Degenerative parkinsonism in patients with psychogenic parkinsonism: A dopamine transporter imaging study.

Abstract

OBJECTIVES:

To evaluate patients with "clinically established" psychogenic parkinsonism (PsyP) using single-photon emission computer tomography (SPECT) with the technetium-99m labeled tracer TRODAT-1, a dopamine transporter (DAT) ligand, and investigate whether these patients have an underlying degenerative parkinsonism.

PATIENTS AND METHODS:

Five patients with PsyP were assessed using demographic data, standard clinical scales for Parkinson's Disease (PD), and a neuropsychiatric interview. DAT imaging using SPECT with TRODAT-1 was performed, and values for caudate/putamen DAT binding potentials (BP) registered. Patients with PsyP were matched with PD (n=5) and healthy control subjects (n=5).

RESULTS:

The mean age (years-old) at first evaluation in the PsyP group was 37.4+/-3.7, and the mean disease duration (years) was 3.9+/-1.2. DAT BPs (means+/-standard deviations) on right/left caudate were, respectively, 0.69+/-0.18 and 0.70+/-0.18 in the PD group versus 1.17+/-0.06 and 1.12+/-0.10 in the control group. DAT BPs on right/left putamen were, respectively, 0.48+/-0.10 and 0.45+/-0.06 in the PD group versus 1.10+/-0.10 and 1.21+/-0.43 in the control group. Two out of five patients from the PsyP group had values for DAT BP in the putamen under the cut-off (< or =0.70) for controls, implying pre-synaptic dopaminergic deficit.

CONCLUSIONS:

Our data in this small group of patients suggest that DAT imaging is a tool that may help in the identification of underlying degenerative parkinsonism in PsyP.

• Authors: Andre C Felicio, Clecio Godeiro-Junior, Tais S Moriyama, Ming C Shih, Marcelo Q Hoexter, Vanderci Borges, Sonia M A Silva, Patricia de Carvalho Aguiar, Luiz A F Andrade, Rodrigo A Bressan, Henrique B Ferraz
• Journal: Clinical neurology and neurosurgery (Clin Neurol Neurosurg) Vol. 112 Issue 4 Pg. 282-5 (May 2010) ISSN: 1872-6968 [Electronic] Netherlands
• PMID: 20061077 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 2009 Elsevier B.V. All rights reserved.

Chemical References

• Dopamine Plasma Membrane Transport Proteins
• Organotechnetium Compounds
• Radiopharmaceuticals
• Tropanes
• technetium Tc 99m TRODAT-1

Topics

• Adult
• Caudate Nucleus (diagnostic imaging)
• Dopamine Plasma Membrane Transport Proteins (metabolism)
• Female
• Humans
• Male
• Neurodegenerative Diseases (diagnostic imaging, metabolism, pathology)
• Organotechnetium Compounds
• Parkinson Disease (diagnostic imaging, metabolism, pathology)
• Putamen (diagnostic imaging)
• Radiopharmaceuticals
• Socioeconomic Factors
• Tomography, Emission-Computed, Single-Photon
• Treatment Outcome
• Tropanes