Document Detail


Pre- and postsynaptic dopamine SPECT in the early phase of idiopathic parkinsonism: a population-based study.
MedLine Citation:
PMID:  20593284     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The aim of this study was to assess the diagnostic contribution of pre- and postsynaptic dopamine SPECT in drug-naïve patients with early idiopathic parkinsonism and to investigate possible differences between idiopathic Parkinson's disease (PD) and atypical parkinsonian syndromes (APS) and possible differences in motor subtypes of parkinsonism.
METHODS: A group of 128 newly diagnosed idiopathic parkinsonian patients and 48 healthy controls was studied. Presynaptic baseline SPECT with (123)I-FP-CIT was performed in all patients and in 120 patients also a baseline postsynaptic SPECT with (123)I-IBZM. Clinical diagnoses were reassessed after 12 months.
RESULTS: Presynaptic uptake in the putamen and caudate was significantly reduced in patients compared to controls. Presynaptic uptake ratios were not different between PD patients and patients with APS, and postsynaptic uptake in APS was not significantly reduced compared to PD or controls. In half of the APS patients both pre- and postsynaptic uptake ratios were reduced on the same side in the striatum. Impaired motor performance was associated with decreased presynaptic uptake in the putamen in PD. The postural instability and gait difficulty (PIGD) subtype of PD had lower presynaptic uptake ratios than patients with tremor-dominated (TD) symptoms.
CONCLUSION: Not only presynaptic putamen uptake ratios, but also caudate ratios were reduced in a majority of the patients in our study. At baseline scan, i.e. in an early stage of the disease, the accuracy of excluding APS in the whole study population was 85% using a combination of pre- and postsynaptic SPECT. Already at baseline, lower presynaptic SPECT ratios were seen in PD with PIGD at onset compared to those with TD subtype.
Authors:
Susanna Jakobson Mo; Jan Linder; Lars Forsgren; Anne Larsson; Lennart Johansson; Katrine Riklund
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-07-01
Journal Detail:
Title:  European journal of nuclear medicine and molecular imaging     Volume:  37     ISSN:  1619-7089     ISO Abbreviation:  Eur. J. Nucl. Med. Mol. Imaging     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-04     Completed Date:  2011-01-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140988     Medline TA:  Eur J Nucl Med Mol Imaging     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  2154-64     Citation Subset:  IM    
Affiliation:
Department of Radiation Sciences, Diagnostic Radiology, Umeå University, 901 85, Umeå, Sweden. susanna.jakobson.mo@diagrad.umu.se
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Case-Control Studies
Diagnosis, Differential
Dopamine / metabolism*
Female
Humans
Male
Motor Activity
Parkinson Disease / metabolism*,  pathology,  physiopathology,  radionuclide imaging*
Receptors, Dopamine D2 / metabolism
Sex Factors
Synapses*
Time Factors
Tomography, Emission-Computed, Single-Photon / methods*
Chemical
Reg. No./Substance:
0/Receptors, Dopamine D2

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