Annals of Clinical and Experimental NeurologyAnnals of Clinical and Experimental NeurologyАнналы клинической и экспериментальной неврологии2075-54732409-2533Eco-Vector59310.25692/ACEN.2019.2.8TechnologiesТехнологииUnknownPET and SPECT in the assessment of monoaminergic brain systems in extrapyramidal disordersПозитронная эмиссионная и однофотонная эмиссионная компьютерная томография в оценке состояния моноаминергических систем мозга при экстрапирамидных расстройствахSelikhovaMarianna V.СелиховаМарианна Валерьевна
United Kingdom
m.selikhova@talk21.comKatuninaElena A.КатунинаЕлена Анатольевна
Russian Federation
m.selikhova@talk21.comWhoneAlanВоунАлан
United Kingdom
m.selikhova@talk21.comSouthmead HospitalБольница СаутмидN.I. Pirogov Russian National Research Medical UniversityФГБОУ ВО «Российский научно-исследовательский медицинский университет им. Н.И. Пирогова»25062019132697826062019Copyright ©; 2019, Selikhova M.V., Katunina E.A., Whone A...Copyright ©; 2019, Selikhova M.V., Katunina E.A., Whone A...2019Selikhova M.V., Katunina E.A., Whone A...Selikhova M.V., Katunina E.A., Whone A...https://creativecommons.org/licenses/by/4.0https://annaly-nevrologii.com/pathID/article/view/593

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.

В клинической неврологии при изучении двигательных расстройств и обследовании пациентов с болезнью Паркинсона (БП) и другими экстрапирамидными заболеваниями особый интерес вызывают биомаркеры центрального нейротрансмиттерного дисбаланса, в первую очередь для оценки обмена дофамина и других моноаминов в головном мозге. Наиболее информативными для этих целей являются методы радиоизотопной визуализации: позитронная эмиссионная томография (ПЭТ) и однофотонная эмиссионная компьютерная томография (ОФЭКТ) с соответствующими радиофармпрепаратами. В статье представлен сравнительный анализ широкого спектра существующих лигандов и молекулярных мишеней для функциональной радиоизотопной нейровизуализации нигростриатной системы и других моноаминергических систем мозга с акцентом на изучении дофаминового транспортера, дофаминовых рецепторов и ферментов обмена дофамина. Оцениваются современные возможности ПЭТ и ОФЭКТ в ранней диагностике БП и дифференциальной диагностике данного заболевания с клинически сходными синдромами (дистонией, атипичным и лекарственным паркинсонизмом, эссенциальным тремором), а также в мониторинге патологического процесса и оценке результатов различных терапевтических вмешательств. Подчеркивается роль методов функциональной радиоизотопной нейровизуализации в прижизненной объективной оценке немоторных проявлений БП, таких как депрессия, нарушения импульсного контроля, патологическая утомляемость, ортостатическая гипотензия.

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