Chronic manganism: A long-term follow-up study with a new dopamine terminal biomarker of 18F-FP-(+)-DTBZ (18F-AV-133) brain PET scan.

Chu-Yun Huang, Chi-Hung Liu, Eusden Tsao, Chia-Ju Hsieh, Yi-Hsin Weng, Ing-Tsung Hsiao, Tzu-Chen Yen, Kun-Ju Lin, Chin-Chang Huang

Journal: Journal of the neurological sciences 2016;353(1-2):102-6

PMID: 25936253

Full Text on Elsevier Science View on PubMed

Abstract

Recent experimental studies revealed that dopamine neuron dysfunction in chronic manganism may be due to a reduced capacity of dopamine release in the striatum. The findings imposed further difficulty in the differential diagnosis between manganism and IPD. We conducted a long-term clinical follow-up study of 4 manganism patients, applying a new tracer (18)F-9-fluoropropyl-(+)-dihydrotetrabenazine ((18)F-AV-133) with positron emission tomography (PET). Twenty age-matched subjects including 4 manganism patients, 8 idiopathic Parkinson's disease (IPD) patients, and 8 healthy controls were enrolled for comparison. Volumes of interest of the bilateral putamen, caudate nuclei and occipital cortex as the reference region were delineated from individual magnetic resonance images. The clinical features of the manganism patients still progressed, with increased scores on the Unified Parkinson Disease Rating Scale. The (18)F-AV-133 uptake in the IPD patients decreased at the bilateral striatum, compared with the healthy controls. In the manganism patients, there was no decreased uptake of radioactivity involving the bilateral striatum, except Patient 4, who had a stroke with decreased uptake in the right posterior putamen. The (18)F-AV-133 PET finding reveals that nigrostriatum neurons are not degenerated in chronic manganism and can provide a useful neuroimage biomarker in the differential diagnosis.

Address: Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Pharmacy, Taipei Medical University, Taipei, Taiwan.; Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, Division of Medical Education, College of Medicine, Chang Gung University, Taoyuan, Taiwan.; Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Environmental and Occupational Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.; Molecular Imaging Center and Nuclear Medicine, Chang Gung University, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Healthy Aging Research Center Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.; Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Neurology, College of Medicine, Chang Gung University, Taoyuan, Taiwan.; Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Neurology, College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: [email protected].

DOI: 10.1016/j.jns.2015.04.018

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MeSH Terms: Adrenergic Uptake Inhibitors, Aged, Brain, Case-Control Studies, Dopamine, Female, Fluorine Radioisotopes, Humans, Longitudinal Studies, Male, Manganese Poisoning, Middle Aged, Parkinson Disease, Positron-Emission Tomography, Taiwan, Tetrabenazine, Tomography Scanners, X-Ray Computed