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Open Access Research article

Enhanced catecholamine transporter binding in the locus coeruleus of patients with early Parkinson disease

Ioannis U Isaias123*, Giorgio Marotta4, Gianni Pezzoli2, Osama Sabri5, Johannes Schwarz3, Paolo Crenna1, Joseph Classen3 and Paolo Cavallari1

Author Affiliations

1 Università degli Studi di Milano, Dipartimento di Fisiologia Umana, Milano, Italy

2 Parkinson Institute, Istituti Clinici di Perfezionamento, Milano, Italy

3 Department of Neurology, University of Leipzig, Leipzig, Germany

4 Department of Nuclear Medicine, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milano, Italy

5 Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany

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BMC Neurology 2011, 11:88  doi:10.1186/1471-2377-11-88

Published: 21 July 2011



Studies in animals suggest that the noradrenergic system arising from the locus coeruleus (LC) and dopaminergic pathways mutually influence each other. Little is known however, about the functional state of the LC in patients with Parkinson disease (PD).


We retrospectively reviewed clinical and imaging data of 94 subjects with PD at an early clinical stage (Hoehn and Yahr stage 1-2) who underwent single photon computed tomography imaging with FP-CIT ([123I] N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl) tropane). FP-CIT binding values from the patients were compared with 15 healthy subjects: using both a voxel-based whole brain analysis and a volume of interest analysis of a priori defined brain regions.


Average FP-CIT binding in the putamen and caudate nucleus was significantly reduced in PD subjects (43% and 57% on average, respectively; p < 0.001). In contrast, subjects with PD showed an increased binding in the LC (166% on average; p < 0.001) in both analyses. LC-binding correlated negatively with striatal FP-CIT binding values (caudate: contralateral, ρ = -0.28, p < 0.01 and ipsilateral ρ = -0.26, p < 0.01; putamen: contralateral, ρ = -0.29, p < 0.01 and ipsilateral ρ = -0.29, p < 0.01).


These findings are consistent with an up-regulation of noradrenaline reuptake in the LC area of patients with early stage PD, compatible with enhanced noradrenaline release, and a compensating activity for degeneration of dopaminergic nigrostriatal projections.