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Open AccessArticle

Tc-99m TRODAT-1 SPECT is a Potential Biomarker for Restless Leg Syndrome in Patients with End-Stage

by Yi-Chou Hou 1,2,3, Yu-Ming Fan 3,4, Ya-Ching Huang 5,6, Ruei-Ming Chen 7, Cheng-Hsu Wang 4,8, Yi-Te Lin 2,3,9, Tzung-Hai Yen 10,11, Kuo-Cheng Lu 3,12,13,* and Yuh-Feng Lin 1,14,15,*
1
Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
2
Department of Internal Medicine, Cardinal Tien Hospital, New Taipei City 231,Taiwan
3
School of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan
4
Department of Nuclear Medicine, Cardinal Tien Hospital, New Taipei City 231,Taiwan
5
Department of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
6
Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
7
Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
8
School of Biomedical Engineering and Environmental Science, National Tsing Hua University, Hsinchu City 300, Taiwan
9
Departments of Hyperbaric Medicine and Neurology, Cardinal Tien Hospital, New Taipei City 231, Taiwan
10
Division of Nephrology, Chang Gung Memorial Hospital, Taipei 105, Taiwan
11
College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
12
Department of Nephrology, Fu Jen Catholic University Hospital, New Taipei City 243, Taiwan
13
Department of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan
14
Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan
15
Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 114, Taiwan
*
Authors to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(3), 889; https://doi.org/10.3390/jcm9030889
Received: 4 March 2020 / Accepted: 19 March 2020 / Published: 24 March 2020
Rationales: Restless leg syndrome (RLS) is a common complication in patients with end-stage renal disease (ESRD). However, there is a lack of biomarkers linking uremic RLS to dopaminergic neurons. Previous studies demonstrated that Tc-99m TRODAT-1 SPECT was a biomarker for RLS but the correlation between the physiologic parameter was lacking. Methods: Overall, 32 patients were enrolled in the study and divided into the following 3 groups: (1) control (n = 13), (2) ESRD without RLS (n = 8) and (3) ESRD with RLS (n = 11). All patients had a clinical diagnosis of RLS and received Tc-99m TRODAT-1 SPECT. A subgroup analysis was performed to compare differences between the control and ESRD with RLS groups. Tc-99m TRODAT-1 SPECT was performed and activities in the striatum and occipital areas were measured using manually delineated regions of interest (ROIs) by an experienced nuclear medicine radiologist who was blinded to clinical data. Results: The total ratio of Tc-99m TRODAT SPECT was lower in the ESRD with RLS group (p = 0.046). The uptake ratio of TRODAT negatively correlated with serum parathyroid hormone (r = −0.577, p = 0.015) and ferritin (r = −0.464, p = 0.039) concentrations. However, the uptake positively correlated with the hemoglobin concentration (r = 0.531, p = 0.011). The sensitivity and specificity of the total TRODAT ratio for predicting RLS in the overall population were 95.0% and 67.7%, respectively, at a cutoff value of 0.980 (area under the curve of receiver operating characteristic curve was 0.767, p = 0.024). Conclusion: In patients with ESRD and RLS, Tc-99m TRODAT might be a potential biomarker. Dysregulated hemoglobin, serum parathyroid hormone and serum ferritin concentrations might influence the uptake of the TRODAT ratio. View Full-Text
Keywords: restless leg syndrome; ESRD; TRODAT-1 restless leg syndrome; ESRD; TRODAT-1
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Hou, Y.-C.; Fan, Y.-M.; Huang, Y.-C.; Chen, R.-M.; Wang, C.-H.; Lin, Y.-T.; Yen, T.-H.; Lu, K.-C.; Lin, Y.-F. Tc-99m TRODAT-1 SPECT is a Potential Biomarker for Restless Leg Syndrome in Patients with End-Stage. J. Clin. Med. 2020, 9, 889.

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