[123I]-IBVM SPECT imaging of cholinergic systems in multiple system atrophy: A specific alteration of the ponto-thalamic cholinergic pathways (Ch5-Ch6)
NeuroImage: Clinical. 2013-01-01; 3: 212-217
DOI: 10.1016/j.nicl.2013.07.012
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1. Neuroimage Clin. 2013 Aug 8;3:212-7. doi: 10.1016/j.nicl.2013.07.012. eCollection
2013.
[(123)I]-IBVM SPECT imaging of cholinergic systems in multiple system atrophy: A
specific alteration of the ponto-thalamic cholinergic pathways (Ch5-Ch6).
Mazere J(1), Meissner WG, Sibon I, Lamare F, Tison F, Allard M, Mayo W.
Author information:
(1)Univ. Bordeaux, INCIA, UMR 5287, F-33400 Talence, France ; CNRS, INCIA, UMR
5287, F-33400 Talence, France ; CHU de Bordeaux, Service de Médecine Nucléaire,
Bordeaux, France.
We evaluated in vivo the integrity of brain cholinergic pathways in Multiple
System Atrophy (MSA) and the relationship between cholinergic dysfunction and
motor disturbances, by measuring the vesicular acetylcholine transporter (VAChT)
expression using Single Photon Emission Computed Tomography (SPECT) and
[(123)I]-iodobenzovesamicol ([(123)I]-IBVM).METHODS: Nine patients with probable
MSA and 12 healthy volunteers underwent a dynamic [(123)I]-IBVM SPECT-CT scan and
a magnetic resonance imaging (MRI) scan. All patients were examined with the
Unified MSA Rating Scale (UMSARS; subscale I = activities of daily living (ADL),
II = motor and IV = disability). CT and MRI images were used to register the
dynamic SPECT image to the Montreal Neurological Institute brain template, which
includes the regions of interest (ROI) of striatum and Ch1 (medial septum
nucleus-hippocampus), Ch4 (nucleus basalis of Meynert-cortex) and Ch5-Ch6
(pedunculopontine and laterodorsal tegmental nuclei-thalamus) cholinergic
pathways. For each ROI, pharmacokinetic modeling of regional time activity curves
led to the calculation of [(123)I]-IBVM to VAChT binding potential (BPND) value,
proportional to VAChT expression.
RESULTS: When compared to controls, BPND values for MSA in Ch5-Ch6 were
significantly decreased in both the pedunculopontine-laterodorsal nuclei and the
thalamus (p = 0.004 and p = 0.006, respectively). Additionally, thalamus BPND
values were correlated with UMSARS ADL (p = 0.006), motor (p = 0.002) and
disability (p = 0.02) sub-scores. UMSARS motor subscale items 13 (postural
instability) and 14 (gait) were also correlated with thalamus BPND values
(p = 0.04).
CONCLUSION: Ch5-Ch6 are the most affected cholinergic pathways in MSA at both
cell bodies and thalamic cholinergic terminals. These results underscore the
relevant role of [(123)I]-IBVM SPECT for improving our understanding of the
pathophysiology in MSA.
DOI: 10.1016/j.nicl.2013.07.012
PMCID: PMC3791287
PMID: 24179865