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proLékaře.cz / Journals / Nuclear Medicine / 2024 - 1

Evaluation of the distribution of dopamine D2 receptors with 123I-IBZM SPECT in laterali-zed and unilateral dystonias

Czech version

Authors: O. Lang 1,2,3;  L. Stejskal 4;  E. Růžička 4
Authors‘ workplace: Kardiologická klinika 3. LF UK, Praha 10 1;  Oddělení nukleární medicíny PMCD s. r. o., Praha 2;  Oddělení nukleární medicíny Oblastní nemocnice Příbram 3;  Neurochirurgická a neuroonkologická klinika 1. LF UK a ÚVN, Praha, ČR 4
Published in: NuklMed 2024;13:2-9
Category: Original Article

Overview

Introduction: Dystonia is a syndrome characterized by sustained muscle contractions frequently causing twisting and repetitive movements of the relative part of the body or abnormal postures. The precise pathophysiology of idiopathic dystonia is still unclear. Systematic investigation of involuntary movements characterized by constant laterality of posture and motion has not yet been done. The aim of our study was to determine the symmetry of the density of dopamine D2 receptors with 123I-IBZM SPECT in relation to the head rotation in patients suffering from unilateral or lateralized dystonia.

Methods: Seventeen patients with a clinical diagnosis of cervical dystonia participated in our study. There were 11 men and 6 women. The mean age was 48 years (25 to 64). Structural lesions of the brain were excluded by CT or MRI. The dopamine D2 receptor ligand used was 123I-IBZM. Imaging was performed with a dual-head SPECT gamma camera. We quantified the area as well as radioactivity accumulation within the striatum and its symmetry using five different methods. We assessed reliability by intraobserver and interobserver (2 readers) variability as well as methodological variability.

Results: From all the tested methods used for symmetry/asymmetry of 123I-IBZM uptake evaluation in striatum no one is more reproducible than the others including the most simple visual assessment. The correspondence with clinical findings was better for quantitative methods. In our study in 13 of 17 patients with (rotational) cervical dystonia the dopamine D2 receptors density predominated in the striatum ipsilateral to the rotation of the head.

Conclusions: The asymmetric accumulation of dopamine D2 receptors corresponding to the side of motor and postural asymmetry supports the view that the direction of circling behavior in animals and the direction of cervical dystonia in human beings might be predisposed.

Keywords:

idiopathic cervical dystonia – 123I-IBZM SPECT – D2 receptor asymmetry

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