Fig. 3: Serial Dopamine -Transporter Ligand-Binding (DAT) SPECT and FDG-PET imaging in both patients. | Nature Communications

Fig. 3: Serial Dopamine -Transporter Ligand-Binding (DAT) SPECT and FDG-PET imaging in both patients.

From: Acetyl-DL-leucine in two individuals with REM sleep behavior disorder improves symptoms, reverses loss of striatal dopamine-transporter binding and stabilizes pathological metabolic brain pattern—case reports

Fig. 3

a, b DAT-SPECT results in patients 1 (a) and 2 (b). The upper part shows representative transversal images of DAT-SPECT at the level of the striatum. For patient 1, three pretreatment images (02/2013, 03/2014, 01/2019) and two images under ADLL therapy (02/2022, 09/2023) are shown. For patient 2, one pretreatment (08/2020) and one image under ADLL therapy (07/2023) are presented. The respective specific-to-non-specific striatal binding ratios of the right putamen are shown directly below the images. The graph shows the specific striatal DAT binding ratios in the striatum, the caudate nucleus and the putamen for the right and left sides. c The time course of the values of the z-score of the Parkinson Disease-related-Pattern (PDRP-z-score) in FDG-PET of patient 1 (blue triangle) is shown from 2014 to 2018 and from 2018 to 2022. ADLL treatment was started in November 2021. For patient 1, the PDRP z-score was 1.72 in 2014, rising to 3.28 in 2018. In 12/2022, 1 year after starting ADLL therapy, the FDG-PET PDRP-z-score was 3.18—similar to the z-score in 2018 (blue triangle). For comparison, the time course of the average PDRP-z-score (mean ± SD, gray shaded area) of 12 untreated iRBD patients from 2014 to 2018 and from 2018 to 2022 are illustrated. This untreated “disease control” iRBD group is divided into the group of converters (n = 5—dark gray circles) and non-converters (n = 7—light gray circles). The average z-scores of the converter group (n = 5; at baseline in 2014: 2.99 ± 1.68; first follow-up in 2018: 5.75 ± 2.28; second follow-up in 2022: 7.85 ± 2.12) were higher than the average z-scores of the non-converter group (n = 7; at baseline in 2014: 1.63 ± 0.69; first follow-up in 2018: 3.02 ± 1.32; second follow-up in 2022: 4.30 ± 2.04). d The time course of the PDRP-z-score in FDG-PET of patient 2 (pink triangle) is shown for 06/2021 (1.02). ADLL treatment was started in January 2022. When the second FDG-PET was performed in 01/2023, after 1 year of continuous ADLL treatment, the z-score was reduced to 0.30. Source data are provided as a Source Data file.

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