Neurotransmitter Synthesizing Systems

Appropriate availability of neurotransmitters and neuromodulators is essential to normal neurological and psychological function. Dysfunction or degeneration of neurons that synthesize these substances can lead to various disorders. For example, Parkinson's disease is caused by selective degeneration of the dopamine-synthesizing neurons of the nigrostriatal system. Uptake of [18F] DOPA, which selectively labels aromatic L-amino acid decarboxylase (AADC), a critical enzyme in the synthesis of dopamine, has been used to estimate both the number of surviving cells and AADC activity among nigral neurons, thus providing a tool to understand the connection between dopamine dysfunction and clinical symptom evolution (Cropley et al. 2006; Ravina et al. 2005). PET scanning using [11C] methyl-L-tryptophan, which is a marker of serotonin (5-HT) synthesis, is being used in identifying overactive serotonin-synthesizing systems in differentiating epileptogenic from nonepileptogenic lesions in tuberous sclerosis (Luat et al. 2007) prior to neurosurgery. In a similar vein, recent functional imaging techniques have combined with neurosurgical treatments such as deep brain stimulation to study brain imaging biomarkers of treatment response (Carbon and Eidelberg 2002).

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