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123-I Ioflupane SPECT Measures of Parkinson Disease Progression in the Parkinson Progression Marker Initiative (PPMI) Trial

Seibyl, JP; Jennings, D; Grachev, I; Coffey, C; Marek, KL; on behalf of the PPMI Investigators
MDS: Sydney, Australia
Download Presentation: Seibyl-PPMI-MDS-2013-Sydney sjl.pdf
Objective: The objective of this study is to report initial quantitative 123-I Ioflupane SPECT one year disease progression data in the PPMI PD cohort.
Background: The Parkinson's Progression marker initiative (PPMI) is a multicenter, international, longitudinal study evaluating clinical, biochemical, and imaging measures of Parkinson's disease (PD) progression.
Methods: In this on-going study, baseline and one year follow-up123-I Ioflupane SPECT scans from 22 imaging centers include 117 Parkinson's subjects. Data were centrally reconstructed, attenuation corrected, and analyzed with a standardized volume of interest template for extraction of regional count densities in the left and right caudate and putamen. Striatal binding ratios (SBR) were calculated using the occipital lobe reference region. Mean percent changes in striatal composite, ipsilateral putamen, and contralateral putamen SBRs were calculated.
Results: PD subjects at baseline had a mean age of 61.1 y and an average disease duration of 8.5 ± 8.2 months. Total UPDRS score was 34.0 ± 12.9 at baseline and 41.1 ± 16.0 at one year follow up. Mean average SBR change encompassing left and right caudate and putamen was -13.3% ± 16.0% (p< 0.0001). Ipsilateral and contralateral striatum showed 13.0% ± 16.5% and 13.5% ± 16.7% change, respectively. No significant differences were noted between ipsilateral and contralateral striatum.
Conclusions: Quantitative DAT 123-I Ioflupane SPECT imaging data acquired at baseline and one year follow-up in PD demonstrate reductions in striatal ratios for both mean striatum and ipsilateral and contralateral putamen. Symmetric rates of striatal signal loss are noted in this preliminary data.