Innovative molecular imaging for clinical research, therapeutic stratification and nosography in neuropsychiatry.
- 1INSERM U1214 Centre d'Imagerie Neuro Toulouse (ToNIC), France
- 2Centre Hospitalier Universitaire de Toulouse, France
- 3INSERM CIC1415 CIC Tours, France
- 4Centre Hospitalier Universitaire de Tours, France
- 5INSERM U1253Imagerie et Cerveau (iBrain), France
- 6Institut National de la Santé et de la Recherche Médicale (INSERM), France
- 7Centre Eugène Marquis, France
- 8Leenaards Center of Memory, University Hospital Vaudois, Switzerland
Over the past few decades, several radiotracers have been developed for neuroimaging applications, especially in PET. Because of their low steric hindrance, PET radionuclides can be used to label molecules that are small enough to cross the blood brain barrier, without modifying their biological properties. As the use of 11C is limited by its short physical half-life (20 min), there has been an increasing focus on developing tracers labelled with 18F for clinical use. The first such tracers allowed cerebral blood flow and glucose metabolism to be measured, and the development of molecular imaging has since enabled to focus more closely on specific targets such as receptors, neurotransmitter transporters, and other proteins. Hence, PET and SPECT biomarkers have become indispensable for innovative clinical research. Currently, the treatment options for a number of pathologies, notably neurodegenerative diseases, remain only supportive and symptomatic. Treatments that slow down or reverse disease progression are therefore the subject of numerous studies, in which molecular imaging is proving to be a powerful tool. PET and SPECT biomarkers already make it possible to diagnose several neurological diseases in vivo and at preclinical stages, yielding topographic and quantitative data about the target. As a result, they can be used for assessing patients' eligibility for new treatments, or for treatment follow-up. The aim of the present review was to map major innovative radiotracers used in neurology and psychiatry, and explain their contribution to clinical research. We categorized them according to their target: dopaminergic, cholinergic or serotoninergic systems, β-amyloid plaques, tau protein, neuroinflammation, glutamate or GABA receptors, or α-synuclein. Most neurological disorders, and indeed mental disorders, involve the dysfunction of one or more of these targets. Combinations of molecular imaging biomarkers can afford us a better understanding of the mechanisms underlying disease development over time, and contribute to early detection/screening, diagnosis, therapy delivery/monitoring, and treatment follow-up in both research and clinical settings.
Keywords: Molecular Imaging, clinical research, Neurology, Psychiatry, PET, SPECT
Received: 26 Feb 2019;
Accepted: 01 Nov 2019.
Copyright: © 2019 Beaurain, Salabert, Santiago-Ribeiro, ARLICOT, Damier, Le Jeune, Demonet and Payoux. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dr. Marie Beaurain, INSERM U1214 Centre d'Imagerie Neuro Toulouse (ToNIC), Toulouse, France, email@example.com