| 제목 |
Correlation between gait analysis and subregional uptake of striatal dopamine transporter on 18F-CIT positron emission tomography in patients with idiopathic Parkinson disease |
| 소속 |
Veterans Health Service Medical Center, Seoul, Department of physical medicine and rehabilitation1, Veterans Health Service Medical Center, Seoul, Department of neurology2 |
| 저자 |
Hyun Min Jeon1*, Seong-Min Kim2, Dae Hyun Kim1† |
Objective: To investigate subregional uptake of striatal dopamine transporter in patients with idiopathic Parkinson disease (IPD) in correlation with three-dimensional gait analysis (3DGA).
Methods: This retrospective study included 88 patients with IPD who underwent 18F-CIT Positron Emission Tomography(CIT-PET) and 3DGA between January 1, 2014 and December 31, 2016. The CIT-PET images were analyzed with 12 striatal subregional (bilateral, ventral striatum, anterior caudate, posterior caudate, anterior putamen, posterior putamen and ventral putamen) and 1 occipital volume of interest templates (Fig 1). Rt striatum of CIT-PET for all patients were set to more affected side according to clinical feature. The level of activity in each voxel of interest (VOI) was calculated. The specific to nonspecific binding ration (SNBR) was defined as follows: (mean standardized uptake value of the striatal subregional VOI – mean standardized uptake value of the occipital VOI)/mean standardized uptake value of the occipital VOI, considering occipital uptake to be nonspecific binding. The correlation between SNBR of 12 striatal subregional area and 3DGA was analyzed after controlling age effect using Pearson’s correlation coefficient.
Results: The mean SNBR of anterior putamen in all patients were positively correlated with contralateral maximal hip extension angle in stance phase and hip maximal flexion angle in swing phase. The mean SNBR of anterior caudate, ventral striatum, ventral putamen in the 46 patients with HY scale 1 were correlated with hypokinetic sign of contralateral limb such as decrease of hip/knee/ankle joint angle during gait cycle. The mean SNBR of posterior putamen and ventral putamen in the 23 patients with HY scale 2 were positively correlate with ilsilateral knee maximal extension moment. There is no correlation between the 19 patients with HY scale 3 and SNBR of entire striatum (Fig 2 & 3).
Conclusion: Hip control during gait cycle was mainly associated with the activity of anterior putamen which including in skeletomotor loop of basal ganglia. Hypokinetic sign was mainly associated with ventral striatum in mild IPD. Kinetics of knee was associated with ipsilateral ventral and posterior putamen in mild to moderate IPD. |
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12 striatal subregional area of CIT-PET
The specific to nonspecific binding ration of 12 striatal subregional area according to HY scale
Correlation between SNBR and 3DGA
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