期刊
NUCLEAR MEDICINE COMMUNICATIONS
卷 27, 期 12, 页码 933-937出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/01.mnm.0000243374.11260.5b
关键词
Parkinson's disease; essential tremor; drug-induced parkinsonism; vascular parkinsonism; parkinsonism; diagnosis; dopamine transporter; I-123-FP-CIT SPECT; levodopa
Background and aims Functional pre-synaptic dopamine brain imaging is generally abnormal when parkinsonism is degenerative (such as in idiopathic Parkinson's disease) and normal in patients with non-degenerative movement disorder (such as essential tremor). However, some patients diagnosed as early Parkinson's disease have normal presynaptic dopamine imaging. Follow-up of patients with normal imaging should help determine whether such patients truly have degenerative parkinsonism (and therefore represent false negative imaging results), or emerge as cases of non-degenerative parkinsonism (and therefore represent initial clinical over-diagnosis of Parkinson's disease). Methods and results One hundred and fifty cases with normal I-123-FP-CIT SPECT undertaken during routine care over a 3-year period were reviewed 2.4 years (interquartile range, 2.2-3.1 years) after SPECT. Diagnosis after follow-up was non-degenerative parkinsonism or tremor in 146 (97%), who did not progress clinically, and degenerative parkinsonism in four (3%), in whom clinicial progression was noted. Anti-Parkinson therapy was used in 36, and withdrawn in 27 with no deterioration in 25. Patients strictly fulfilling Brain Bank criteria (part 1) were more likely to undergo a trial of anti-Parkinson therapy (P<0.05) but were no more likely to maintain or respond to anti-Parkinson therapy than those not fulfilling criteria. Conclusion The clinical profile and therapy response during follow-up of patients with normal presynaptic dopamine imaging supports the diagnosis of a non-degenerative movement disorder in nearly all cases.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据