SPECT exploration of the dopamine transporter in Parkinson Disease and in Parkinsonisms

In this thesis I will describe the results of some studies conducted during my Ph.D regarding the exploration of some Parkinson Disease and Parkinsonisms’ features by mean of Dopamine transporter SPECT. SPECT investigation represents a valid instrument to study the extensive field of movement disorders giving also important information in regard to the pathophysiologic pathways underlying these diseases. In Chapter 1 a short review on clinical application of SPECT methodology will explain its usefulness in the differential diagnosis of Movement disorders. Chapter 2 will focus on the complex regulation of the Dopamine transporter Proteome. In Chapter 3 and 4 the results of two recently published works regarding some motor and non motor aspects of Parkinson disease will be discussed in detail. Dementia represents a frequent non motor symptom with poor clinical outcome in PD but the pathological mechanisms are still debated. Similarly, tremor represents the most popular Parkinsonian symptom but also the less related to dopaminergic degeneration. The results of a multicenter cross over and of a longitudinal SPECT study in Corticobasal Syndrome will be discussed respectively in Chapter 5 and 6. This rare parkinsonism represents a challenge in movement disorder diagnostic tool and the actual clinical criteria have still a too low accuracy. Lastly, chapter 7 focus on a very “hot topic” in functional neuroimaging studies: the preliminary results of an ongoing trial shows a possible interaction between FP-CIT and a new dopaminergic treatment with intriguing consequences in aspects such as neuroprotection/neurotoxicity, disease modifying or tolerance mechanisms to medical treatment.