Elizabeth Katherine Anna Triumbari, Daniele Antonio Pizzuto, Anna Rita Bentivoglio, Carla Piano, Salvatore Annunziata, Guido Maria Meduri, Daniela Di Giuda
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引用次数: 0
摘要
目的 正电子发射计算机断层扫描（PET）和单光子发射计算机断层扫描（SPECT）可在体内评估大脑多巴胺能通路的完整性和功能性。为了确定 PET 和 SPECT 对亨廷顿舞蹈症（HD）患者多巴胺能通路评估的有用性，我们对已发表的文献进行了系统性综述。采用诊断准确性研究质量评估标准对纳入的文章进行评估。然后对数据进行评估和讨论，以帮助临床医生确定何时（在患者病程中）、如何（通过 PET 或 SPECT）以及为何（取决于研究结果）对显性和显性前 HD 患者的多巴胺能通路进行功能评估是有用的。结果 在找到的 572 篇文章中，有 33 篇被纳入本系统综述，其中 6 篇评估了 SPECT 的应用，27 篇评估了 PET 的应用。总体而言，报告纹状体和纹状体外多巴胺能系统变性的观点是一致的，而且往往与临床和神经心理参数相关。突触前多巴胺转运体、囊泡单胺转运体-2 或突触后多巴胺受体 D1 和 D2 的非线性进行性减少不断被描述，极有可能成为疾病进展的敏感生物标志物，并对改变疾病的干预措施做出反应。结论尽管文献数据有限，但本系统综述显示，SPECT 和 PET 可用于监测 HD 各个阶段纹状体和纹状体外多巴胺能通路退化的不同方面，并可用于评估对疾病改变干预措施的反应。
Assessment of dopaminergic pathways in Huntington’s Disease: when, how, why? A (clinician-friendly) systematic review of the literature on PET and SPECT applications
Purpose
Positron Emission Tomography (PET) and Single Photon Emission Computerized Tomography (SPECT) allow the in-vivo evaluation of brain dopaminergic pathways’ integrity and functionality. A systematic review of published literature was performed to determine the usefulness of PET and SPECT for the assessment of dopaminergic pathways in patients with Huntington’s Disease (HD).
Methods
PubMed/Medline databases were searched to identify studies responding to our aim. Included articles were appraised using the Quality Assessment of Diagnostic Accuracy Studies criteria. Evaluation and discussion of data was then designed to assist clinicians identifying when (during patients’ course of the disease), how (through PET or SPECT) and why (depending on the findings) it would be useful to perform a functional assessment of dopaminergic pathways in patients with manifest and pre-manifest HD.
Results
Of 572 articles found, 33 were included in this systematic review, 6 among which evaluated the application of SPECT, and 27 the application of PET. Overall, there was an agreement in reporting dopaminergic system degeneration at both striatal and extra-striatal levels, often correlated with clinical and neuropsychological parameters. The non-linear progressive reduction of presynaptic dopamine transporter, vesicular monoamine transporter-2, or of post-synaptic dopamine receptors D1 and D2 was constantly described having a high potential of offering sensitive biomarkers of disease progression and response to disease-modifying interventions.
Conclusions
Despite limited literature data, this systematic review revealed that SPECT and PET are useful to monitor different aspects of striatal and extra-striatal dopaminergic pathways degeneration during all stages of HD and may serve for response to disease-modifying interventions assessment.
期刊介绍：
Clinical and Translational Imaging is an international journal that publishes timely, up-to-date summaries on clinical practice and translational research and clinical applications of approved and experimental radiopharmaceuticals for diagnostic and therapeutic purposes. Coverage includes such topics as advanced preclinical evidence in the fields of physics, dosimetry, radiation biology and radiopharmacy with relevance to applications in human subjects. The journal benefits a readership of nuclear medicine practitioners and allied professionals involved in molecular imaging and therapy.
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