[Differential diagnosis of parkinsonism using dopamine transporters brain SPECT]

Med Clin (Barc). 2004 Mar 13;122(9):325-8. doi: 10.1016/s0025-7753(04)74224-4.
[Article in Spanish]

Abstract

Background and objective: Parkinsonism is a group of neurological disorders characterized by extrapiramidal signs. Often, the differential diagnosis between parkinsonism, essential tremor and drug-induced parkinsonism is difficult. The aim of the study was to evaluate the utility of (123I)-FP-CIT SPECT in patients with movement disorders.

Patients and method: 52 patients were referred from the neurology department to characterize those with parkinsonism. Patients were clinically evaluated and those with Parkinson's disease were assessed using the rating scale Hoehn & Yahr and the UPDRS motor score. Subsequently, a (123I)-FP-CIT SPECT was performed with a qualitative analysis.

Results: All patients with essential tremor and drug-induced parkinsonism had a normal SPECT. All patients with parkinsonism displayed SPECT defects, except for four who had a normal SPECT result. Two of them were categorized as vascular parkinsonisms, one patient had a Shy-Drager's syndrome and the another one had probably a Parkinson's disease. The sensitivity and specificity were 90.47% (38/42; CI95%, 81.59%-99.35%) and 100% (10/10; CI95%, 69.15%-100%), respectively.

Conclusions: (123I)-FP-CIT SPECT is an effective tool to study the integrity of the dopaminergic nigrostriatal system. Moreover, it permits to characterize the different types of parkinsonism.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Basal Ganglia / diagnostic imaging
  • Basal Ganglia / metabolism
  • Basal Ganglia / pathology
  • Brain / diagnostic imaging*
  • Carrier Proteins / metabolism
  • Diagnosis, Differential
  • Dopamine Plasma Membrane Transport Proteins
  • Female
  • Humans
  • Male
  • Membrane Glycoproteins*
  • Membrane Transport Proteins* / metabolism
  • Middle Aged
  • Nerve Tissue Proteins* / metabolism
  • Parkinson Disease / diagnostic imaging*
  • Parkinson Disease / metabolism
  • Parkinson Disease / pathology
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tomography, Emission-Computed, Single-Photon / methods*
  • Tropanes*

Substances

  • Carrier Proteins
  • Dopamine Plasma Membrane Transport Proteins
  • Membrane Glycoproteins
  • Membrane Transport Proteins
  • Nerve Tissue Proteins
  • Tropanes
  • 2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane