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[ 123 I]β‐CIT SPECT distinguishes vascular parkinsonism from Parkinson's disease
Author(s) -
Gerschlager Willibald,
Bencsits Gerhard,
Pirker Walter,
Bloem Bastiaan R.,
Asenbaum Susanne,
Prayer Daniella,
Zijlmans Jan C.M.,
Hoffmann Martha,
Brücke Thomas
Publication year - 2002
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.10092
Subject(s) - putamen , parkinsonism , caudate nucleus , parkinson's disease , dopaminergic , medicine , central nervous system disease , spect imaging , gastroenterology , nuclear medicine , single photon emission computed tomography , disease , pathology , dopamine
We investigated whether [ 123 I]‐β‐CIT and single‐photon emission computed tomography (SPECT) imaging distinguishes patients with clinically suspected vascular parkinsonism (VP) from patients with idiopathic Parkinson's disease (PD). [ 123 I]β‐CIT SPECT is a sensitive marker of dopaminergic degeneration, and the degree of striatal binding reduction in PD correlates with disease severity. Thirteen patients who fulfilled rigid clinical criteria for VP (mean ± S.D.: age, 76.5 ± 5.3 years; disease duration, 3.6 ± 2.8 years), 20 PD patients (age, 66.2 ± 9.5 years; disease duration, 4.3 ± 2.7 years), and 30 healthy persons (age, 44.6 ± 19.2 years) underwent [ 123 I]β‐CIT SPECT imaging. Age‐corrected striatal β‐CIT binding was reduced on average by 40.8% in PD but was near normal in the VP group (mean reduction, 1.2%). This difference was statistically significant ( Z = 4.68; P < 0.001). The left–right asymmetry of striatal β‐CIT binding was significantly increased in the PD group compared with normal controls and the VP group (F(2) = 17.4, P <0.001). Moreover, putamen–caudate nucleus ratios were significantly reduced in PD compared with both VP patients and healthy controls (F(2) = 65.5, P < 0.001). Whole striatal β‐CIT binding was more than one standard deviation above the mean PD values in all but one of the individual VP patients. Our findings suggest that the presynaptic dopaminergic deficits seen in PD are absent in most patients with VP. [ 123 I]β‐CIT SPECT imaging may be useful to help distinguish between PD and VP patients during life. © 2002 Movement Disorder Society