Parkinson disease (PD) is a multisystem disorder marked by progressive dopaminergic neuronal degeneration in the substantia nigra, as well as nondopaminergic systems. Our aim was to investigate longitudinal changes in N-(3-[¹⁸F]fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane (¹⁸F-FP-CIT) binding at the putamen, substantia nigra, and raphe nuclei in PD. Methods: This retrospective cohort study enrolled 127 patients with PD, who underwent ¹⁸F-FP-CIT PET scans twice or more, and 71 age- and sex-matched healthy controls. A temporal trajectory model was created to estimate the longitudinal trajectories of ¹⁸F-FP-CIT PET specific binding ratios (SBRs) of the putamen, substantia nigra, and raphe nuclei from the prodromal to advanced stages. Associations between SBRs and age and motor severity were evaluated. Results: At baseline, the PD group showed significantly lower ¹⁸F-FP-CIT SBR of the putamen and substantia nigra and higher ¹⁸F-FP-CIT SBR of the median raphe than did the control group. Longitudinally, ¹⁸F-FP-CIT decline of the putamen and substantia nigra began 11.3 and 3.4 y, respectively, before clinical onset on the more affected side. ¹⁸F-FP-CIT decline of the raphe nuclei remained constant for up to 20 y of disease duration. Topographically, ¹⁸F-FP-CIT SBR of the substantia nigra progressed from the caudal and anterolateral to the rostral and posteromedial regions. Conclusion: These results provide in vivo evidence of decreased striatal synaptic dopamine transporter availability approximately 8 y before decreased nigral neuronal dopamine transporter availability, which is strongly correlated with motor deficit. Serotonin transporter availability in the raphe nuclei was elevated in and remained largely unchanged during the disease span.

帕金森病 （PD） 是一种多系统疾病，其特征是黑质和非多巴胺能系统中的进行性多巴胺能神经元变性。我们的目的是研究 N-（3-[¹⁸F] 氟丙基-2β-碳甲氧基-3β-（4-碘苯基）去甲烷 （¹⁸F-FP-CIT） 在 PD 中壳核、黑质和中缝核处结合的纵向变化。方法： 这项回顾性队列研究招募了 127 例 PD 患者，他们接受了 ¹⁸次 F-FP-CIT PET 扫描两次或更多次，以及 71 例年龄和性别匹配的健康对照。创建了一个时间轨迹模型来估计壳核、黑质和中缝核从前驱期到晚期的 ¹⁸个 F-FP-CIT PET 特异性结合比 （SBR） 的纵向轨迹。评估 SBR 与年龄和运动严重程度之间的关联。结果：在基线时，PD 组显示壳核和黑质的 ¹⁸F-FP-CIT SBR 显着降低，中缝的 ¹⁸F-FP-CIT SBR 高于对照组。纵向上，壳核和黑质的 ¹⁸F-FP-CIT 下降分别在 11.3 年和 3.4 年开始，然后才在受影响较严重的一侧临床发作。¹⁸中缝核的 F-FP-CIT 下降在长达 20 年的病程中保持不变。地形学上，黑质的 ¹⁸F-FP-CIT SBR 从尾部和前外侧发展到喙部和后内侧区域。结论：这些结果提供了体内证据，表明纹状体突触多巴胺转运蛋白可用性降低，大约在黑神经元多巴胺转运蛋白可用性降低前 8 年，这与运动缺陷密切相关。 中缝核中血清素转运蛋白的可用性在疾病期间升高，并且基本保持不变。