An imaging study of parkinsonism among African‐Caribbean and Indian London communities
Identifieur interne : 004576 ( Main/Exploration ); précédent : 004575; suivant : 004577An imaging study of parkinsonism among African‐Caribbean and Indian London communities
Auteurs : Michele T. M. Hu [Royaume-Uni] ; K. Ray Chaudhuri [Royaume-Uni] ; Jozef Jarosz [Royaume-Uni] ; Lidia Yaguez [Royaume-Uni] ; David J. Brooks [Royaume-Uni]Source :
- Movement Disorders [ 0885-3185 ] ; 2002-11.
Descripteurs français
- Pascal (Inist)
- Wicri :
English descriptors
- KwdEn :
- Adult, African, African Continental Ancestry Group, African‐Caribbean, Aged, Brain (radionuclide imaging), Caribbean Basin, Cerebral Cortex (radionuclide imaging), Corpus Striatum (radionuclide imaging), Cross-Cultural Comparison, Diagnosis, Differential, Emission, Energy Metabolism (physiology), European Continental Ancestry Group, Exploration, Female, Fluorodeoxyglucose F18 (diagnostic use), Human, Humans, India (ethnology), Indian, Lewy Body Disease (radionuclide imaging), London, Magnetic Resonance Imaging, Male, Middle Aged, Multiple System Atrophy (radionuclide imaging), Neuropsychological Tests, Neuropsychological test, Nuclear magnetic resonance imaging, Parkinson disease, Parkinsonian Disorders (radiography), Positron, Psychometrics, Supranuclear Palsy, Progressive (radionuclide imaging), Tomography, West Indies (ethnology), parkinsonism.
- MESH :
- chemical , diagnostic use : Fluorodeoxyglucose F18.
- geographic , ethnology : India, West Indies.
- physiology : Energy Metabolism.
- radiography : Parkinsonian Disorders.
- radionuclide imaging : Brain, Cerebral Cortex, Corpus Striatum, Lewy Body Disease, Multiple System Atrophy, Supranuclear Palsy, Progressive.
- Adult, African Continental Ancestry Group, Aged, Cross-Cultural Comparison, Diagnosis, Differential, European Continental Ancestry Group, Female, Humans, London, Magnetic Resonance Imaging, Male, Middle Aged, Neuropsychological Tests.
Abstract
We previously reported on 131 parkinsonian patients of African‐Caribbean and Indian origin attending movement disorders clinics in six London Hospitals, of whom approximately 20% manifested atypical parkinsonism with a late‐onset, akinetic‐rigid predominant syndrome, postural instability and minimal resting tremor refractory to levodopa therapy and dopamine agonists (see Hu et al., Neurology 2000;54[Suppl.3]: A188 and Hu et al., Mov Disord 2000;15[Suppl.3]:S212). To better elucidate the phenotype of these atypical patients 18FDG/18F‐dopa positron emission tomography (PET) were performed in a subgroup to look for cortical and striatal metabolic changes suggestive of multiple system atrophy (MSA), progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), or dementia with Lewy bodies. Magnetic resonance imaging (MRI) rating of cerebral vascular lesion load, putaminal atrophy, and neuropsychological testing were also performed. Discriminant function analysis of 18F‐dopa/18FDG striatal metabolism in 43 patients failed to separate atypical ethnic minority from typical Caucasian Parkinson's disease (PD) patients. Additionally, atypical Indian and African‐Caribbean patients did not show cortical reductions in glucose metabolism suggestive of PSP, CBD, or DLB. Cerebral vascular lesion load rated in these patients did not differ between atypical and typical PD groups, and none of the atypical patients had MRI changes suggestive of MSA or PSP. Our results suggest the atypical parkinsonian phenotype seen in African‐Caribbean and Indian patients represents a levodopa‐refractory form of PD separate from MSA or PSP in most patients. © 2002 Movement Disorder Society
Url:
DOI: 10.1002/mds.10261
Affiliations:
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<term>Aged</term>
<term>Brain (radionuclide imaging)</term>
<term>Caribbean Basin</term>
<term>Cerebral Cortex (radionuclide imaging)</term>
<term>Corpus Striatum (radionuclide imaging)</term>
<term>Cross-Cultural Comparison</term>
<term>Diagnosis, Differential</term>
<term>Emission</term>
<term>Energy Metabolism (physiology)</term>
<term>European Continental Ancestry Group</term>
<term>Exploration</term>
<term>Female</term>
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<term>Middle Aged</term>
<term>Multiple System Atrophy (radionuclide imaging)</term>
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<term>Neuropsychological test</term>
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<term>Parkinsonian Disorders (radiography)</term>
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<term>Psychometrics</term>
<term>Supranuclear Palsy, Progressive (radionuclide imaging)</term>
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<term>parkinsonism</term>
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<front><div type="abstract" xml:lang="fr">We previously reported on 131 parkinsonian patients of African‐Caribbean and Indian origin attending movement disorders clinics in six London Hospitals, of whom approximately 20% manifested atypical parkinsonism with a late‐onset, akinetic‐rigid predominant syndrome, postural instability and minimal resting tremor refractory to levodopa therapy and dopamine agonists (see Hu et al., Neurology 2000;54[Suppl.3]: A188 and Hu et al., Mov Disord 2000;15[Suppl.3]:S212). To better elucidate the phenotype of these atypical patients 18FDG/18F‐dopa positron emission tomography (PET) were performed in a subgroup to look for cortical and striatal metabolic changes suggestive of multiple system atrophy (MSA), progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), or dementia with Lewy bodies. Magnetic resonance imaging (MRI) rating of cerebral vascular lesion load, putaminal atrophy, and neuropsychological testing were also performed. Discriminant function analysis of 18F‐dopa/18FDG striatal metabolism in 43 patients failed to separate atypical ethnic minority from typical Caucasian Parkinson's disease (PD) patients. Additionally, atypical Indian and African‐Caribbean patients did not show cortical reductions in glucose metabolism suggestive of PSP, CBD, or DLB. Cerebral vascular lesion load rated in these patients did not differ between atypical and typical PD groups, and none of the atypical patients had MRI changes suggestive of MSA or PSP. Our results suggest the atypical parkinsonian phenotype seen in African‐Caribbean and Indian patients represents a levodopa‐refractory form of PD separate from MSA or PSP in most patients. © 2002 Movement Disorder Society</div>
</front>
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