Abstract
In idiopathic Parkinson's disease (PD), a tremor-dominant type (TDT), an akinetic-rigid type (ART), and a mixed type (MT) are distinguished. We compared cerebral [I-123]FP-CIT SPECT in the PD subtypes (67 patients Hoehn and Yahr stage 1:26 with ART, 19 with MT, 22 with TDT). We measured the ratios putamen/occipital lobe binding and caudate nucleus/occipital lobe binding. Parkinsonian motor symptoms were quantified by UPDRS motor scale. In both putamen and caudate nucleus contralateral to the clinically affected body side TDT patients showed a significantly higher FP-CIT uptake than ART or MT patients (ANOVA; p<0.01). Contralateral putamen and caudate nucleus FP-CIT uptake correlated significantly with severity of rigidity (p<0.01) and hypokinesia (p<0.01) but not with severity of resting or postural tremor (p>0.05). The missing correlation between striatal FP-CIT uptake and tremor suggests, that further systems besides the nigrostriatal dopaminergic system may contribute to generation of parkinsonian tremor.
MeSH terms
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Adult
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Age of Onset
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Aged
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Binding, Competitive / drug effects
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Caudate Nucleus / diagnostic imaging
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Caudate Nucleus / metabolism
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Caudate Nucleus / physiopathology
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Corpus Striatum / diagnostic imaging*
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Corpus Striatum / physiopathology
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Diagnosis, Differential
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Disease Progression
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Dopamine / metabolism*
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Dopamine Plasma Membrane Transport Proteins / metabolism*
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Female
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Humans
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Male
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Middle Aged
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Muscle Rigidity / diagnostic imaging
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Muscle Rigidity / metabolism
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Muscle Rigidity / physiopathology
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Occipital Lobe / diagnostic imaging
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Occipital Lobe / metabolism
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Occipital Lobe / physiopathology
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Parkinson Disease / diagnosis*
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Parkinson Disease / diagnostic imaging*
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Parkinson Disease / physiopathology
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Predictive Value of Tests
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Putamen / diagnostic imaging
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Putamen / metabolism
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Putamen / physiopathology
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Substantia Nigra / metabolism
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Substantia Nigra / physiopathology
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Tomography, Emission-Computed, Single-Photon / methods
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Tremor / diagnostic imaging
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Tremor / metabolism
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Tremor / physiopathology
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Tropanes* / pharmacokinetics
Substances
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Dopamine Plasma Membrane Transport Proteins
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Tropanes
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2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane
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Dopamine