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[^99mTc]TRODAT-1 SPECT imaging correlates with odor identification in early Parkinson disease

From the Parkinson’s Disease and Movement Disorders Center (Drs. Siderowf, Lloyd, Colcher, Hurtig, Stern, and Moberg), Department of Neurology, University of Pennsylvania, Philadelphia; Department of Radiology (Dr. Newberg and N. Wintering) and Smell and Taste Center, Department of Otorhinolaryngology: Head & Neck Surgery (Drs. Doty and Moberg), University of Pennsylvania Medical Center, Philadelphia; Division of Neurology (Dr. Chou), Memorial Hospital of Rhode Island, Pawtucket; Parkinson’s Disease Research, Education, and Clinical Center (Drs. Stern, Doty, Duda, Weintraub, and Moberg), Philadelphia Veteran’s Affairs Medical Center, PA; Eli Lilly (Dr. Mozley), Lilly Corporate Center, Indianapolis, IN; and Departments of Neurology (Drs. Duda, Weintraub, and Moberg) and Psychiatry (Dr. Weintraub), Hospital of the University of Pennsylvania, Philadelphia.

Address correspondence and reprint requests to Dr. Andrew Siderowf, Parkinson Disease and Movement Disorders Center, Pennsylvania Hospital, 330 South Ninth Street, Philadelphia, PA 19107; e-mail: siderowa{at}pahosp.com

Background: In vivo imaging of the dopamine transporter with [^99mTc]TRODAT-1 (TRODAT) and olfactory testing have both been proposed as potential biomarkers in Parkinson disease (PD).

Objective: To evaluate the relationship between TRODAT SPECT imaging, odor identification skills, and motor function in patients with early PD.

Methods: Twenty-four patients with a clinical diagnosis of early-stage PD (mean Hoehn & Yahr stage = 1.4) underwent TRODAT imaging, Unified PD Rating Scale (UPDRS) ratings of motor function, and administration of the University of Pennsylvania Smell Identification Test (UPSIT). Brain images were obtained using a standardized processing protocol and specific uptake ratios for striatal regions of interest were calculated. Partial correlations between the imaging indices, disease duration, UPSIT scores, and UPDRS motor scores were then calculated.

Results: UPSIT scores were correlated with TRODAT uptake in the striatum as a whole (r = 0.66, p = 0.001). The putamen showed the strongest correlation with the UPSIT (r = 0.74; p < 0.001). The correlation between dopamine transporter density in the caudate and UPSIT was moderate (r = 0.36, p = 0.11), but was not significant.

Conclusions: Olfactory function is highly correlated with dopamine transporter imaging abnormalities in early Parkinson disease (PD). Further studies are warranted to determine whether changes over time in these two measures are also correlated in early PD.

Supported by National Institutes of Health Grants R01 AG-17524 (A.N.), MH63381 (P.J.M.), M01-RR00040 (General Clinical Research Center; R.L.D.), and R01-AG 17496 (R.L.D.). A.S. is supported by grant K-08 HS00004 from the Agency for Healthcare Research and Quality (AHRQ). J.E.D. is supported by an Advanced Career Development Award from the Biomedical Laboratory Research and Development Service of the Department of Veterans Affairs.

Drs. Siderowf and Newberg have served as consultants to Amersham Health. Dr. Newberg has also received research support from Amersham Health. This research was not supported or supervised in any way by Amersham.

Received September 6, 2004. Accepted in final form January 27, 2005.

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