Distribution Of Dopamine Transporter In Brain Of Parkinson’s Disease And Therapeutic Effect Of Nimodipine And Nicotinic Acid

Objective:Analysis of the characteristics of brain dopamine transporter distribution in Parkinson’s disease（PD）and the clinical efficacy of nimodipine combined with niacin.Methods:Twenty patients with Parkinson’s disease who were first diagnosed or diagnosed but not yet receiving dopamine replacement therapy in our hospital from October 2020 to October 2022 and 6 healthy controls were selected.Clinical data such as name,gender,education level and disease duration were collected from all patients.PD patients were divided into early PD group and middle and late PD group according to the modified Hoehn-Yahr scales,and ¹¹C-CFT uptake values of caudate nucleus,anterior putamen and posterior putamen were analyzed in the three groups.PD patients were treated with different treatment regimens,10 patients were given Madopar and/or Pramipexole,the other 10 patients were treated with nimodipine and niacin on top of this.All PD patients were scored on the UPDRSIII,Hoehn-Yahr,HAMA,HAMD,MMSE,and Mo CA scales.The scales were evaluated again after 12 months of treatment,and the clinical efficacy of the drugs was analyzed by comparing the changes in scale scores of PD patients before and after treatment and between the groups.Results:（1）The caudate nucleus,anterior putamen and posterior putamen ¹¹C-CFT uptake values were significantly lower in the PD group compared with the healthy control group,and the differences were statistically significant（P<0.05）.Compared with the early PD group,the caudate nucleus,anterior putamen and posterior putamen ¹¹C-CFT uptake values were reduced in middle and late PD group,the differences were statistically significant（P<0.05）.（2）¹¹C-CFT PET image shows that dopamine in the brain of healthy individuals is mainly concentrated in the bilateral basal ganglia area in an"eight"shape,and the distribution of radioactivity in the bilateral caudate nucleus and putamen is symmetrical.In early PD patients,the distribution of radioactivity in the basal ganglia was asymmetrical,and the most significant reduction was in the unilateral posterior putamen.In middle and late PD patients,the distribution of radioactivity in both putamen was significantly reduced.（3）The ¹¹C-CFT uptake index in caudate and putamen of PD patients was significantly and negatively correlated with Hoehn-Yahr and UPDRSIII score,and was not significantly correlated with age,disease duration and education.（4）Combined treatment with nimodipine and niacin resulted in a more significant reduction in UPDRSIII scores,with a statistically significant difference（P<0.05）.Conclusion:The ¹¹C-CFT uptake in the caudate nucleus,anterior putamen and posterior putamen was significantly reduced in patients with Parkinson’s disease,and the reduction was more pronounced in middle and late PD patients;combined treatment with nimodipine and niacin could better improve motor symptoms and delay disease progression.