Akinetic-rigid and tremor-dominant Parkinson's disease patients show different patterns of FP-CIT Single photon emission computed tomography

Authors

  • Carsten Eggers MD,

    1. Department of Neurology, University of Cologne, Cologne, Germany
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    • Carsten Eggers, Deniz Kahraman, Matthias Schmidt, and Lars Timmermann contributed equally to this work.

  • Deniz Kahraman MD,

    1. Department of Nuclear Medicine, University of Cologne, Cologne, Germany
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    • Carsten Eggers, Deniz Kahraman, Matthias Schmidt, and Lars Timmermann contributed equally to this work.

  • Gereon R. Fink MD,

    1. Department of Neurology, University of Cologne, Cologne, Germany
    2. Cognitive Neurology Section, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany
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  • Matthias Schmidt MD,

    1. Department of Nuclear Medicine, University of Cologne, Cologne, Germany
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    • Carsten Eggers, Deniz Kahraman, Matthias Schmidt, and Lars Timmermann contributed equally to this work.

  • Lars Timmermann MD

    Corresponding author
    1. Department of Neurology, University of Cologne, Cologne, Germany
    • Department of Neurology, University Hospital Cologne, Kerpener Str. 62, 50924 Cologne
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    • Carsten Eggers, Deniz Kahraman, Matthias Schmidt, and Lars Timmermann contributed equally to this work.


  • Relevant conflicts of interest/financial disclosures: Nothing to report. Full financial disclosures and author roles may be found in the online version of this article.

Abstract

Objective:

To elucidate whether Parkinson's disease subtypes show a different pattern of Iodine-123 fluoropropyl–;carbomethoxy-3 β-(FP-CIT) single photon emission computed tomography (SPECT) binding in accordance with neuropathological findings.

Methods:

We analyzed a database of consecutive patients with FP-CIT scan (n = 190) over a 3-year period and identified 122 patients (50 women, 72 men, mean age 62 ± 11.1 years) with a diagnosis of idiopathic Parkinson's disease. Patient's characteristics and FP-CIT scan results were analyzed and compared for the subgroups tremor-dominant versus akinetic-rigid and equivalent type of Parkinson's disease.

Results:

The analysis of all Parkinson's disease patients showed a significant difference between the FP-CIT uptake in the subgroups tremor-dominant and akinetic-rigid. After matching these samples for age, disease duration, disease severity (Hoehn & Yahr grade, Unified Parkinson's Disease Rating Scale score), and levodopa-equivalent dose, these findings were balanced between both groups (n = 23/23) without a significant difference (P > 0.05). However, there was a clear, significant association of visually analyzed shapes of the striatum in FP-CIT SPECT and clinical Parkinson's disease subtype.

Conclusion:

These results confirm neuropathological models for a reduced dopaminergic projection to the dorsal putamen in akinetic-rigid patients as well as the lateral putamen and caudate nucleus in tremor-dominant patients in vivo. © 2011 Movement Disorder Society

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