Variability of FP-CIT PET Patterns Associated With Clinical Features of Multiple System Atrophy
- Authors
- Lee, R.; Shin, J.H.; Choi, H.; Kim, H.-J.; Cheon, G.J.; Jeon, B.
- Issue Date
- Mar-2021
- Publisher
- NLM (Medline)
- Citation
- Neurology, v.96, no.12, pp e1663 - e1671
- Journal Title
- Neurology
- Volume
- 96
- Number
- 12
- Start Page
- e1663
- End Page
- e1671
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/62543
- DOI
- 10.1212/WNL.0000000000011634
- ISSN
- 0028-3878
1526-632X
- Abstract
- OBJECTIVE: To validate the role of the dopamine transporter (DAT) imaging as a biomarker in multiple system atrophy (MSA), we analyzed the association between spatial patterns of [18F]fluoro-propyl-carbomethoxy-iodophenyl-tropane ([18F]FP-CIT) PET and the clinical characteristics of MSA. METHODS: Sixty-five patients with MSA who underwent [18F]FP-CIT PET between 2009 and 2018 were retrospectively enrolled. To identify spatial patterns of [18F]FP-CIT PET, principal component (PC) analysis was used and correlated with the clinical presentation. RESULTS: Of the 65 patients, 42 presented with parkinsonian subtype of MSA, and 23 presented with cerebellar subtype of MSA (mean age 63.7 ± 9.3 years; disease duration, 1.8 ± 1.8 years). Each PC represents a specific pattern of degeneration: PC1 and PC2 were associated with the DAT binding of the entire putamen and the posterior putamen, respectively. PC3 was associated with increased [18F]FP-CIT uptake of the caudate and decreased uptake of the dorsal pons. PC2 was significantly correlated with the presence of parkinsonism (p = 5.34 × 10-5) and a positive levodopa response (p = 0.044), with age as a cofactor. PC3 was correlated with the presence of urinary incontinence (p = 0.036). Onset age was significantly correlated with both PC2 (R = 0.48, p = 5.0 × 10-5) and PC3 (R = -0.39, p = 0.0013). CONCLUSIONS: The spatial pattern of DAT binding can reflect distinct clinical features of MSA and provides insight into the underlying pathophysiology of a broad spectrum of clinical features in MSA. © 2021 American Academy of Neurology.
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