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[I-123] FP-CIT spect study in vascular parkinsonism and Parkinson's disease

Zijlmans, J; Evans, A; Fontes, F; Katzenschlager, R; Gacinovic, S; Lees, AJ; Costa, D; (2007) [I-123] FP-CIT spect study in vascular parkinsonism and Parkinson's disease. MOVEMENT DISORD , 22 (9) 1278 - 1285. 10.1002/mds.21479.

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Abstract

There is substantial evidence to support a role for small vessel disease (SVD) as a cause for vascular parkinsonism (VP). Using [(123) I] FP-CIT SPECT (single photon emission computed tomography), we have tried to determine whether VP patients have pre-synaptic dopaminergic function similar to PD patients, and whether the severity of parkinsonian symptoms as well as the levodopa response in VP patients are correlated with pre-synaptic dopaminergic dysfunction. Thirteen patients fulfilling operational clinical criteria for VP had [(123) I] FP-CIT scans. Mean [(123) I] FP-CIT uptake in the basal ganglia was significantly lower in VP patients than in healthy controls, and the asymmetry index was not significantly different between these groups. In contrast, compared with the PD group, only the mean asymmetry index was significantly lower in VP patients. None of the parameters measured was significantly different between VP patients who had an insidious onset of parkinsonism (VPi) and those who had an acute onset (VPa). There was a significant correlation between the bilateral basal ganglia FP-CIT uptake reduction in the VP patients and UPDRS motor scores, but not with the mean % reduction in motor UPDRS after levodopa. We suggest that in the majority of VP patients, pre-synaptic dopaminergic function is reduced. The presence of a rather symmetrical FP-CIT uptake in the basal ganglia may help to distinguish VP from PD and could therefore be used as a criterion for the clinical diagnosis of VP. (c) 2007 Movement Disorder Society

Type: Article
Title: [I-123] FP-CIT spect study in vascular parkinsonism and Parkinson's disease
DOI: 10.1002/mds.21479
Keywords: vascular parkinsonism, FP-CIT SPECT, L-dopa challenge, criteria, DOPAMINE TRANSPORTERS, SUBSTANTIA-NIGRA, BASAL GANGLIA, CLINICAL-DIAGNOSIS, INFARCTS, TOMOGRAPHY, ACCURACY, TREMOR, BRAIN, PET
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/143024
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