Clinical Applications of [¹²³I]FP-CIT SPECT Imaging

Dopamine transporter (DAT) imaging with [123I]N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane ([123I]FP-CIT) single-photon emission computed tomography (SPECT) is commonly used in routine clinical studies to exclude or detect a loss of striatal DATs in individual patients with a movement disorder or dementia. In this chapter, we describe the clinical applications of [123I]FP-CIT SPECT imaging. To facilitate the interpretation of [123I]FP-CIT SPECT images, we first describe the results of [123I]FP-CIT SPECT studies in healthy controls. Thereafter, we describe the typical findings when applying this technique in movement disorders and dementia characterised by a loss of striatal DATs (e.g. Parkinson's disease and dementia with Lewy bodies). We will also describe the possibilities to analyse [123I]FP-CIT SPECT scans in the setting of routine clinical practice. Finally, we briefly discuss the characterisation of extrastriatal [123I]FP-CIT binding and its potential role in future studies.</p

Clinical Applications of [¹²³I]FP-CIT SPECT Imaging

Dopamine transporter (DAT) imaging with [123I]N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane ([123I]FP-CIT) single-photon emission computed tomography (SPECT) is commonly used in routine clinical studies to exclude or detect a loss of striatal DATs in individual patients with a movement disorder or dementia. In this chapter, we describe the clinical applications of [123I]FP-CIT SPECT imaging. To facilitate the interpretation of [123I]FP-CIT SPECT images, we first describe the results of [123I]FP-CIT SPECT studies in healthy controls. Thereafter, we describe the typical findings when applying this technique in movement disorders and dementia characterised by a loss of striatal DATs (e.g. Parkinson's disease and dementia with Lewy bodies). We will also describe the possibilities to analyse [123I]FP-CIT SPECT scans in the setting of routine clinical practice. Finally, we briefly discuss the characterisation of extrastriatal [123I]FP-CIT binding and its potential role in future studies.</p

Clinical Applications of [¹²³I]FP-CIT SPECT Imaging

Dopamine transporter (DAT) imaging with [123I]N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane ([123I]FP-CIT) single-photon emission computed tomography (SPECT) is commonly used in routine clinical studies to exclude or detect a loss of striatal DATs in individual patients with a movement disorder or dementia. In this chapter, we describe the clinical applications of [123I]FP-CIT SPECT imaging. To facilitate the interpretation of [123I]FP-CIT SPECT images, we first describe the results of [123I]FP-CIT SPECT studies in healthy controls. Thereafter, we describe the typical findings when applying this technique in movement disorders and dementia characterised by a loss of striatal DATs (e.g. Parkinson's disease and dementia with Lewy bodies). We will also describe the possibilities to analyse [123I]FP-CIT SPECT scans in the setting of routine clinical practice. Finally, we briefly discuss the characterisation of extrastriatal [123I]FP-CIT binding and its potential role in future studies.</p

Clinical Applications of [¹²³I]FP-CIT SPECT Imaging

Dopamine transporter (DAT) imaging with [123I]N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)nortropane ([123I]FP-CIT) single-photon emission computed tomography (SPECT) is commonly used in routine clinical studies to exclude or detect a loss of striatal DATs in individual patients with a movement disorder or dementia. In this chapter, we describe the clinical applications of [123I]FP-CIT SPECT imaging. To facilitate the interpretation of [123I]FP-CIT SPECT images, we first describe the results of [123I]FP-CIT SPECT studies in healthy controls. Thereafter, we describe the typical findings when applying this technique in movement disorders and dementia characterised by a loss of striatal DATs (e.g. Parkinson's disease and dementia with Lewy bodies). We will also describe the possibilities to analyse [123I]FP-CIT SPECT scans in the setting of routine clinical practice. Finally, we briefly discuss the characterisation of extrastriatal [123I]FP-CIT binding and its potential role in future studies.</p

Globalisation of science in kilometres

The ongoing globalisation of science has undisputedly a major impact on how and where scientific research is being conducted nowadays. Yet, the big picture remains blurred. It is largely unknown where this process is heading, and at which rate. Which countries are leading or lagging? Many of its key features are difficult if not impossible to capture in measurements and comparative statistics. Our empirical study measures the extent and growth of scientific globalisation in terms of physical distances between co-authoring researchers. Our analysis, drawing on 21 million research publications across all countries and fields of science, reveals that contemporary science has globalised at a fairly steady rate during recent decades. The average collaboration distance per publication has increased from 334 kilometres in 1980 to 1553 in 2009. Despite significant differences in globalisation rates across countries and fields of science, we observe a pervasive process in motion, moving towards a truly interconnected global science system

Safety and efficacy outcomes of double vs. triple antithrombotic therapy in patients with atrial fibrillation following percutaneous coronary intervention: a systematic review and meta-analysis of non-vitamin K antagonist oral anticoagulant-based randomized clinical trials.

Abstract Aims To investigate the safety and efficacy of double vs. triple antithrombotic therapy (DAT vs. TAT) in patients with atrial fibrillation (AF) and acute coronary syndrome or who underwent percutaneous coronary intervention (PCI). Methods and results A systematic review and meta-analysis was performed using PubMed to search for non-vitamin K antagonist oral anticoagulant (NOAC)-based randomized clinical trials comparing DAT vs. TAT in AF patients undergoing PCI. Four trials encompassing 10 234 patients (DAT = 5496 vs. TAT = 4738) were included. The primary safety endpoint (ISTH major or clinically relevant non-major bleeding) was significantly lower with DAT compared with TAT [risk ratio (RR) 0.66, 95% confidence interval (CI) 0.56–0.78; P < 0.0001; I2 = 69%], which was consistent across all available bleeding definitions. This benefit was counterbalanced by a significant increase of stent thrombosis (RR 1.59, 95% CI 1.01–2.50; P = 0.04; I2 = 0%) and a trend towards higher risk of myocardial infarction with DAT. There were no significant differences in all-cause and cardiovascular death, stroke and major adverse cardiovascular events. The comparison of NOAC-based DAT vs. vitamin K antagonist (VKA)-TAT yielded consistent results and a significant reduction of intracranial haemorrhage (RR 0.33, 95% CI 0.17–0.65; P = 0.001; I2 = 0%). Conclusion Double antithrombotic therapy, particularly if consisting of a NOAC instead of VKA and a P2Y12 inhibitor, is associated with a reduction of bleeding, including major and intracranial haemorrhages. This benefit is however counterbalanced by a higher risk of cardiac—mainly stent-related—but not cerebrovascular ischaemic occurrences

Nifedipine and metoprolol in suspected unstable angina

It is now well accepted that the role of newly developed drugs used in the clinical management of patients needs to be evaluated in properly designed randomised clinical trials. In 1980, the Interuniversity Cardiology Institute of the Netherlands initiated the Holland Interuniversity Nifedipine/metoprolol Trial (HINT). The objective of this randomised, doubleblind, multicentre trial was to evaluate the effectiveness of nifedipine (a calcium antagonist) and metoprolol (a beta blocker) in preventing recurrence of ischaemia or progression to myocardial infarction in patients suspected of having unstable angina at hospital admission, a topic which at that time had not been well investigated. The trial was designed to follow cardiologic practice as closely as possible. In particular, patients were entered as soon as unstable angina was suspected at hospital admission, without waiting for enzyme assessments to exclude evolving myocardial infarction. The first patient was enrolled on 1 February 1981. On 30 October 1984 patient enrolment was discontinued because an interim analysis suggested that the risk of myocardial infarction was higher in patients assigned to nifedipine than in patients treated with the other trial medications. The main findings have been published previously[11• This supplement of the European Heart Journal provides a more detailed report

The Effect of Escitalopram on Central Serotonergic and Dopaminergic Systems in Patients with Cervical Dystonia, and Its Relationship with Clinical Treatment Effects:A Double-Blind Placebo-Controlled Trial

Purpose:The pathophysiology of cervical dystonia (CD) is thought to be related to changes in dopamine and serotonin levels in the brain. We performed a double-blind trial with escitalopram (selective serotonin reuptake inhibitor; SSRI) in patients with CD. Here, we report on changes in dopamine D(2/3)receptor (D2/3R), dopamine transporter (DAT) and serotonin transporter (SERT) binding potential (BPND) after a six-week treatment course with escitalopram or placebo.Methods:CD patients had [123I]FP-CIT SPECT (I-123 fluoropropyl carbomethoxy-3 beta-(4-iodophenyltropane) single-photon emission computed tomography) scans, to quantify extrastriatal SERT and striatal DAT, and [123I]IBZM SPECT (I-123 iodobenzamide SPECT) scans to quantify striatal D2/3R BPND before and after six weeks of treatment with either escitalopram or placebo. Treatment effect was evaluated with the Clinical Global Impression scale for dystonia, jerks and psychiatric symptoms, both by physicians and patients.Results:In both patients treated with escitalopram and placebo there were no significant differences after treatment in SERT, DAT or D2/3R BPND. Comparing scans after treatment with escitalopram (n = 8) to placebo (n = 8) showed a trend (p= 0.13) towards lower extrastriatal SERT BPND in the SSRI group (median SERT occupancy of 64.6%). After treatment with escitalopram, patients who reported a positive effect on dystonia or psychiatric symptoms had significantly higher SERT occupancy compared to patients who did not experience an effect.Conclusion:Higher extrastriatal SERT occupancy after treatment with escitalopram is associated with a trend towards a positive subjective effect on dystonia and psychiatric symptoms in CD patients