Increased anteroventral striatal dopamine transporter and motor recovery after subthalamic deep brain stimulation in Parkinson’s disease

壳核 多巴胺转运体 脑深部刺激 丘脑底核 伏隔核 医学 尾状核 腹侧纹状体 帕金森病 纹状体 多巴胺 内科学 麻醉 内分泌学 多巴胺能 疾病
作者
Takao Nozaki,Kenji Sugiyama,Tetsuya Asakawa,Hiroki Namba,Masamichi Yokokura,Tatsuhiro Terada,Tomoyasu Bunai,Yasuomi Ouchi
出处
期刊:Journal of Neurosurgery [American Association of Neurological Surgeons]
卷期号:137 (2): 468-478 被引量:2
标识
DOI:10.3171/2021.10.jns211364
摘要

Subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease is effective; however, its mechanism is unclear. To investigate the degree of neuronal terminal survival after STN-DBS, the authors examined the striatal dopamine transporter levels before and after treatment in association with clinical improvement using PET with [11C]2β-carbomethoxy-3β-(4-fluorophenyl)tropane ([11C]CFT).Ten patients with Parkinson's disease who had undergone bilateral STN-DBS were scanned twice with [11C]CFT PET just before and 1 year after surgery. Correlation analysis was conducted between [11C]CFT binding and off-period Unified Parkinson's Disease Rating Scale (UPDRS) scores assessed preoperatively and postoperatively.[11C]CFT uptake reduced significantly in the posterodorsal putamen contralateral to the parkinsonism-dominant side after 1 year; however, an increase was noted in the contralateral anteroventral putamen and ipsilateral ventral caudate postoperatively (p < 0.05). The percentage increase in [11C]CFT binding was inversely correlated with the preoperative binding level in the bilateral anteroventral putamen, ipsilateral ventral caudate, contralateral anterodorsal putamen, contralateral posteroventral putamen, and contralateral nucleus accumbens. The percentage reduction in UPDRS-II score was significantly correlated with the percentage increase in [11C]CFT binding in the ipsilateral anteroventral putamen (p < 0.05). The percentage reduction in UPDRS-III score was significantly correlated with the percentage increase in [11C]CFT binding in the ipsilateral anteroventral putamen, ventral caudate, and nucleus accumbens (p < 0.05).STN-DBS increases dopamine transporter levels in the anteroventral striatum, which is correlated with the motor recovery and possibly suggests the neuromodulatory effect of STN-DBS on dopaminergic terminals in Parkinson's disease patients. A preoperative level of anterior striatal dopamine transporter may predict reserve capacity of STN-DBS on motor recovery.
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