Difference In Binding Potential Research Articles

Increased binding of peripheral benzodiazepine receptor in mild cognitive impairment–dementia converters measured by positron emission tomography with [11C]DAA1106

Subjects with mild cognitive impairment (MCI) have “prodromal or incipient” dementia with neuropathological changes. Peripheral benzodiazepine receptor (PBR) binding was shown to reflect activated microglia, one of the predictive biomarkers of conversion to dementia. We sought to evaluate PBR binding in MCI subjects using positron emission tomography (PET). PET scans with [11C]DAA1106, a potent and selective ligand for PBR, were performed on seven MCI subjects, 10 patients with Alzheimer's disease (AD) and 10 age-matched control subjects. PBR binding in the regions of interest was quantified by binding potential (BP). Five MCI subjects were clinically followed for 5years after their initial PET scans. [11C]DAA1106 binding to PBR was significantly increased in widespread areas in MCI subjects when compared to healthy controls. We found no significant difference in BP between MCI and AD patients. MCI subjects with [11C]DAA1106 binding values higher than the control mean +0.5 standard deviation (S.D.) developed dementia within 5years. Our finding of higher DAA binding in MCI subjects indicated that microglial activation may occur before the onset of dementia. In vivo detection of microglial activation may provide useful prognostic information with respect to stratifying MCI subjects at increased risk of dementia.

Measurement of dopamine D2 receptors in living human brain using [11C]raclopride with ultra-high specific radioactivity

High specific radioactivity is preferable in the measurement of neuroreceptor bindings with positron emission tomography (PET) because receptor occupancy by mixed cold ligand hampers the accurate estimation of receptor binding. Recently, we succeeded in synthesizing [(11)C]raclopride, a dopamine D(2) receptor ligand, with ultra-high specific radioactivity, i.e., several thousand GBq/μmol. In the present study, we compared the [(11)C]raclopride bindings to dopamine D(2) receptors between radioligands with ultra-high specific radioactivity and ordinary high specific radioactivity in healthy human subjects. Two PET studies using [(11)C]raclopride with ultra-high specific radioactivity (4302-7222 GBq/μmol) or ordinary high specific radioactivity (133-280 GBq/μmol) were performed on different days in 14 healthy men. Binding potential (BP) was calculated by the simplified reference tissue method, peak equilibrium method, and area-under-the-curve method for each region-of-interest using time-activity data in the cerebellum as a reference brain region. BP values for radioligands with ultra-high specific radioactivity and ordinary high specific radioactivity calculated by the simplified reference tissue method were 4.06 ± 0.29 and 4.10 ± 0.25 in the putamen, 0.44 ± 0.07 and 0.47 ± 0.07 in the thalamus and 0.37 ± 0.06 and 0.38 ± 0.06 in the temporal cortex, respectively (mean ± S.D.). No significant difference in BP was observed between ultra-high specific radioactivity and ordinary high specific radioactivity in any of the brain regions. BP values of [(11)C]raclopride with ultra-high specific radioactivity did not differ from those with ordinary high specific radioactivity in the measured brain regions, including striatal and extrastriatal regions.

The molecular background of sex difference in depressive disorders: still an enigma

There is no doubt that adult females are significantly more often affected by depression and anxiety disorders than males. Virtual every study enrolls more women than men and it is assumed that the number of women suffering from depression doubles that of men. Interestingly, this difference is not present before adolescence. Not only the incidence and prevalence of depression is gender-specific, the same is true for the clinical phenomenology. The female excess is more pronounced in comorbid depression and anxiety and less in the pure forms. Other forms affecting women to a significantly higher degree than other subtypes are the so-called atypical depression [1] and somatic depression [2]. The main pathophysiological concept of depression relies on the biogenic amine 5-hydroxytryptophan (5HT) named serotonin. There is convincing evidence that the central serotonergic system plays a key role in the development, treatment and response rate of this affective disorder. Serotonin depletion induces depression in vulnerable subjects. Pharmacological restoration of high extracellular serotonin level relieves symptoms and is associated with termination of depressive episodes, which are frequently observed in the Western population and represent a relevant socioeconomic and medical problem. So far, the unequivocal facts for which strong evidence exist from epidemiologic studies and animal experiments. For in vivo studies on brain function in depression and other psychiatric disorders, nuclear medicine imaging provides a valuable and powerful imaging tool. By positron emission tomography, the serotonin transporter, the serotonin 2A and the serotonin 1A receptor binding potential (BP) can be selectively quantified. In this regard, particular interest is put on PET with [carbonyl-C]WAY-100635, a highly selective ligand for the 5-HT1A receptor that is the main inhibitory serotonergic receptor subtype. One should expect that, based on the overwhelming evidence for the predominance of female depressive patients, this armamentarium can easily visualise the molecular sex differences in the serotonergic system. However, the results remain inconsistent despite that the majority of investigators demonstrated a reduction of 5-HT1A receptor BP in distinct brain regions of depressive subjects [3–5], whereas no significant 5-HT1A receptor BP difference was found in patients with major depressive disorder (MDD) in comparison to controls in another comparable study by Parsey et al. [6]. Given that females show a significant predominance in depression, the consideration of a sex difference in 5-HT1A receptor BP is quite compelling. Indeed, a very recent study demonstrated a higher 5-HT1Areceptor BP and a lower serotonin transporter BP in females compared to males in healthy subjects [7]. Some years earlier, Parsey et al. also demonstrated a higher 5-HT1A receptor BP in females in several brain regions playing a role in mood disorders [8]. The study of Stein et al. in this EJNMMI issue focused on the 5-HT1A receptor BP in a sample of young healthy volunteers, determining the structure by two independent methods with the surprising result that there was a trend to though nonsignificant lower 5-HT1A receptor BP in females than in males [9]. These results were obtained by both an automated template-based method and by visual region of Eur J Nucl Med Mol Imaging (2008) 35:2156–2158 DOI 10.1007/s00259-008-0928-5

GABA A/Benzodiazepine receptor binding in patients with schizophrenia using [ 11C]Ro15-4513, a radioligand with relatively high affinity for α5 subunit

Dysfunction of the GABA system is considered to play a role in the pathology of schizophrenia. Individual subunits of GABA A/Benzodiazepine (BZ) receptor complex have been revealed to have different functional properties. α5 subunit was reported to be related to learning and memory. Changes of α5 subunit in schizophrenia were reported in postmortem studies, but the results were inconsistent. In this study, we examined GABA A/BZ receptor using [ 11C]Ro15-4513, which has relatively high affinity for α5 subunit, and its relation to clinical symptoms in patients with schizophrenia. [ 11C]Ro15-4513 bindings of 11 patients with schizophrenia (6 drug-naïve and 5 drug-free) were compared with those of 12 age-matched healthy control subjects using positron emission tomography. Symptoms were assessed using the Positive and Negative Syndrome Scale. [ 11C]Ro15-4513 binding was quantified by binding potential (BP) obtained by the reference tissue model. [ 11C]Ro15-4513 binding in the prefrontal cortex and hippocampus was negatively correlated with negative symptom scores in patients with schizophrenia, although there was no significant difference in BP between patients and controls. GABA A/BZ receptor including α5 subunit in the prefrontal cortex and hippocampus might be involved in the pathophysiology of negative symptoms of schizophrenia.

Up-regulation of hippocampal serotonin metabolism in mild cognitive impairment

Recent studies have suggested modifications of serotonin cerebral metabolism and of 5-HT(1A) receptors density in Alzheimer disease (AD). This study aims at exploring hippocampus 5-HT(1A) receptor density in patients at the amnesic mild cognitive impairment (aMCI) and mild AD dementia stages. With use of PET with a selective 5-HT(1A) antagonist, 2'-methoxyphenyl-(N-2'-pyridinyl)-p-[(18)F]fluoro-benzamidoethylpiperazine ([(18)F]MPPF), the hippocampus 5-HT(1A) binding potential (BP) was quantified in 10 patients with mild AD, in 11 patients with aMCI, and in 21 aged paired control subjects. To take into account hippocampal atrophy, a partial volume correction was applied to the [(18)F]MPPF data, leading to the calculation of a corrected BP (BP(c)). Comparison of hippocampus BP over populations was performed using Kruskal-Wallis rank analysis. Hippocampus serotonergic receptor binding distinguishes patients from controls and patients with aMCI from patients with AD. In aMCI patients, the mean hippocampus BP(c) was 59% higher than the controls' (p < 0.005), and it was conversely 35% lower in patients with mild AD (p < 0.01). The difference in BP(c) values between patients with aMCI and mild AD was large, resulting in a p value of <0.0005. These differences were not related to hippocampus atrophy. A compensatory mechanism illustrated by an up-regulation of serotonergic metabolism has been shown at the stage of amnesic mild cognitive impairment (aMCI) in contrast with a dramatic decrease at later stages of Alzheimer disease (AD). This difference of hippocampus serotonergic receptor labeling allows distinguishing of patients with aMCI from those with mild AD. Exploring 5-HT(1A) receptors with 2'-methoxyphenyl-(N-2'-pyridinyl)-p-(18)F-fluoro-benzamidoethylpiperazine PET seems to be of interest for better understanding pathophysiologic changes at early stages of AD.

Sex Differences in Striatal Dopamine Release in Healthy Adults

Sex differences in addictive disorders have been described. Preclinical studies have implicated the striatal dopamine system in these differences, but human studies have yet to substantiate these findings. Using positron emission tomography (PET) scans with high-specific-activity [11C] raclopride and a reference tissue approach, we compared baseline striatal dopamine binding potential (BP) and dopamine release in men and women following amphetamine and placebo challenges. Subjective drug effects and plasma cortisol and growth hormone responses were also examined. Although there was no sex difference in baseline BP, men had markedly greater dopamine release than women in the ventral striatum. Secondary analyses indicated that men also had greater dopamine release in three of four additional striatal regions. Paralleling the PET findings, men's ratings of the positive effects of amphetamine were greater than women's. We found no sex difference in neuroendocrine hormone responses. We report for the first time a sex difference in dopamine release in humans. The robust dopamine release in men could account for increased vulnerability to stimulant use disorders and methamphetamine toxicity. Our findings indicate that future studies should control for sex and may have implications for the interpretation of sex differences in other illnesses involving the striatum.

Effects of image reconstruction algorithm on neurotransmission PET studies in humans: Comparison between filtered backprojection and ordered subsets expectation maximization

Both reconstruction algorithms, filtered backprojection (FBP) and ordered subsets expectation maximization (OSEM), are widely used in clinical positron emission tomography (PET) studies. Image reconstruction for most neurotransmission PET scan data is performed by FBP, while image reconstruction for whole-body [18F]FDG scan data is usually performed by OSEM. Although several investigators have compared FBP and OSEM in terms of the quantification of regional radioactivity and physiological parameters calculated from PET data, only a few studies have compared the two reconstruction algorithms in PET studies that estimate neurotransmission, i.e., neuroreceptor and neurotransporter binding. In this study we compared mean regional radioactivity concentration in the late phase and binding potential (BP) between FBP and OSEM algorithms in neurotransmission PET studies for [11C]raclopride and [11C]DASB. Dynamic PET scans with [11C]raclopride in 3-dimensional mode were performed on seven healthy subjects. Dynamic PET scans with [11C]DASB in 2-dimensional mode were performed on another seven subjects. OSEM images were post-filtered so that its transverse spatial resolution became similar to that of FBP with the same Hanning filter (Kernel FWHM 6 mm). In both PET studies we calculated the BP of [11C]raclopride and [11C]DASB by a reference tissue model for each ROI (region of interest). There was no significant difference in mean regional radioactivity concentration between FBP and OSEM for [11C]raclopride and [11C]DASB. Only +2.4 - +3.2%, but still a significant difference in BP of [11C]raclopride between FBP and OSEM was observed in the striatum. There was no significant difference in BP between FBP and OSEM in other than the striatum for [11C]raclopride and in all regions for [11C]DASB. In addition, there was no significant difference in root mean square error between FBP and OSEM when BP was calculated. The BP values were similar between FBP and OSEM algorithms with [11C]raclopride and [11C]DASB. This study indicates that OSEM can be used for human neurotransmission PET studies for calculating BP although OSEM was not necessarily superior to FBP in the present study.

Altered Serotonin 1A Binding in Major Depression: A [carbonyl-C-11]WAY100635 Positron Emission Tomography Study

Serotonin 1A receptors (5-HT(1A)) are implicated in the pathophysiology of major depressive disorder (MDD) and in the action of selective serotonin reuptake inhibitors (SSRI). SSRI desensitize 5-HT(1A) and down-regulate 5-HT transporters (5-HTT) with the latter persisting for weeks after discontinuation of SSRI. MDD subjects are more likely to be homozygous for the functional 5-HT(1A) G(-1019) allele of the promoter polymorphism and are postulated to have higher 5-HT(1A) than healthy volunteers (controls). We measure 5-HT(1A) in MDD, assess the effects of antidepressant exposure (AE), and examine the role of the C(-1019)G polymorphism. Genotyped and determined 5-HT(1A) binding potential (BP) by positron emission tomography (PET) using [carbonyl-C-11]-WAY-100635 in 28 medication-free MDD subjects during a current major depressive episode and 43 controls. No difference in BP between controls and MDD subjects (p = .235). There was a difference in BP comparing the controls, antidepressant naive (AN) MDD subjects, and subjects with AE across all regions (p = .013). Post hoc testing reveals higher BP in AN compared to controls (p = .008) and to AE (p = .007). The GG genotype is overrepresented in MDD subjects (p = .059), and BP appears higher with the G allele. AN have higher 5-HT(1A) than controls and AE suggesting a model of depression characterized by an over expression of autoinhibitory somatodendritic 5-HT(1A) receptors, perhaps due to the higher expressing G allele, that may result in reduced terminal field 5-HT release. AE appears to have long-term effects on 5-HT(1A).

Brain Serotonin Transporter Binding Potential Measured With Carbon11–Labeled DASB Positron Emission Tomography

Although brain serotonin transporter (5-HTT) density has been investigated in subjects with a history of major depressive episodes (MDE), there has never been an investigation of brain 5-HTT during a current MDE. Brain 5-HTT binding potential (BP) may have an important role during MDE due to major depressive disorder, because the 5-HTT regulates extracellular 5-HT. The BP is an index of receptor density. Carbon 11-labeled 3-amino-4-(2-dimethylaminomethyl-phenylsulfanyl)-benzonitrile (DASB) positron emission tomography (PET) is the first brain imaging technique that can measure the 5-HTT BP in cortical and subcortical brain regions in vivo. The purposes of this study were to investigate 5-HTT BP during MDE and to determine the relationship between 5-HTT BP and negativistic dysfunctional attitudes during MDE. Dysfunctional attitudes are negatively biased assumptions and beliefs regarding oneself, the world, and the future. Our recent publication of increased serotonin2 BP in MDE with severely negativistic dysfunctional attitudes suggests that this subgroup of MDE subjects has very low levels of extracellular serotonin. Regional 5-HTT BP was measured in 20 nonsmoking medication-free (> or =3 months) depressed subjects and 20 age-matched nonsmoking, medication-free, healthy subjects using [11C]DASB PET. Dysfunctional attitudes were measured using the Dysfunctional Attitudes Scale. No difference in regional 5-HTT BP was found between MDE and healthy subjects; however, the subgroup of MDE subjects with highly negativistic dysfunctional attitudes had significantly higher 5-HTT BP compared with healthy subjects in brain regions mainly sampling serotonergic nerve terminals (prefrontal cortex, anterior cingulate, thalamus, bilateral caudate, and bilateral putamen; average, 21% greater; F(1,26), 5.6-12.2 [P values, .03-.002]). In the MDE subjects, increased 5-HTT BP was strongly associated with more negativistic dysfunctional attitudes in brain regions primarily sampling serotonergic nerve terminals (prefrontal cortex, anterior cingulate, thalamus, caudate, and putamen; r = 0.64-0.74 [P values, .003 to <.001]). Serotonin transporters play an important role during depression. The magnitude of regional 5-HTT BP can provide a vulnerability to low levels of extracellular serotonin and symptoms of extremely negativistic dysfunctional attitudes.