11C-flumazenil positron emission tomography demonstrates reduction of both global and local cerebral benzodiazepine receptor binding in a patient with Stiff Person Syndrome

J Neurol. 2008 Sep;255(9):1361-4. doi: 10.1007/s00415-008-0920-9. Epub 2008 Jun 27.

Abstract

Stiff Person Syndrome (SPS) is a rare autoimmune disorder associated with antibodies against glutamic acid decarboxylase (GAD-Ab), the key enzyme in gamma-aminobutyric acid synthesis (GABA). In order to investigate the role of cerebral benzodiazepinereceptor binding in SPS, we performed [(11)C]flumazenil (FMZ) positron emission tomography (PET) in a female patient with SPS compared to nine healthy controls. FMZ is a radioligand to the postsynaptic central benzodiazepine receptor which is co-localized with the GABA-A receptor. In the SPS patient, we found a global reduction of cortical FMZ binding. In addition, distinct local clusters of reduced radiotracer binding were observed. These data provide first in vivo evidence for a reduced postsynaptic GABA-A receptor availability which may reflect the loss of GABAergic neuronal inhibition in SPS.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Binding, Competitive
  • Brain / diagnostic imaging
  • Brain / metabolism*
  • Brain / physiopathology
  • Carbon Radioisotopes
  • Cerebral Cortex / diagnostic imaging
  • Cerebral Cortex / metabolism
  • Cerebral Cortex / physiopathology
  • Dominance, Cerebral / physiology
  • Female
  • Flumazenil
  • Humans
  • Middle Aged
  • Positron-Emission Tomography / methods*
  • Receptors, GABA-A / metabolism*
  • Stiff-Person Syndrome / metabolism*
  • Stiff-Person Syndrome / pathology
  • Stiff-Person Syndrome / physiopathology

Substances

  • Carbon Radioisotopes
  • Receptors, GABA-A
  • Flumazenil