Background: Anecdotal evidence suggests that patients diagnosed with the parkinsonian subtype of multiple system atrophy (MSA-P) may show uptake of the second-generation tau positron emission tomography (PET) tracer F-Florzolotau (previously known as F-APN-1607) in the putamen.
Objectives: This study systematically investigated the localization and magnitude of F-Florzolotau uptake in a relatively large cohort of patients with MSA-P.
Methods: F-Florzolotau PET imaging was performed in 31 patients with MSA-P, 24 patients with Parkinson's disease (PD), and 20 age-matched healthy controls. F-Florzolotau signal in the striatum was analyzed by visual inspection and classified as either positive or negative. Regional F-Florzolotau binding was also expressed as standardized uptake value ratio (SUVR) to assess whether it was associated with core symptoms of MSA-P after adjustment for potential confounders.
Results: By visual inspection and semiquantitative SUVR comparisons, patients with MSA-P showed elevated F-Florzolotau uptake in the putamen, globus pallidus, and dentate-a finding that was not observed in PD. This increased signal was significantly associated with the core symptoms of MSA-P. In addition, patients with MSA-P with cerebellar ataxia showed an elevated F-Florzolotau uptake in the cerebellar dentate.
Conclusions: F-Florzolotau tau PET imaging findings may reflect the clinical severity of MSA-P and can potentially discriminate between this condition and PD. © 2022 International Parkinson and Movement Disorder Society.
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