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Association of vascular parkinsonism with impaired neuronal integrity in the striatum

M Ihara1, H Tomimoto, K Ishizu

  • 1Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan. ihara@kuhp.kyoto-u.ac.jp

Journal of Neural Transmission (Vienna, Austria : 1996)
|January 18, 2007
PubMed

Insights

Reduced striatal neuronal integrity, measured by [11C]flumazenil PET scans, is linked to gait disturbance in patients with white matter lesions (WMLs), suggesting a key factor in developing vascular parkinsonism (VaP).

Area of Science:

  • Neuroimaging
  • Neurology
  • Radiochemistry

Background:

  • White matter lesions (WMLs) are common in aging and cerebrovascular disease.
  • Gait disturbance can be a symptom of vascular parkinsonism (VaP), but its underlying pathophysiology in WML patients is not fully understood.
  • Positron Emission Tomography (PET) offers a method to assess neuronal integrity.

Purpose of the Study:

  • To investigate differences in neuronal integrity between WML patients with and without gait disturbance suggestive of VaP.
  • To explore the relationship between striatal neuronal integrity and motor symptoms in WML patients.

Main Methods:

  • Utilized Positron Emission Tomography (PET) with [11C]flumazenil (FMZ) to evaluate neuronal integrity in 14 patients with extensive WMLs (MRI-confirmed).
  • Calculated FMZ distribution volume (FMZ-V(d)) in regions of interest using non-linear curve fitting and voxel-by-voxel analysis.
  • Employed statistical parametric mapping for data analysis and correlated FMZ-V(d) with motor UPDRS scores.

Main Results:

  • Striatal FMZ-V(d) values showed an inverse correlation with motor UPDRS scores (r = 0.70, p < 0.005).
  • Reduced striatal FMZ-V(d) was significantly associated with the presence of gait disturbance in WML patients.
  • Neuronal integrity differences in the striatum were identified between the two patient groups.

Conclusions:

  • Decreased neuronal integrity in the striatum, as indicated by reduced FMZ-V(d) on PET scans, may be a critical factor determining the development of VaP in patients with WMLs.
  • PET imaging with [11C]flumazenil can help differentiate WML patients who develop gait disturbances suggestive of VaP.
  • Striatal neuronal integrity is a potential biomarker for VaP in the context of white matter lesions.

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