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

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