Asymmetrical pre-synaptic and post-synaptic changes in the striatal dopamine projection in dopa naïve parkinsonism

• DOI: 10.1093/brain/116.4.853
• Publication Date: 2007-01-04T09:52:09Z
• Authors: Guy V. Sawle; E. Diane Playford; David J. Brooks; Niall Quinn; Richard S. J. Fra...
• Keywords: Raclopride; Putamen

Nine L-dopa naïve patients with clinically diagnosed parkinsonism were studied using positron emission tomography 6-L-[18F]fluorodopa ([18F]dopa, a pre-synaptic tracer) and [11C]raclopride (which binds to D2 receptors). Putamen [18F]dopa uptake was reduced in all patients, confirming loss of function affecting the nigrostriatal projection. In eight putamen lowest (always contralateral most affected side) had highest binding, suggesting upregulation post-synaptic receptors. ninth patient binding lower uptake, indicating an additional deficit. All nine shown be responsive. The subsequent clinical course former has been typical idiopathic Parkinson's disease, whilst developed postural hypotension, Urinary incontinence respiratory stridor multiple system atrophy. Reduced parkinsonian might serve as useful early marker this condition.