Get access

123I-Ioflupane SPECT in the diagnosis of suspected psychogenic Parkinsonism

Authors

  • Carles Gaig MD,

    1. Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències, Hospital Clínic, University of Barcelona, Barcelona, Spain
    Search for more papers by this author
  • Maria José Martí MD, PhD,

    Corresponding author
    1. Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències, Hospital Clínic, University of Barcelona, Barcelona, Spain
    • Hospital Clínic, Service of Neurology. Villarroel 170, Barcelona 08036, Spain
    Search for more papers by this author
  • Eduardo Tolosa MD, PhD,

    1. Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències, Hospital Clínic, University of Barcelona, Barcelona, Spain
    Search for more papers by this author
  • Francesc Valldeoriola MD, PhD,

    1. Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències, Hospital Clínic, University of Barcelona, Barcelona, Spain
    Search for more papers by this author
  • Pilar Paredes MD,

    1. Nuclear Medicine Service, Hospital Clínic, University of Barcelona, Barcelona, Spain
    Search for more papers by this author
  • Francisco Juan Lomeña MD, PhD,

    1. Nuclear Medicine Service, Hospital Clínic, University of Barcelona, Barcelona, Spain
    Search for more papers by this author
  • Fernando Nakamae MD

    1. Movement Disorders Unit, Neurology Service, Institut Clínic de Neurociències, Hospital Clínic, University of Barcelona, Barcelona, Spain
    Search for more papers by this author

Abstract

Psychogenic Parkinsonism (PsyP) can be clinically difficult to differentiate from Parkinson's disease (PD). Striatal dopamine transporter (DAT) imaging could be helpful in differentiating them. We performed 123I-Ioflupane single-photon emission computed tomography (SPECT) in 9 patients with suspected PsyP. In 1 patient, 123I-Ioflupane SPECT disclosed bilateral decrease of striatal tracer uptake that indicated nigrostriatal degeneration. In this patient, a parkin gene mutation was detected. In the other 8 patients, 123I-Ioflupane SPECT was normal and supported the initial suspicion of PsyP. Normal DAT imaging supports the diagnosis of PsyP, whereas reduced striatal tracer uptake suggests an underlying neurodegenerative Parkinsonism and should encourage the search for additional causes for the syndrome. © 2006 Movement Disorder Society

Ancillary