Objective: We aimed to investigate the correlations between brain perfusion and striatal dopamine transporter (DAT) activity in parkinsonian syndromes and to characterize the difference in whole brain effect of striato-nigral dysfunction among disorders.

Background: We reported that striatal DAT activity and ipsilateral prefrontal perfusion were positively correlated in patients with Parkinson’s disease (PD).

Methods: We recruited 55 patients with PD, 23 dementia with Lewy bodies (DLB), 24 multiple system atrophy (MSA), 22 progressive supranuclear palsy (PSP), and 27 corticobasal syndrome (CBS), who scanned both perfusion SPECT (123I-IMP) and DAT SPECT (123I-FP-CIT). Striatal specific biding ratio of DAT SPECT, calculated by Bolt’s method, were utilized to represent striatal DAT activity. Perfusion images were standardized by SPM12. To clarify regional asymmetry, multiple regression analysis was performed for original and flipped perfusion images with right and left striatal DAT as independent valuables. Statistical threshold was set at p < 0.05 with family wise error correction after non-parametric statistics based on threshold-free cluster enhancement.

Results: In PD, cerebral perfusion was correlated with striatal DAT positively in bilateral prefrontal cortex and negatively in bilateral cerebellum. In DLB, positive correlation was found in bilateral frontal cortex, insula and caudate and negative correlation was found in bilateral paracentral area. In MSA, positive correlation was found in ipsilateral dorsolateral prefrontal cortex and contralateral motor cortex. In PSP, positive correlation was found in bilateral hippocampus and caudate and ipsilateral dorsal frontal area. In CBS, positive correlation was found in ipsilateral prefrontal cortex, anterior cingulate, caudate and orbitofrontal cortex, negative correlation was found in contralateral dorsolateral prefrontal cortex.

Conclusions: Correlations between cerebral perfusion and striatal DAT were demonstrated in various brain areas in Parkinsonian syndromes. Positive correlations in frontal lobe were common in all disorders and it possibly accounts for presynaptic function of striatal dopamine transporter. Perfusion asymmetry was characteristics of CBS group. These findings may contribute to understanding pathophysiology of Parkinsonian syndromes or differential diagnosis.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/correlation-between-cerebral-perfusion-and-striatal-dopamine-transporter-activity-by-dual-spect-study-in-parkinsonian-syndromes/