Source-Based Morphometry Multivariate Approach to Analyze [¹²³I]FP-CIT SPECT Imaging

Purpose: [¹²³I]FP-CIT (DaTSCAN®) single-photon emission computed tomography (SPECT) imaging is widely used to study neurodegenerative parkinsonism, by measuring presynaptic dopamine transporter (DAT) in striatal regions. Beyond DAT, [¹²³I]FP-CIT may be considered for other monoaminergic systems, in particular the serotonin transporter (SERT). Independent component analysis (ICA) implemented in source-based morphometry (SBM) could represent an alternative method to explore monoaminergic pathways, studying the relationship among voxels and grouping them into “neurotransmission” networks. Procedures: One hundred forty-three subjects [84 with Parkinson’s disease (PD) and 59 control individuals (CG)] underwent DATSCAN® imaging. The [¹²³I]FP-CIT binding was evaluated by multivariate SBM approach, as well as by a whole-brain voxel-wise univariate (statistical parametric mapping, SPM) approach. Results: As compared to the univariate whole-brain approach (SPM) (only demonstrating striatal [¹²³I]FP-CIT binding reduction in PD group), SBM identified six sources of non-artefactual origin, including basal ganglia and cortical regions as well as brainstem. Among them, three sources (basal ganglia and cortical regions) presented loading scores (as index of [¹²³I]FP-CIT binding) significantly different between PD and CG. Notably, even if not significantly different between PD and CG, the remaining three non-artefactual sources were characterized by a predominant frontal, brainstem, and occipito-temporal involvement. Conclusion: The concept of source blind separation by the application of ICA (as implemented in SBM) represents a feasible approach to be considered in [¹²³I]FP-CIT (DaTSCAN^®) SPECT imaging. Taking advantage of this multivariate analysis, specific patterns of variance can be identified (involving either striatal than extrastriatal regions) that could be useful in differentiating neurodegenerative parkinsonisms.