Brain monoamine systems in multiple system atrophy: A positron emission tomography study

• Published in: Neurobiology of disease Vol. 46; no. 1; pp. 130 - 136
• Main Authors: Lewis, Stephanie J, Pavese, Nicola, Rivero-Bosch, Maria, Eggert, Karla, Oertel, Wolfgang, Mathias, Christopher J, Brooks, David J, Gerhard, Alex
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2012; Elsevier
• Subjects: 18F-dopa; Aged; Biogenic Monoamines - metabolism; Brain - diagnostic imaging; Brain - metabolism; Dihydroxyphenylalanine - analogs & derivatives; Dopamine - metabolism; Extrastriatal; Female; Fluorine Radioisotopes; Humans; Male; Middle Aged; Monoamine; Multiple system atrophy (MSA); Multiple System Atrophy - diagnostic imaging; Multiple System Atrophy - metabolism; Neurology; Norepinephrine - metabolism; Parkinson Disease - diagnostic imaging; Parkinson Disease - metabolism; Parkinson's disease; Positron emission tomography (PET); Positron-Emission Tomography - methods; Serotonin - metabolism; Monoamine; 18F-dopa; Positron emission tomography (PET); Parkinson's disease; Multiple system atrophy (MSA); Extrastriatal
• ISSN: 0969-9961; 1095-953X
• DOI: 10.1016/j.nbd.2011.12.053

Abstract Post-mortem studies of multiple system atrophy (MSA) patients have shown widespread subcortical neurodegeneration. In this study, we have used18 F-dopa PET, a marker of monoaminergic nerve terminal function, to explore in vivo changes in striatal and extrastriatal dopamine, noradrenaline, and serotonin transmission for a cohort of patients with MSA with predominant parkinsonism. Fourteen patients with MSA, ten patients with idiopathic Parkinson's disease (PD) matched for disease duration, and ten healthy controls were studied with18 F-dopa PET. Regions of interest (ROIs) were placed to sample18 F-dopa uptake in thirteen structures and mean activity was compared between groups. The MSA patients showed significantly decreased18 F-dopa uptake in putamen, caudate nucleus, ventral striatum, globus pallidus externa and red nucleus compared to controls, whereas PD patients only had decreased18 F-dopa uptake in putamen, caudate nucleus, and ventral striatum. MSA cases with orthostatic hypotension had lower18 F-dopa uptake in the locus coeruleus than patients without this symptom. In conclusion,18 F-dopa PET showed more widespread basal ganglia dysfunction in MSA than in PD with similar disease duration, and extrastriatal loss of monoaminergic innervation could be detected in the red nucleus and locus coeruleus. In contrast to PD, there was no evidence of early compensatory increases in regional18 F-dopa uptake.