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Dopaminergic denervation using [123I]-FPCIT and pain in Parkinson’s disease: a correlation study

  • Estelle Dellapina
  • Jean Pellaprat
  • Djilali Adel
  • Jerome Llido
  • Estelle Harroch
  • Jean Baptiste Martini
  • Aurélie Kas
  • Anne Sophie Salabert
  • Fabienne Ory-Magne
  • Pierre Payoux
  • Christine Brefel-CourbonEmail author
Neurology and Preclinical Neurological Studies - Original Article
  • 16 Downloads

Abstract

In patients with Parkinson’s disease (PD), abnormal activations of nociceptive brain areas and lowered pain thresholds were reported, probably reflecting a central modification of pain processing. The aim of this study was to investigate the possible correlation between the striatal and extrastriatal dopaminergic system and pain threshold in PD patients. We included 25 PD patients with various intensities of central pain (visual analog scale). Subjective pain threshold (thermotest) and a motor examination (UPDRS III) were performed. Patients underwent SPECT imaging with [123I]-FP-CIT. We analyzed the correlation between [123I]-FP-CIT binding and subjective pain threshold, using a simple linear regression model for striatal uptake and a voxel-based approach for extrastriatal uptake. The covariables were age, sex, duration of PD, and UPDRS motor score. A pain matrix mask was also used to identify clusters in relation with pain matrix. Striatal analysis revealed that [123I]-FP-CIT binding was negatively correlated with age (p = 0.02), duration of PD (p = 0.0002) and UPDRS motor score (p = 0.006), but no correlation with pain threshold was observed. The extrastriatal analysis showed a positive correlation between [123I]-FP-CIT binding and subjective heat pain threshold for the left posterior cingulate cortex (PCC) (p < 0.001) and negative correlations for the right secondary visual cortex (p < 0.001) and left insula (p < 0.001). When applying the pain matrix mask, correlations remained significant only in the left PCC and the left insula. We suggest that pain perception abnormalities in PD are not directly related to striatal dopaminergic dysfunction. Painful sensations may be related to extrastriatal monoaminergic systems.

Keywords

Parkinson’s disease Central pain [123I]-FP-CIT Dopaminergic system 

Notes

Acknowledgements

This work was supported by a Toulouse University Hospital grant.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  • Estelle Dellapina
    • 1
  • Jean Pellaprat
    • 1
  • Djilali Adel
    • 1
  • Jerome Llido
    • 1
  • Estelle Harroch
    • 2
  • Jean Baptiste Martini
    • 3
    • 4
  • Aurélie Kas
    • 4
    • 5
  • Anne Sophie Salabert
    • 1
    • 6
  • Fabienne Ory-Magne
    • 1
    • 2
  • Pierre Payoux
    • 1
    • 6
  • Christine Brefel-Courbon
    • 1
    • 2
    • 7
    Email author
  1. 1.ToNIC, Toulouse Neuroimaging CenterUniversity of Toulouse, Inserm, UPSToulouseFrance
  2. 2.Department of NeurologyUniversity Hospital of ToulouseToulouseFrance
  3. 3.CATIParisFrance
  4. 4.INSERM, U 1146 LIBParisFrance
  5. 5.Department of Nuclear MedicinePitié-Salpêtrière Hospital, APHPParisFrance
  6. 6.Department of Nuclear MedicineUniversity Hospital of ToulouseToulouseFrance
  7. 7.Department of Clinical PharmacologyService de Pharmacologie Médicale et Clinique, Faculty of MedicineToulouseFrance

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