Tomoyuki Miyamoto1, Masayuki Miyamoto2, Kyoko Numahata3, Hiroyuki Onoue3, Yasuhisa Akaiwa3, Toshimi Sairenchi4. 1. Department of Neurology, Dokkyo Medical University Saitama Medical Center, Japan. Electronic address: miyatomo@dokkyomed.ac.jp. 2. Center of Sleep Medicine, Dokkyo Medical University Hospital, Japan. 3. Department of Neurology, Dokkyo Medical University Saitama Medical Center, Japan. 4. Department of Public Health, Dokkyo Medical University, Japan.
Abstract
PURPOSE: We examined dopamine transporter (DAT) binding in Japanese patients with idiopathic rapid eye movement sleep behavior disorder (IRBD) as a biomarker for the development of Lewy body disease (LBD). METHODS: [123I]FP-CIT SPECT (DAT-SPECT) scans of 74 IRBD patients were compared to those from healthy Japanese subjects, and the predictive value for conversion to LBD during a 5-year follow-up was evaluated. RESULTS: Baseline DAT deficits (Z-score ≤ -2.5) were observed in 25 (33.8%) of the IRBD patients. During follow-up, 25 patients (33.8%) developed LBD [19 Parkinson's disease and 6 dementia with Lewy bodies], with a mean latency of 2.4 ± 1.6 years from imaging. The receiver operating characteristics curve revealed that the Z-score of baseline DAT binding in the striatum of abnormal DAT-SPECT patients who later developed LBD differed from those who remained disease-free. Kaplan-Meier survival analysis showed an increased risk of LBD in patients with a Z-score ≤ -2.5 for DAT binding in the striatum of abnormal DAT-SPECT patients compared to patients with a Z-score > -2.5. CONCLUSIONS: DAT-SPECT identifies IRBD patients at short-term risk for developing LBD. Decreased DAT binding in the striatum (Z-score ≤ -2.5) predicts development of LBD within 5 years, and may be useful in future disease-prevention trials in IRBD patients.
PURPOSE: We examined dopamine transporter (DAT) binding in Japanese patients with idiopathic rapid eye movement sleep behavior disorder (IRBD) as a biomarker for the development of Lewy body disease (LBD). METHODS: [123I]FP-CIT SPECT (DAT-SPECT) scans of 74 IRBD patients were compared to those from healthy Japanese subjects, and the predictive value for conversion to LBD during a 5-year follow-up was evaluated. RESULTS: Baseline DAT deficits (Z-score ≤ -2.5) were observed in 25 (33.8%) of the IRBD patients. During follow-up, 25 patients (33.8%) developed LBD [19 Parkinson's disease and 6 dementia with Lewy bodies], with a mean latency of 2.4 ± 1.6 years from imaging. The receiver operating characteristics curve revealed that the Z-score of baseline DAT binding in the striatum of abnormal DAT-SPECT patients who later developed LBD differed from those who remained disease-free. Kaplan-Meier survival analysis showed an increased risk of LBD in patients with a Z-score ≤ -2.5 for DAT binding in the striatum of abnormal DAT-SPECT patients compared to patients with a Z-score > -2.5. CONCLUSIONS:DAT-SPECT identifies IRBD patients at short-term risk for developing LBD. Decreased DAT binding in the striatum (Z-score ≤ -2.5) predicts development of LBD within 5 years, and may be useful in future disease-prevention trials in IRBD patients.
Authors: Lilian Calderón-Garcidueñas; Ravi Philip Rajkumar; Elijah W Stommel; Randy Kulesza; Yusra Mansour; Adriana Rico-Villanueva; Jorge Orlando Flores-Vázquez; Rafael Brito-Aguilar; Silvia Ramírez-Sánchez; Griselda García-Alonso; Diana A Chávez-Franco; Samuel C Luévano-Castro; Edgar García-Rojas; Paula Revueltas-Ficachi; Rodolfo Villarreal-Ríos; Partha S Mukherjee Journal: Int J Environ Res Public Health Date: 2021-06-22 Impact factor: 3.390