Clinical features and nigrostriatal dysfunction in patients with combined postural and resting tremors.

Abstract

BACKGROUND:

The characteristics of clinical features and nigrostriatal dopaminergic dysfunction in patients with combined postural and resting tremors have been less clearly reported.

METHODS:

The present study examined 43 patients with a visible persistent bilateral postural tremor and a unilateral/bilateral resting tremor involving the hands and forearms. The patients had experienced tremors for more than 3 years, with no evidence of Parkinson's disease or other parkinsonian disorders. Visual and quantitative analyses of [18F] N-(3-fluoropropyl)-2beta-carbon ethoxy-3beta-(4-iodophenyl) nortropane (FP-CIT) PET in 36 patients were performed. Seventeen age-matched normal controls were also studied.

RESULTS:

On visual analysis, 28 patients (78%) showed normal [18F] FP-CIT uptake and eight (22%) showed significantly reduced uptake, suggesting nigrostriatal dopaminergic neuronal degeneration. The reduced [18F] FP-CIT uptake was significantly associated with earlier age-at-onset of tremor and asymmetric presentation of resting tremor. On quantitative analysis, there were statistically significant differences in the [18F] FP-CIT uptake ratio in the posterior putamen between patients with reduced uptake (2.37 ± 1.83) and patients with normal uptake (6.39 ± 1.35) (P < 0.001). However, posterior putamen uptake levels in patients with normal [18F] FP-CIT uptake on visual analysis were similar to those in normal controls (7.22 ± 1.29) (P = 0.291).

CONCLUSION:

The nigrostriatal dopaminergic dysfunction in patients with combined postural and resting tremors may be associated with earlier age-at-onset of tremor and asymmetric pattern of resting tremor, which might help to correctly diagnose patients with mixed tremors.

• Authors: Sooyeoun You, Mi-Jung Kim, Sung Reul Kim, Mi Jung Kim, Minyoung Oh, Jae Seung Kim, Sun Ju Chung
• Journal: Parkinsonism & related disorders (Parkinsonism Relat Disord) Vol. 19 Issue 12 Pg. 1118-22 (Dec 2013) ISSN: 1873-5126 [Electronic] England
• PMID: 23973013 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 Elsevier Ltd. All rights reserved.

Chemical References

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

Topics

• Aged
• Aged, 80 and over
• Brain (diagnostic imaging)
• Female
• Humans
• Male
• Middle Aged
• Positron-Emission Tomography
• Radiopharmaceuticals
• Tremor (diagnosis, diagnostic imaging)
• Tropanes