open access
The symptoms asymmetry of drug-induced parkinsonism is not related to nigrostriatal cell degeneration: a SPECT-DaTSCAN study
Affiliations- Department of Extrapyramidal Diseases, Medical University of Lodz, Poland, Pomorska 251, 92-213 Łódź, Poland
- Department of Nuclear Medicine, Medical University of Łódź, Poland, Czechosłowacka 8/10, 90-001 Łódź, Poland
- Department of Quality Control and Radiological Protection, Medical University of Łódź, Poland, Czechosłowacka 8/10, 90-001 Łódź, Poland
open access
Abstract
Aim. Drug-induced parkinsonism (DIP) is the most common form of parkinsonism after Parkinson’s disease (PD) itself. It has been widely believed that DIP is characterised by symmetry of symptoms. Studies of patients with DIP in whom PD had been ruled out by SPECT-DaTSCAN have shown that symptom asymmetry is a common element of DIP clinical presentation. The aim of our study was to determine whether the asymmetry of symptoms in DIP is related to any abnormality within the presynaptic part of the nigrostriatal dopaminergic system.
Materials and methods. Eleven patients with the diagnosis of DIP and asymmetric symptoms were studied. Their individual SPECT-DaTSCANs were normal. Indices calculated for the whole group of radiotracer uptake in the whole striatum, putamen and caudate contralateral to more severe DIP symptoms were compared to values obtained in the opposite hemisphere.
Results. We did not find significant differences in radiotracer uptake in structures contralateral to more severe clinical symptoms when compared to the homolateral hemisphere.
Conclusions. Our results have not confirmed the presence of a presynaptic nigrostriatal deficit which could be related to asymmetry of DIP. The factors responsible for the asymmetry of DIP symptoms should be sought in the postsynaptic part of the nigrostriatal dopaminergic system.
Abstract
Aim. Drug-induced parkinsonism (DIP) is the most common form of parkinsonism after Parkinson’s disease (PD) itself. It has been widely believed that DIP is characterised by symmetry of symptoms. Studies of patients with DIP in whom PD had been ruled out by SPECT-DaTSCAN have shown that symptom asymmetry is a common element of DIP clinical presentation. The aim of our study was to determine whether the asymmetry of symptoms in DIP is related to any abnormality within the presynaptic part of the nigrostriatal dopaminergic system.
Materials and methods. Eleven patients with the diagnosis of DIP and asymmetric symptoms were studied. Their individual SPECT-DaTSCANs were normal. Indices calculated for the whole group of radiotracer uptake in the whole striatum, putamen and caudate contralateral to more severe DIP symptoms were compared to values obtained in the opposite hemisphere.
Results. We did not find significant differences in radiotracer uptake in structures contralateral to more severe clinical symptoms when compared to the homolateral hemisphere.
Conclusions. Our results have not confirmed the presence of a presynaptic nigrostriatal deficit which could be related to asymmetry of DIP. The factors responsible for the asymmetry of DIP symptoms should be sought in the postsynaptic part of the nigrostriatal dopaminergic system.
Keywords
drug-induced parkinsonism, asymmetry of symptoms, presynaptic nigrostriatal deficit, SPECT-DaTSCAN
About this articleTitle
The symptoms asymmetry of drug-induced parkinsonism is not related to nigrostriatal cell degeneration: a SPECT-DaTSCAN study
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Short Communication
Pages
311-314
Published online
2019-08-19
Page views
1469
Article views/downloads
340
DOI
Pubmed
Bibliographic record
Neurol Neurochir Pol 2019;53(4):311-314.
Keywords
drug-induced parkinsonism
asymmetry of symptoms
presynaptic nigrostriatal deficit
SPECT-DaTSCAN
Authors
Agata Gajos
Janusz Dąbrowski
Małgorzata Bieńkiewicz
Anna Płachcińska
Jacek Kuśmierek
Andrzej Bogucki
References (14)- Shin HW, Chung S. Drug-Induced parkinsonism. J Clin Neurol. 2012; 8(1): 15–21.
- Susatia F, Fernandez HH. Drug-induced parkinsonism. Curr Treat Options Neurol. 2009; 11(3): 162–169.
- Thanvi B, Treadwell S. Drug induced parkinsonism: a common cause of parkinsonism in older people. Postgrad Med J. 2009; 85(1004): 322–326.
- Kägi G, Bhatia KP, Tolosa E. The role of DAT-SPECT in movement disorders. J Neurol Neurosurg Psychiatry. 2010; 81(1): 5–12.
- Bajaj N, Hauser RA, Grachev ID. Clinical utility of dopamine transporter single photon emission CT (DaT-SPECT) with (123I) ioflupane in diagnosis of parkinsonian syndromes. J Neurol Neurosurg Psychiatry. 2013; 84(11): 1288–1295.
- Diaz-Corrales FJ, Sanz-Viedma S, Garcia-Solis D, et al. Clinical features and 123I-FP-CIT SPECT imaging in drug-induced parkinsonism and Parkinson's disease. Eur J Nucl Med Mol Imaging. 2010; 37(3): 556–564.
- Tinazzi M, Ottaviani S, Isaias IU, et al. [123I]FP-CIT SPET imaging in drug-induced Parkinsonism. Mov Disord. 2008; 23(13): 1825–1829.
- Lorberboym M, Treves TA, Melamed E, et al. [123I]-FP/CIT SPECT imaging for distinguishing drug-induced parkinsonism from Parkinson's disease. Mov Disord. 2006; 21(4): 510–514.
- Yomtoob J, Koloms K, Bega D. DAT-SPECT imaging in cases of drug-induced parkinsonism in a specialty movement disorders practice. Parkinsonism Relat Disord. 2018; 53: 37–41.
- Tinazzi M, Antonini A, Bovi T, et al. Clinical and [123I]FP-CIT SPET imaging follow-up in patients with drug-induced parkinsonism. J Neurol. 2009; 256(6): 910–915.
- Brigo F, Matinella A, Erro R, et al. [¹²³I]FP-CIT SPECT (DaTSCAN) may be a useful tool to differentiate between Parkinson's disease and vascular or drug-induced parkinsonisms: a meta-analysis. Eur J Neurol. 2014; 21(11): 1369–1390.
- Ba F, Martin WR. Dopamine transporter imaging as a diagnostic tool for parkinsonism and related disorders in clinical practice. Parkinsonism Relat Disord. 2015; 21(2): 87–94.
- Iranzo A, Valldeoriola F, Lomeña F, et al. Serial dopamine transporter imaging of nigrostriatal function in patients with idiopathic rapid-eye-movement sleep behaviour disorder: a prospective study. Lancet Neurol. 2011; 10(9): 797–805.
- Iranzo A, Santamaria J, Tolosa E. Idiopathic rapid eye movement sleep behaviour disorder: diagnosis, management, and the need for neuroprotective interventions. Lancet Neurol. 2016; 15(4): 405–419.
