Prospective F-18 FDOPA PET Imaging Study in Human PD.

Purpose: We present the findings of our final prospective study submitted to the U.S. Food and Drug Administration (FDA) for New Drug Application (NDA) approval for the use of 3,4-dihydroxy-6-[18F]fluoro-l-phenylalanine (F-18 FDOPA) positron emission tomography (PET) imaging for Parkinson's disease (PD). The primary aim was to determine the sensitivity, specificity, and predictive values of F-18 FDOPA PET in parkinsonian patients with respect to clinical standard-of-truth (SOT). Secondary outcomes included the inter-rater reliability, and correlation of quantitative measures for PET with dopaminergic status. Methods: In 68 parkinsonian subjects, F-18 FDOPA PET scan from 80 to 100 min was acquired following a CT scan. Scan images were presented to one expert in F-18 FDOPA image interpretation and two physicians with prior experience in I-123 FPCIT single-photon emission computed tomography image interpretation. Fifty-six subjects completed the study with a follow-up for SOT determination. Image readers were blind to the clinical/quantitative data; SOT clinician was blind to the image data. Results: For 47 of the 56 patients, SOT was in agreement with the PET scan results. For nine patients, SOT suggested dopaminergic deficit, whereas the imaging showed normal uptake. The specificity and positive predictive values are 91% and 92%, respectively, suggesting high probability that those who test positive by the PET scan truly have dopaminergic degeneration. The sensitivity was 73%. Inter-rater agreement was 0.6-0.8 between the different readers. Conclusion: Our prospective study demonstrates high specificity and moderate sensitivity of F-18 FDOPA PET for PD. We received NDA approval in October 2019. Supplementary Information: The online version contains supplementary material available at 10.1007/s13139-022-00748-4.

In utero exposure to maternal anti-aquaporin-4 antibodies alters brain vasculature and neural dynamics in male mouse offspring.

The fetal brain is constantly exposed to maternal IgG before the formation of an effective blood-brain barrier (BBB). Here, we studied the consequences of fetal brain exposure to an antibody to the astrocytic protein aquaporin-4 (AQP4-IgG) in mice. AQP4-IgG was cloned from a patient with neuromyelitis optica spectrum disorder (NMOSD), an autoimmune disease that can affect women of childbearing age. We found that embryonic radial glia cells in neocortex express AQP4. These cells are critical for blood vessel and BBB formation through modulation of the WNT signaling pathway. Male fetuses exposed to AQP4-IgG had abnormal cortical vasculature and lower expression of WNT signaling molecules Wnt5a and Wnt7a. Positron emission tomography of adult male mice exposed in utero to AQP4-IgG revealed increased blood flow and BBB leakiness in the entorhinal cortex. Adult male mice exposed in utero to AQP4-IgG had abnormal cortical vessels, fewer dendritic spines in pyramidal and stellate neurons, and more S100ß+ astrocytes in the entorhinal cortex. Behaviorally, they showed impairments in the object-place memory task. Neural recordings indicated that their grid cell system, within the medial entorhinal cortex, did not map the local environment appropriately. Collectively, these data implicate in utero binding of AQP4-IgG to radial glia cells as a mechanism for alterations of the developing male brain and adds NMOSD to the conditions in which maternal IgG may cause persistent brain dysfunction in offspring.

Blood-brain barrier permeability in Parkinson's disease patients with and without dyskinesia.

OBJECTIVE: Recent studies on a rodent model of Parkinson's disease (PD) have raised the possibility of increased blood-brain barrier (BBB) permeability, demonstrated by histology, autoradiography, and positron emission tomography (PET). However, in human PD patients, in vivo evidence of increased BBB permeability is lacking. We examined the hypothesis that levodopa treatment increases BBB permeability in human subjects with PD, particularly in those with levodopa-induced dyskinesia (LID). METHODS: We used rubidium-82 (82Rb) and PET to quantify BBB influx in vivo in 19 PD patients, including eight with LID, and 12 age- and sex-matched healthy subjects. All subjects underwent baseline 82Rb scans. Seventeen chronically levodopa-treated patients were additionally rescanned during intravenous levodopa infusion. Influx rate constant, K1, by compartmental modeling or net influx transport, Ki, by graphical approach could not be estimated reliably. However, Vd, the "apparent volume of distribution" based on the 82Rb concentration in brain tissue and blood, was estimated with good stability as a local measure of the volume of distribution. RESULTS: Rubidium influx into brain tissue was undetectable in PD patients with or without LID, scanned on and off drug. No significant differences in regional Vd were observed for PD patients with or without LID relative to healthy subjects, except in left thalamus. Moreover, changes in Vd measured off- and on-levodopa infusion were also not significant for dyskinetic and non-dyskinetic subjects. CONCLUSION: 82Rb PET did not reveal significant changes in BBB permeability in PD patients.

Human Radiation Dosimetry for the N-Methyl-D-Aspartate Receptor Radioligand 11C-CNS5161.

UNLABELLED: (11)C-CNS5161 (N-(2-chloro-5-methylthiophenyl)-N'-(3-methylthiophenyl)-N'-(11)C-methylguanidine) has been successfully used in PET imaging of N-methyl-d-aspartate (NMDA) receptors. However, no human dosimetry data have been published. We are planning to use this radiotracer for investigating NMDA receptor function in systemic lupus erythematosus, traumatic brain injury, and Parkinson disease. We have therefore undertaken (11)C-CNS5161 PET imaging to measure the whole-body distribution of this radionuclide and to estimate radiation dose to various organs. METHODS: Dynamic PET studies of the whole body were performed on 5 healthy adults. Regions of interest were drawn over the visualized structures. Resultant time-activity curves were generated and used to determine residence times for dosimetry calculations. S factors were implemented within the OLINDA/EXM software for each structure or organ. RESULTS: For (11)C-CNS5161, organ doses ranged from 0.0002 to 0.0393 mGy/MBq (0.0006-0.1455 rad/mCi). The critical organ for radiation burden was the lungs, with a dose of 0.0393 mGy/MBq (0.1455 rad/mCi). Radiation doses to the reproductive and blood-forming organs were 0.0023, 0.0002, and 0.0020 mGy/MBq (0.0086, 0.0006, and 0.0074 rad/mCi) for the ovaries, testes, and red marrow, respectively. The effective dose equivalent was 0.0106 mSv/MBq (0.0392 rem/mCi). CONCLUSION: The radiation dosimetry for (11)C-CNS5161 for a standard single injection of 555 MBq (15 mCi) will result in an effective dose equivalent of 5.9 mSv (0.59 rem) and a lung dose of 21.8 mGy (2.18 rad) in young, healthy subjects.

Excel2SVM: a stand-alone Python tool for data analysis via support vector machines.

The creation of classification kernel models to categorize unknown data samples of massive magnitude is an extremely advantageous tool for the scientific community. Excel2SVM, a stand-alone Python mathematical analysis tool, bridges the gap between researchers and computer science to create a simple graphical user interface that allows users to examine data and perform maximal margin classification. This valuable ability to train support vector machines and classify unknown data files is harnessed in this fast and efficient software, granting researchers full access to this complicated, high-level algorithm. Excel2SVM offers the ability to convert data to the proper sparse format while performing a variety of kernel functions along with cost factors/modes, grids, crossvalidation, and several other functions. This program functions with any type of quantitative data making Excel2SVM the ideal tool for analyzing a wide variety of input. The software is free and available at www.bioinformatics.org/excel2svm. A link to the software may also be found at www.kernel-machines.org. This software provides a useful graphical user interface that has proven to provide kernel models with accurate results and data classification through a decision boundary.

Substituent effects in formally quintuple-bonded ArCrCrAr compounds (Ar = terphenyl) and related species.

The effects of different terphenyl ligand substituents on the quintuple Cr-Cr bonding in arylchromium(I) dimers stabilized by bulky terphenyl ligands (Ar) were investigated. A series of complexes, ArCrCrAr (1-4; Ar = C6H2-2,6-(C6H3-2,6-iPr2)2-4-X, where X = H, SiMe3, OMe, and F), was synthesized and structurally characterized. Their X-ray crystal structures display similar trans-bent C(ipso)CrCrC(ipso) cores with short Cr-Cr distances that range from 1.8077(7) to 1.8351(4) A. There also weaker Cr-C interactions [2.294(1)-2.322(2) A] involving an C(ipso) of one of the flanking aryl rings. The data show that the changes induced in the Cr-Cr bond length by the different substituents X in the para positions of the central aryl ring of the terphenyl ligand are probably a result of packing rather than electronic effects. This is in agreement with density functional theory (DFT) calculations, which predict that the model compounds (4-XC6H4)CrCr(C6H4-4-X) (X = H, SiMe3, OMe, and F) have similar geometries in the gas phase. Magnetic measurements in the temperature range of 2-300 K revealed temperature-independent paramagnetism in 1-4. UV-visible and NMR spectroscopic data indicated that the metal-metal-bonded solid-state structures of 1-4 are retained in solution. Reduction of (4-F3CAr')CrCl (4-F3CAr' = C6H2-2,6-(C6H3-2,6-iPr2)2-4-CF3) with KC8 gave non-Cr-Cr-bonded fluorine-bridged dimer {(4-F3CAr')Cr(mu-F)(THF)}2 (5) as a result of activation of the CF3 moiety. The monomeric, two-coordinate complexes [(3,5-iPr2Ar*)Cr(L)] (6, L = THF; 7, L = PMe3; 3,5-iPr2Ar* = C6H1-2,6-(C6H-2,4,6-iPr3)2-3,5-iPr2) were obtained with use of the larger 3,5-Pri2-Ar* ligand, which prevents Cr-Cr bond formation. Their structures contain almost linearly coordinated CrI atoms, with high-spin 3d5 configurations. The addition of toluene to a mixture of (3,5-iPr2Ar*)CrCl and KC8 gave the unusual dinuclear benzyl complex [(3,5-iPr2Ar*)Cr(eta3:eta6-CH2Ph)Cr(Ar*-1-H-3,5-iPr2)] (8), in which a C-H bond from a toluene methyl group was activated. The electronic structures of 5-8 have been analyzed with the aid of DFT calculations.

Radiosynthesis of [18F] N-(3-Fluoropropyl)-2-beta-Carbomethoxy-3-beta-(4-Bromophenyl) Nortropane and the regional brain uptake in non human primate using PET.

A synthetic procedure for the preparation of [18F]FPCBT, an imaging agent for the dopamine transporter (DAT), has been developed. The radiosynthesis was carried out in a two step procedure. Even though the yield was low, we were able to prepare 20 to 30 mCi of the product, which was enough for two or three studies. The radiochemical purity was greater than 96%. The in vivo properties of this radiotracer were evaluated using baboon and it showed highest uptake in the striatum. The studies also revealed that the maximum uptake was reached within 7 to 10 minutes post injection. Plasma metabolite analysis indicated that there is only one metabolite and it is less lipophilic than the parent compound. [18F]FPCBT displayed good brain uptake and its high target to non target ratio indicate that it is a potential candidate for DAT imaging.