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J Neurol Neurosurg Psychiatry 85:159-164 doi:10.1136/jnnp-2012-304811
  • Neuropsychiatry
  • Research paper

Depressive symptoms in Parkinson's disease are related to reduced [123I]FP-CIT binding in the caudate nucleus

  1. Odile A van den Heuvel1,2,3
  1. 1Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
  2. 2Department of Anatomy & Neurosciences, VU University Medical Center, Amsterdam, The Netherlands
  3. 3Neuroscience Campus Amsterdam, VU/VUmc, Amsterdam, The Netherlands
  4. 4Department of Nuclear Medicine & PET Research, VU University Medical Center, Amsterdam, The Netherlands
  5. 5Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands
  1. Correspondence to Chris Vriend, Departments of Psychiatry, and Anatomy and Neuroscience, VUmc, Medical Faculty Building, room G102-b, van der Boechorststraat 7, Amsterdam 1081 BT, The Netherlands; c.vriend{at}vumc.nl
  • Received 18 December 2012
  • Revised 16 May 2013
  • Accepted 5 June 2013
  • Published Online First 29 June 2013

Abstract

Background Depression is a common neuropsychiatric symptom in Parkinson's disease (PD). In previous research, PD-related depression was associated with striatal dopaminergic deficits, presumably due to degeneration of brainstem dopaminergic projections. Segregated areas of the striatum are crucially involved in various parallelly arranged cortical-striatal-thalamocortical circuits and serve functions in, among others, motor control or emotion. This suggests regional specificity of dopaminergic deficits in the striatum in motor and depressive symptoms in PD.

Methods In this cross-sectional retrospective study, we correlated severity scores of depressive and motor symptoms in 100 non-demented PD patients (median Hoehn & Yahr stage: 2) with dopamine loss in specific regions of the striatum as measured by [123I]FP-CIT SPECT tracer binding to the dopamine transporter (DaT).

Results Depressive symptoms were related to lower DaT binding in the right caudate nucleus, while motor symptoms were associated with decreased DaT binding in the right putamen. This double dissociation was most pronounced in early-stage PD patients.

Conclusions These results suggest that depressive symptoms in PD are associated with dopamine loss in the caudate nucleus, possibly related to degeneration of dopaminergic projections from the ventral tegmental area, while motor symptoms are associated with low dopamine signalling to the putamen and loss of nigrostriatal projections. This is consistent with the neuroanatomy of partially segregated cortical-striatal-thalamocortical circuits and supports the role of dysfunctional associative and motivational circuits in PD-related depression.

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