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.

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 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.