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Progressive loss of raphe nuclei serotonin transporter in early Parkinson’s disease: a longitudinal 123I-FP-CIT SPECT study

Lookup NU author(s): Professor David BrooksORCiD, Professor Nicola PaveseORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


Background: Serotonergic raphe nuclei dysfunction has been documented in Parkinson’s disease, both in pathological and neuroimaging studies, and has been associated with scores of tremor and non-motor symptoms. However, no in vivo longitudinal investigations have been conducted to assess the rate of decline of raphe serotonin transporter availability in the early stages of the disease. Objective: To measure the rate of decline of raphe serotonin transporter availability over a two-year interval in patients with recently diagnosed disease and its association with non-motor symptoms over time. Methods: Baseline and two-year follow-up 123ioflupane-fluoropropyl-carbomethoxy-3-beta-4-iodo-phenyltropane (123I-FP-CIT) SPECT scans of 173 early Parkinson’s disease patients enrolled in the Parkinson’s Progressive Markers Initiative were analysed and non-motor symptoms scores recorded.Results: A 16.6±20.9% (mean±SD) reduction in raphe serotonin transporter availability was found from baseline to two-year follow-up in the entire cohort. No differences in progression were found between tremor dominant and postural instability/gait difficulty phenotypes. At follow-up 34.1% of patients showed a moderate-to-severe reduction of raphe serotonin transporter availability with respect to the controls’ mean. We did not find any significant correlation between raphe serotonin transporter availability and scores of depression, excessive daytime sleepiness and REM sleep behaviour disorder.Conclusion: 123I-FP-CIT SPECT was able to measure longitudinal reductions in raphe serotonin transporter availability in the early phases of Parkinson’s disease. About four years after diagnosis, raphe serotonin transporter availability was significantly reduced in more than one third of the population, but does not appear to be correlated to non-motor symptoms at this stage.

Publication metadata

Author(s): Pasquini J, Ceravolo R, Brooks DJ, Bonuccelli U, Pavese N

Publication type: Article

Publication status: Published

Journal: Parkinsonism & Related Disorders

Year: 2019

Volume: 77

Pages: 170-175

Print publication date: 01/08/2020

Online publication date: 05/04/2019

Acceptance date: 25/03/2019

Date deposited: 10/04/2019

ISSN (print): 1353-8020

ISSN (electronic): 1873-5126

Publisher: Elsevier Ltd


DOI: 10.1016/j.parkreldis.2019.03.025


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