Parkinson Clinical Trial
Official title:
Evaluation of Myocardial Sympathetic Denervation in Parkinson's Disease Using [18F]FDOPA
The purpose of this study is to evaluate the added value of PET-CT with [18F]FDOPA tracer for
Assessment of the Myocardial Sympathetic Denervation in patients with or suspected with
Parkinson's disease.
The investigators expect to see normal values of uptake ratio of [18F]FDOPA , in patients
with no synuclein underline pathology or previously known cardiovascular disease (no history
of high blood pressure or take medications that influence the sympathetic system- exclusion
criteria). Low values of uptake ratio is presumed to be found in patients diagnosed with
Parkinson's disease or other synuclein pathology.
The expected normal ratio of Heart/liver uptake values will be determined from scans of
patients refered to [18F]FDOPA scan and were found to have normal [18F]FDOPA scan of the
basal ganglia and no cardiovascular diseases.
L-3,4-dihydroxy-6-[18F]fluoro-phenylalanine ([18F]FDOPA) might be a useful tracer for
assessing myocardial sympathetic denervation in Parkinson's disease (PD) Patients. Compared
to the routinely used I123 MIBG scan, [18F]FDOPA seems to have an advantage for the following
reasons:
1. meta-iodobenzylguanidine (MIBG) is a false analog of norepinephrine while [18F]FDOPA is
the radiolabelled form of DOPA, a direct precursor of dopamine which is subsequently
converted to norepinephrine
2. 123I MIBG, un-like norepinephrine, dose not undergo intracellular metabolism (19) while
[18F]FDOPA undergo complex intracellular metabolism (17)
3. Studies have shown that I123 MIBG reuptake is almost exclusive by uptake mechanism 1.
Uptake-2 mechanism of 123I-MIBG by the myocardium is not significant. Reuptake of
norepinephrine (NE) in the synaptic cleft and is mainly by uptake 1 system but also in
small amount by uptake 2 systems. The investigators assumption is that this double
mechanism of reuptake will increase the concentration of [18F]FDOPA for better imaging
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