PET Measurements of Neuroreceptor Occupancy by Typical and Atypical Neuroleptics

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PET Measurements of Neuroreceptor Occupancy by Typical and Atypical Neuroleptics 7. KuhI DE, Metter EJ, Riege WH. Patterns of local cerebral glucose utilization measurement oflocal cerebral glucose utilization: theory, procedure and normal values determined in Parkinson's disease by the [@0F]fluorodeoxyglucose method. Ann Neurol in the conscious and anesthetized albino rat. J Neurochem l977;28:897—9l6. l984;l5:4l9—424. 27. Reivich M, Alavi A, Wolf A, et al. Glucose metabolic rate kinetic model parameter 8. KuhI DE, Metier EJ, Riege WH, Markham CH. Pattems of local cerebral glucose determination in humans: the lumped constants and rate constants for [‘8F]fluorode utilization in Parkinson's disease and Huntington's disease. Ann Neurol 1984; oxyglucose and [‘‘Cjdeoxyglucose.J Cereb Blood Flow Metab l985;5: 179—192. l5(suppl):5l19—5125. 28. Foster NL, Gilman 5, Berent 5, et al. Cerebralhypometabolism in progressive supranuclear 9. Peppard RF, Martin WR, Carr GD, et al. 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Goto I, Taniwaki T, Hosokawa 5, et al. PET studies in dementia. J Neurol Sci positron emission tomography. J Cereb Blood Flow Metab l99l;l 1:735—744. 1993;l14:1—6. 23. Talairach J, Toumoux P. Co-planar stereotaxic atlas ofthe human brain. Thieme, New 42. Kalaria RN, Hank SI. Reduced glucose transporter at the blood-brain barrier and in York 1988. cerebral cortex in Alzheimer's disease. J Neurochem 1989;53:1083—1088. 24. Bevington PR. Data reduction and error analysis for the physical sciences. New York: 43. Marcus DL, de Leon MJ, Goldman J, et al. Altered glucose metabolism in microves Mc Graw-Hill; 1969:232—241. sets from patients with Alzheimer's disease. Ann Neurol l989;26:9l—94. 25. Marquardt DW. An algorithm for least-squares estimation of nonlinear parameters. J 44. Huang 5-C, Phelps ME, Hoffman EJ, Kuhl DE. Error sensitivity of fluorodeoxyglu SocApplMath 1963;ll:43l—44l. cose method for measurement of cerebral metabolic rate of glucose. J Cereb Blood 26. Sokoloff L, Reivich M, Kennedy C, et al. The [‘4C]deoxyglucosemethod for the Flow Metab l981;l:39I—40l. PET Measurements of Neuroreceptor Occupancy by Typical and Atypical Neuroleptics Peter F. Goyer, Marc S. Berridge, Evan D. Morris, William E. Semple, Beth A. Compton-Toth, S. Charles Schulz, Dean F. Wong, Floro Miraldi and Herbert Y. Meltzer Cleveland Veterans Affairs Medical Center, Cleveland, Ohio; Departments ofRadiology and Psychiatry, Case Western Reserve University Medical School and University Hospitals, Cleveland, Ohio; and Department of Radiology, Johns Hopkins University Medical School, Baltimore, Maryland subjects who were b@ngtreated with ckzapine, an atypk@alanlipsy The goal of this study was to use PET and 11C-N-methylspiperone chotic drug. ResuI@ Among the three groups, there were significant (11C-NMSP)to measurethe differencesin relativeoccupancyof differences in5-HT@ indices, D2 indk@esand the ratio of 5-HT@to D2 serotonin (5-hydroxytryptamine-2 or 5-HT@) and dopamine-2 (D2) indices. With no overlap, the 5-HT@,index separated allsubjects who neuroreceptors in subjects being treated with typical or atypical recsived clozapne and the D2 index separated the remaining two antipsychotic drugs. Methods: We used PET and single-dose groups. Conclusion: Typkal antipsychotk@and atypical antipsychotic 11C-NMSP to measure receptor indices and relative receptor occu subjects do have differingpatterns of 5-HT@ and D2 relative receptor pancy of 5-HT2Areceptors in frontal cortex and D2 receptors in occupancy when measured with a single PE@scan, single 11C-NMSP basal ganglia infive subjects who were neuroleptic free, fivesubjects who were being treated with typical antipsychotic drugs and five radiotracer dose and no separately injected “cold―pharmaceutical. Key Words PET; carbon-i 1-N-methylspiperone; neuroreceptor cc cupancy ReceivedMar.24, 1995;revisionaccepted Nov.1, 1995. Forcorrespondenceorreprintscontact:PeterF.Goyer,MD,chiefofstaff,cleveland J NucIMed1996;37:1122—1127 vAMc(B).10,000BreCkSVIlieRd.,Brecksville,OH44141. 1122 THEJOURNALOFNUCLEARMEDICINE•Vol. 37 •No. 7 •July 1996 InvitroN-methylspiperone(NMSP)hasbeencharacterizedas 5-HT2Areceptorsandlow occupancyof D2receptors,whilethe a high affinity dopamine-2 (D2) receptor ligand in rat and reverse is true of typical antipsychotic drugs. Meltzer (18,19) human caudate (1 ) as well as a serotonin-2 (5-hydroxytrypta suggested that the superior efficacy and low extrapyramidal mine-2 or 5-HT2A) receptor ligand in rat and human frontal side effects of clozapine may be related not to absolute receptor cortex (1 ). NMSP has been characterized in vivo as a D2 and occupancy ofthe individual 5-HT2A and D2 receptors but to the 5-HT2Aligand in mice (2), baboons(3,4) andhumans(5,6). [In extent of 5-HT2A receptor occupancy relative to D2 receptor accordance with the Serotonin Receptor Nomenclature Com occupancy. mittee (7), 5-HT2A will be the notation used for receptors This study was designed to use ‘‘C-NMSP as a single previously denoted as 5-HT2.] radiotracer to examine relative receptor occupancy produced by In 1983, Wagner et al. (5) reported the use of ‘1C-NMSP clozapine and by typical antipsychotic drugs of 5-HT2A recep with PET to image D2 receptors in human basal ganglia. tors in frontal cortex and of D2 receptors in basal ganglia to test Subsequently, Wong et al.
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