkinson's disease were evaluated with Hoehn-Yahr scale, UPDRS(on/off stage), duration, main symptoms(rigidity, tremor, bradykinesia), unilaterality and operation. The two statistical parameters were assessed with 123I-IPT SPECT. One is uptake ratio of basal ganglia and occipital cortex, basal ganglia and cerebellum. The other is three graded visual assessment. RESULTS: The uptake ratio of 123I-IPT SPECT in patients with Parkinson's disease were decreased with higher grade of Hoehn-Yahr scale, and more decreased in 2 hours than in 1 hour. But there was no statistical significance. The visual assessment was significantly correlated with Hoehn-Yahr scale(p<0.045). The early differential diagnosis between Parkinson's disease and Parkinson Plus syndrome could be allowed with visual assessment. But other clinical features of Parkinson's disease was not correlated with finding of 123I-IPT SPECT. CONCLUSION: The visual assessment of 123I-IPT SPECT imaging is useful in the early differential diagnosis and in confirming a clinical severity of Parkinson's disease.

Dopamine Transporter Density of the Basal Ganglia Assessed with 123IIPT SPECT in Drug-Naive Children with Tourette's Disorder / 신경정신의학

OBJECTIVES: Previous studies in patients with Tourette's disorder suggested presynaptic dopaminergic dysfunction, demonstrating increased dopamine densities. In present study, we investigated dopamine transporter densities using I-123N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl)tropane(I-123-IPT)-SPECT in drug-naive children with Tourette's disorder and postulated that dopamine transporter density reflected dopamine concentrations. METHODS: Eight drug-naive children with Tourette's disorder and six normal children were included in the with the brain SPECT 2 hours after an intravenous administration of I-123-IPT. Obtained SPECT data were reconstructed for the assessment of specific/nonspecific dopamine transporter binding ratio of basal ganglia and were evaluated both quantitatively and qualitatively. We investigated correlation between total tic severity of children with Tourette's disorder assessed with YGTSS and specific/nonspecific binding ratio of basal ganglia. RESULTS: Drug-naive children with Tourette's disorder had a significantly greater increase of speciffic/nonspecific dopamine transporter binding ratio of left basal ganglia than normal children. However, no significant differences in specific/nonspecific dopamine transporter binding ratio of right basal ganglia were found between children with Tourette's disorder and normal children. Also, we found no significant correlation between total tic severity of children with Tourette's disorder and specific/ nonspecific binding ratio of basal ganglia. CONCLUSION: These findings support the hypothesis of dopamine dysregulation in presynaptic dopamine function of the basal ganglia in the pathophysiology of Tourette's disorder.

Dopamine Transporter Density of the Basal Ganglia in Children with Attention Deficit Hyperactivity Disorder Assessed with I-123 IPT SPECT / 대한정신약물학회지

OBJECTIVE: ADHD has been known as a psychiatric disorder in childhood associated with dopamine dysregulation. In the present study, we investigated dopamine transporter (DAT) density using I-123N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl) tropane (I-123-IPT)-SPECT in children with ADHD on the hypothesis that alterations of DAT density in the basal ganglia were suggestive of dopaminergic dysfunction in children with ADHD. METHODS: Nine drug-naive children with ADHD and six normal children were included in the study. We performed brain SPECT two hours after the intravenous administration of I-123-IPT and made both quantitative and qualitative analyses using the obtained SPECT data, which were reconstructed for the assessment of specific/nonspecific DAT binding ratios in the basal ganglia. We then investigated the correlation between ADHD Rating Scale (ARS) scores of children with ADHD and specific/nonspecific DAT binding ratios in the basal ganglia. RESULTS: Children with ADHD had significantly greater specific/nonspecific DAT binding ratio of the basal ganglia comparing to normal children. However, no significant correlation were found between ARS scores of children with ADHD and specific/nonspecific DAT binding ratio of basal ganglia in children with ADHD. CONCLUSION: These findings support the complex dysregulation of the dopaminergic neurotransmitter system in children with ADHD.

SPECT Imaging of Dopamine Transporter with I-123 IPT in Normal Controls and Parkinson's Patients

OBJECTIVES: Dopamine transporter concentrations have been known to decrease in Parkinson's disease(PD). The aim of the present study was to evaluate the correlation between SPECT measurements of [I-123]N-(3-iodopropene-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl) tropane(IPT) as an imaging agent for measuring changes in transporter concentrations with PD. PATIENTS AND METHODS:IPT labelled with 4.87+/-1.29mCi(180.19+/-47.73 MBq) of [I-123] was intravenously injected into 23 patients(age:58+/-12) with PD and three normal controls(NC)(age:37+/-7) as bolus. Brain SPECT were then performed at 1 hour and 2 hours after injection on a double headed camera. The statistical parameters were the contrast ratio of left basal ganglia(BG) and right basal ganglia to occipital cortex(OCC) per milli curies of injected radiotracer at 1 hour and 2 hours. The correlations were evaluated between these parameters and Hoehn-Yahr classification of the patients. RESULTS: The(BG-OCC)/OCC/mCi ratios at 1 hour and 2 hours for PD and NC were 0.14+/-0.07 and 0.27+/-0.07(1 hour) and 0.12+/-0.07 and 0.34+/-0.04(2 hour), respectively. The(BG-OCC)/OCC/mCi ratios of Parkinson's disease were decreased with higher grade of Hoehn-Yahr classification of the patients. The ratio between BG and OCC for PD were clearly separated from NC and may be useful outcome measures for clinical diagnosis. CONCLUSION: The findings suggest that IPT may be a very useful tracer for early diagnosis and treatment of PD and study of dopamine re-uptake site.

Striatal dopamine transporter changes in patients with essential tremor and idiopathic Parkinson's disease

BACKGROUNDS: There have been controversies about the association between essential tremor (ET) and Parkinson's disease. To examine the nigrostriatal dopaminergic neurons in patients with ET, we measured the striatal dopamine transporter levels with [123I] N-(3-iodopropene-2-yl)-2?-carbomethoxy-3?-(4-chlorophenyl) tropane(IPT) single photon emission computed tomography (SPECT). METHODS: This study included nine patients with postural tremor, six patients with postural and rest tremor, 11 patients with idiopathic Parkinson's disease, and 21 age matches controls. Using triple headed gamma camera, brain SPECT scans were performed at 115 and 120 minutes after the injection of 6.23?1.37mCi(range 5-10mCi) of I123 labeled IPT. We averaged two images. Regions of interest were drawn on the middle set image at the level of basal ganglia (BG) for each subject. Amounts of striatal dopamine transporter were measured by calculating the ratio between the average counts of the basal ganglia minus occipital cortex (OCC) and the counts of the OCC((BG-OCC)/OCC). RESULTS: The mean of (BG-OCC)/OCC ratios of 9 isolated postural tremor patients (3.60?0.83) was not statistically different from that of the controls (P>0.05). However, the mean of (BG-OCC)/OCC ratios of 4 patients with postural and rest tremor (2.61?0.18) was significantly lower than that of the controls (P<0.01). Four of the six patients with postural and rest tremor had mean ratios lower than 2.0 standard deviations from the mean of the controls. CONCLUSION: In their later clinical courses, some patients with postural tremor may develop rest tremor in association with a damage in the nigrostriatal dopaminergic system.

The Measurement of Sensitivity and Comparative Analysis of Simplified Quantitation Methods to Measure Dopamine Transporters Using I-123 IPT Pharmacokinetic Computer Simulations / 대한핵의학회잡지

Recently, [I-123]IPT SPECT has been used for early diagnosis of Parkinson's patients(PP) by imaging dopamine transporters. The dynamic time activity curves in basal ganglia(BG) and occipital cortex(OCC) without blood samples were obtained for 2 hours. These data were then used to measure dopamine transporters by operationally defined ratio methods of (BG-OCC)/OCC at 2 hrs, binding potential Rv=k3/k4 using graphic method or RA= (ABBG-ABOCC)/ABOCC for 2 hrs, where ABBG represents accumulated binding activity in basal ganglia(integral 0 120minBG(t)dt) and ABOCC represents accumulated binding activity in occipital cortex(integral 0 120minBG(t)dt). The purpose of this study was to examine the IPT pharmacokinetics and investigate the usefulness of simplified methods of (BG-OCC)/OCC, RA, and RA which are often assumed that these values reflect the true values of k3/k4. The rate constants K1, k2, k3 and k4 to be used for simulations were derived using [I-123]IPT SPECT and aterialized blood data with a standard three compartmental model. The sensitivities and time activity curves in BG and OCC were computed by changing K1 and k3(only BG) for every 5min over 2 hours. The values (BG-OCC)/OCC, RA, and Rv were then computed from the time activity curves and the linear regression analysis was used to measure the accuracies of these methods. The rate constants K1, k2, k3, k4 at BG and OCC were 1.26+/-5.41%, 0.044+/-19.58%, 0.031+/-24.36%, 0.008+/-22.78% and 1.36+/-4.76%, 0.170+/-6.89%, 0.007+/-23.89%, 0.007+/-45.09%, respectively. The Sensitivities for ((delta S/S)/(delta k3/k3)) and ((delta S/delta S)/(delta K1/K1)) at 30min and 120min were measured as (0.19, 0.50) and (0.61, 0.23), respectively. The correlation coefficients and slopes of ((BG-OCC)/OCC, RA, and Rv) with k3/k4 were (0.98, 1.00, 0.99) and (1.76, 0.47, 1.25), respectively. These simulation results indicate that a late [1-123]IPT SPECT image may represent the distribution of the dopamine transporters. Good correlations were shown between (BG-OCC)/OCC, RA or Rv and true k3/k4,, although the slopes between them were not unity. Pharmacokinetic computer simulations may be very useful technique in studying dopamine transpoter systems.