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[I-123]-FP-CIT-SPECT demonstrates dopaminergic deficit in orthostatic tremor

Katzenschlager, R; Costa, D; Gerschlager, W; O'Sullivan, J; Zijlmans, J; Gacinovic, S; Pirker, W; ... Brown, P; + view all (2003) [I-123]-FP-CIT-SPECT demonstrates dopaminergic deficit in orthostatic tremor. ANN NEUROL , 53 (4) 489 - 496. 10.1002/ana.10475.

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Abstract

There is increasing evidence of a potential role of the dopaminergic system in orthostatic tremor (OT): Association with parkinsonism and treatment effects of L-dopa and dopamine agonists have been reported. Eleven patients with isolated OT had single-photon emission computed tomography (SPECT) using I-123-FP-CIT ([I-123]-2beta-carbomethoxy-3beta-(-4-iodophenyl)-N-(3-fluoropropyl)-nortropane) as dopamine transporter tracer. Results were compared with 12 age-matched normal controls and 12 patients with Parkinson's disease (PD). A marked reduction in striatal tracer binding was found in OT compared to normal controls (p < 0.001). Tracer uptake was significantly higher and more symmetrical than in PD, and caudate and putamen were equally affected. L-dopa challenges, performed in seven patients, showed a small but non-significant improvement on EMG and a small but significant improvement in clinical parameters on blinded video rating. Two-month open-label L-dopa treatment (600 mg/day) led to a small improvement in two of five patients but no significant overall change. Olfactory function on University of Pennsylvania Smell Identification Test was normal. Our finding of a marked tracer uptake reduction on dopamine transporter SPECT supports a role of the dopaminergic system in OT. Lack of evidence of a clinically relevant therapeutic response to L-dopa suggests that other mechanisms must also be involved in the pathogenesis.

Type: Article
Title: [I-123]-FP-CIT-SPECT demonstrates dopaminergic deficit in orthostatic tremor
DOI: 10.1002/ana.10475
Keywords: POSITRON EMISSION TOMOGRAPHY, PARKINSONS-DISEASE, MAGNETIC STIMULATION, GLOBUS-PALLIDUS, SPECT, NEURONS, IODINE-123-BETA-CIT, IDENTIFICATION, TRANSPORTERS, ACTIVATION
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences
URI: http://discovery.ucl.ac.uk/id/eprint/116014
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