Akinetic-rigid and tremor-dominant Parkinson's disease patients show different patterns of FP-CIT single photon emission computed tomography

Mov Disord. 2011 Feb 15;26(3):416-23. doi: 10.1002/mds.23468. Epub 2011 Jan 24.

Abstract

Objective: To elucidate whether Parkinson's disease subtypes show a different pattern of Iodine-123 fluoropropyl-;carbomethoxy-3 β-(FP-CIT) single photon emission computed tomography (SPECT) binding in accordance with neuropathological findings.

Methods: We analyzed a database of consecutive patients with FP-CIT scan (n = 190) over a 3-year period and identified 122 patients (50 women, 72 men, mean age 62 ± 11.1 years) with a diagnosis of idiopathic Parkinson's disease. Patient's characteristics and FP-CIT scan results were analyzed and compared for the subgroups tremor-dominant versus akinetic-rigid and equivalent type of Parkinson's disease.

Results: The analysis of all Parkinson's disease patients showed a significant difference between the FP-CIT uptake in the subgroups tremor-dominant and akinetic-rigid. After matching these samples for age, disease duration, disease severity (Hoehn & Yahr grade, Unified Parkinson's Disease Rating Scale score), and levodopa-equivalent dose, these findings were balanced between both groups (n = 23/23) without a significant difference (P > 0.05). However, there was a clear, significant association of visually analyzed shapes of the striatum in FP-CIT SPECT and clinical Parkinson's disease subtype.

Conclusion: These results confirm neuropathological models for a reduced dopaminergic projection to the dorsal putamen in akinetic-rigid patients as well as the lateral putamen and caudate nucleus in tremor-dominant patients in vivo.

MeSH terms

  • Aged
  • Brain Mapping
  • Corpus Striatum / diagnostic imaging
  • Corpus Striatum / pathology
  • Female
  • Fluorine Radioisotopes
  • Humans
  • Male
  • Middle Aged
  • Muscle Rigidity / diagnostic imaging*
  • Muscle Rigidity / etiology
  • Parkinson Disease / complications
  • Severity of Illness Index
  • Tomography, Emission-Computed, Single-Photon / methods*
  • Tremor / diagnostic imaging*
  • Tremor / etiology
  • Tropanes*

Substances

  • Fluorine Radioisotopes
  • Tropanes
  • 2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane