The role of radiotracer imaging in Parkinson disease

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperReviewResearchpeer-review

  • B. Ravina, NINDS-NIH
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  • D. Eidelberg, N. Shore-Long Isl. Jewish Hlth. S.
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  • J. E. Ahlskog, Mayo Clinic
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  • R. L. Albin, University of Michigan, Ann Arbor, Michigan.
  • ,
  • D. J. Brooks
  • M. Carbon, N. Shore-Long Isl. Jewish Hlth. S.
  • ,
  • V. Dhawan, N. Shore-Long Isl. Jewish Hlth. S.
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  • A. Feigin, N. Shore-Long Isl. Jewish Hlth. S.
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  • S. Fahn, Columbia University, College of Physicians and Surgeons
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  • M. Guttman, Centre for Addiction and Mental Health
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  • K. Gwinn-Hardy, NINDS-NIH
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  • H. McFarland, NINDS-NIH
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  • R. Innis, National Institute of Mental Health
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  • R. G. Katz, US Food and Drug Administration
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  • K. Kieburtz, Mount Sinai Medical Center
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  • S. J. Kish, Centre for Addiction and Mental Health
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  • N. Lange, Depts. of Psychiat. and Biostatist., Harvard University
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  • J. W. Langston, National Institutes of Health
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  • K. Marek, Inst. for Neurodeg. Disorders
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  • L. Morin, NINDS-NIH
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  • C. Moy, NINDS-NIH
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  • D. Murphy, NINDS-NIH
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  • W. H. Oertel, Philipps-Universität Marburg
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  • G. Oliver, NINDS-NIH
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  • Y. Palesch, Medical University of South Carolina
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  • W. Powers, Washington University in St. Louis
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  • J. Seibyl, Inst. for Neurodeg. Disorders
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  • K. D. Sethi, Medical College of Georgia
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  • C. W. Shults, University of California, San Diego
  • ,
  • P. Sheehy, NINDS-NIH
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  • A. J. Stoessl, The University of British Columbia
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  • R. Holloway, Mount Sinai Medical Center

Radiotracer imaging (RTI) of the nigrostriatal dopaminergic system is a widely used but controversial biomarker in Parkinson disease (PD). Here the authors review the concepts of biomarker development and the evidence to support the use of four radiotracers as biomarkers in PD: [18F]fluorodopa PET, (+)-[11C]dihydrotetrabenazine PET, [123I] β-CIT SPECT, and [18F] fluorodeoxyglucose PET. Biomarkers used to study disease biology and facilitate drug discovery and early human trials rely on evidence that they are measuring relevant biologic processes. The four tracers fulfill this criterion, although they do not measure the number or density of dopaminergic neurons. Biomarkers used as diagnostic tests, prognostic tools, or surrogate endpoints must not only have biologic relevance but also a strong linkage to the clinical outcome of interest. No radiotracers fulfill these criteria, and current evidence does not support the use of imaging as a diagnostic tool in clinical practice or as a surrogate endpoint in clinical trials. Mechanistic information added by RTI to clinical trials may be difficult to interpret because of uncertainty about the interaction between the interventions and the tracer.

Original languageEnglish
JournalNeurology
Volume64
Issue2
Pages (from-to)208-215
Number of pages8
ISSN0028-3878
DOIs
Publication statusPublished - 25 Jan 2005
Externally publishedYes

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