PET and SPECT in the assessment of monoaminergic brain systems in extrapyramidal disorders

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Abstract

In clinical neurology, biomarkers of central neurotransmitter imbalance have been of particular interest in the study of motor disorders and examination of patients with Parkinson’s disease (PD) and other extrapyramidal diseases, primarily to assess the exchange of dopamine and other monoamines in the brain. Radioisotope visualization methods, such as positron emission tomography (PET) and single-photon emission computed tomography (SPECT) with the corresponding radiopharmaceuticals, are the most informative for these purposes. This article presents a comparative analysis of the wide range of existing ligands and molecular targets for functional neuroimaging using radioisotopes of the nigrostriatal system and the other monoaminergic systems of the brain, with emphasis on the study of the dopamine transporter, dopamine receptors and dopamine-metabolysing enzymes. The modern possibilities of PET and SPECT for the early diagnosis of PD, and the differential diagnosis of this disease with clinically similar syndromes (dystonia, atypical and drug-induced parkinsonism, essential tremor), as well as for monitoring the pathological process and assessing the results of various therapeutic interventions are evaluated. The role of functional neuroimaging in the objective assessment in vivo of the non-motor symptoms of PD, such as depression, impulse control disorders, pathological fatigue and orthostatic hypotension, is emphasized.

About the authors

Marianna V. Selikhova

Southmead Hospital

Author for correspondence.
Email: m.selikhova@talk21.com
United Kingdom, Bristol

Elena A. Katunina

N.I. Pirogov Russian National Research Medical University

Email: m.selikhova@talk21.com
Russian Federation, Moscow

Alan Whone

Southmead Hospital

Email: m.selikhova@talk21.com
United Kingdom, Bristol

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