How useful is [123I]β-CIT SPECT in clinical practice?
Identifieur interne : 001786 ( Main/Corpus ); précédent : 001785; suivant : 001787How useful is [123I]β-CIT SPECT in clinical practice?
Auteurs : J. Eerola ; P J Tienari ; S. Kaakkola ; P. Nikkinen ; J. LaunesSource :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2005-09.
English descriptors
- KwdEn :
- CIT, carbomethoxy-3β-(4-iodophenyl)tropane, DAT, dopamine transporters, DLB, dementia with Lewy bodies, MSA, multiple system atrophy, PSP, progressive supranuclear palsy, Parkinson’s disease, ROC, receiver operating characteristic, ROI, region of interest, SPECT, SPECT, single photon emission computed tomography, dopamine transporter, β-CIT.
Abstract
Objective: To assess the accuracy and clinical usefulness of [123I]β-CIT (2β-carbomethoxy-3β-(4-iodophenyl)tropane) SPECT in the differential diagnosis of Parkinson’s disease. Subjects: 185 consecutive patients with symptoms of movement disorder were studied. The diagnoses were Parkinson’s disease (92), essential tremor (16), vascular parkinsonism (15), various Parkinson plus syndromes (P+) (12), dementia with Lewy bodies (DLB) (5), dystonia (5), drug induced movement disorder (12), and other diagnoses (8). A reference group (psychogenic parkinsonism) comprised 20 subjects with complaints suggesting extrapyramidal disease but with no unequivocal signs on clinical examination and no abnormalities on brain imaging. Results: β-CIT uptake was significantly lower in the whole striatum as well as separately in the putamen and in the caudate nucleus in Parkinson’s disease than in the reference group or in drug induced movement disorder, essential tremor, or dystonia. The uptake of β-CIT in the vascular parkinsonism group was heterogeneous and mean β-CIT uptake fell between the reference group and the Parkinson’s disease group. In the P+ and DLB groups the striatal uptake ratios overlapped those of the Parkinson’s disease group. Conclusions: [123I]β-CIT SPECT may not be as useful a tool in the clinical differential diagnosis of Parkinson’s disease as was previously believed, but it was 100% sensitive and specific for the diagnosis in younger patients (age <55 years). In older patients (age >55 years) specificity was substantially lower (68.5%). This differential specificity reflected the different distribution of differential diagnostic disorders (P+, DLB, vascular parkinsonism) in the older and younger age groups.
Url:
DOI: 10.1136/jnnp.2004.045237
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ISTEX:D5A4864F8C615DA696A0852513585210BA4D8462Le document en format XML
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Kaakkola</name><affiliation><mods:affiliation>Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland</mods:affiliation></affiliation></author><author><name sortKey="Nikkinen, P" sort="Nikkinen, P" uniqKey="Nikkinen P" first="P" last="Nikkinen">P. Nikkinen</name><affiliation><mods:affiliation>HUSLAB, Division of Clinical Physiology and Nuclear Medicine, Helsinki University Central Hospital</mods:affiliation></affiliation></author><author><name sortKey="Launes, J" sort="Launes, J" uniqKey="Launes J" first="J" last="Launes">J. 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Eerola</name><affiliation><mods:affiliation>Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland</mods:affiliation></affiliation></author><author><name sortKey="Tienari, P J" sort="Tienari, P J" uniqKey="Tienari P" first="P J" last="Tienari">P J Tienari</name><affiliation><mods:affiliation>Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland</mods:affiliation></affiliation></author><author><name sortKey="Kaakkola, S" sort="Kaakkola, S" uniqKey="Kaakkola S" first="S" last="Kaakkola">S. Kaakkola</name><affiliation><mods:affiliation>Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland</mods:affiliation></affiliation></author><author><name sortKey="Nikkinen, P" sort="Nikkinen, P" uniqKey="Nikkinen P" first="P" last="Nikkinen">P. Nikkinen</name><affiliation><mods:affiliation>HUSLAB, Division of Clinical Physiology and Nuclear Medicine, Helsinki University Central Hospital</mods:affiliation></affiliation></author><author><name sortKey="Launes, J" sort="Launes, J" uniqKey="Launes J" first="J" last="Launes">J. Launes</name><affiliation><mods:affiliation>Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2005-09">2005-09</date><biblScope unit="volume">76</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1211">1211</biblScope></imprint><idno type="ISSN">0022-3050</idno></series><idno type="istex">D5A4864F8C615DA696A0852513585210BA4D8462</idno><idno type="DOI">10.1136/jnnp.2004.045237</idno><idno type="href">jnnp-76-1211.pdf</idno><idno type="PMID">16107353</idno><idno type="local">0761211</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-3050</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>CIT, carbomethoxy-3β-(4-iodophenyl)tropane</term><term>DAT, dopamine transporters</term><term>DLB, dementia with Lewy bodies</term><term>MSA, multiple system atrophy</term><term>PSP, progressive supranuclear palsy</term><term>Parkinson’s disease</term><term>ROC, receiver operating characteristic</term><term>ROI, region of interest</term><term>SPECT</term><term>SPECT, single photon emission computed tomography</term><term>dopamine transporter</term><term>β-CIT</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective: To assess the accuracy and clinical usefulness of [123I]β-CIT (2β-carbomethoxy-3β-(4-iodophenyl)tropane) SPECT in the differential diagnosis of Parkinson’s disease. Subjects: 185 consecutive patients with symptoms of movement disorder were studied. The diagnoses were Parkinson’s disease (92), essential tremor (16), vascular parkinsonism (15), various Parkinson plus syndromes (P+) (12), dementia with Lewy bodies (DLB) (5), dystonia (5), drug induced movement disorder (12), and other diagnoses (8). A reference group (psychogenic parkinsonism) comprised 20 subjects with complaints suggesting extrapyramidal disease but with no unequivocal signs on clinical examination and no abnormalities on brain imaging. Results: β-CIT uptake was significantly lower in the whole striatum as well as separately in the putamen and in the caudate nucleus in Parkinson’s disease than in the reference group or in drug induced movement disorder, essential tremor, or dystonia. The uptake of β-CIT in the vascular parkinsonism group was heterogeneous and mean β-CIT uptake fell between the reference group and the Parkinson’s disease group. In the P+ and DLB groups the striatal uptake ratios overlapped those of the Parkinson’s disease group. Conclusions: [123I]β-CIT SPECT may not be as useful a tool in the clinical differential diagnosis of Parkinson’s disease as was previously believed, but it was 100% sensitive and specific for the diagnosis in younger patients (age <55 years). In older patients (age >55 years) specificity was substantially lower (68.5%). This differential specificity reflected the different distribution of differential diagnostic disorders (P+, DLB, vascular parkinsonism) in the older and younger age groups.</div></front></TEI><istex><corpusName>bmj</corpusName><author><json:item><name>J Eerola</name><affiliations><json:string>Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland</json:string></affiliations></json:item><json:item><name>P J Tienari</name><affiliations><json:string>Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland</json:string></affiliations></json:item><json:item><name>S Kaakkola</name><affiliations><json:string>Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland</json:string></affiliations></json:item><json:item><name>P Nikkinen</name><affiliations><json:string>HUSLAB, Division of Clinical Physiology and Nuclear Medicine, Helsinki University Central Hospital</json:string></affiliations></json:item><json:item><name>J Launes</name><affiliations><json:string>Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Papers</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Memory disorders (neurology)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Movement disorders (other than Parkinsons)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Neuroimaging</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Memory disorders (psychiatry)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>CIT, carbomethoxy-3β-(4-iodophenyl)tropane</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>DAT, dopamine transporters</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>DLB, dementia with Lewy bodies</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>MSA, multiple system atrophy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>PSP, progressive supranuclear palsy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>ROC, receiver operating characteristic</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>ROI, region of interest</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>SPECT, single photon emission computed tomography</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Parkinson’s disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>dopamine transporter</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>SPECT</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>β-CIT</value></json:item></subject><language><json:string>eng</json:string></language><abstract>Objective: To assess the accuracy and clinical usefulness of [123I]β-CIT (2β-carbomethoxy-3β-(4-iodophenyl)tropane) SPECT in the differential diagnosis of Parkinson’s disease. Subjects: 185 consecutive patients with symptoms of movement disorder were studied. The diagnoses were Parkinson’s disease (92), essential tremor (16), vascular parkinsonism (15), various Parkinson plus syndromes (P+) (12), dementia with Lewy bodies (DLB) (5), dystonia (5), drug induced movement disorder (12), and other diagnoses (8). A reference group (psychogenic parkinsonism) comprised 20 subjects with complaints suggesting extrapyramidal disease but with no unequivocal signs on clinical examination and no abnormalities on brain imaging. Results: β-CIT uptake was significantly lower in the whole striatum as well as separately in the putamen and in the caudate nucleus in Parkinson’s disease than in the reference group or in drug induced movement disorder, essential tremor, or dystonia. The uptake of β-CIT in the vascular parkinsonism group was heterogeneous and mean β-CIT uptake fell between the reference group and the Parkinson’s disease group. In the P+ and DLB groups the striatal uptake ratios overlapped those of the Parkinson’s disease group. Conclusions: [123I]β-CIT SPECT may not be as useful a tool in the clinical differential diagnosis of Parkinson’s disease as was previously believed, but it was 100% sensitive and specific for the diagnosis in younger patients (age >55 years). In older patients (age >55 years) specificity was substantially lower (68.5%). This differential specificity reflected the different distribution of differential diagnostic disorders (P+, DLB, vascular parkinsonism) in the older and younger age groups.</abstract><qualityIndicators><score>7.917</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 792 pts (letter)</pdfPageSize><refBibsNative>false</refBibsNative><keywordCount>18</keywordCount><abstractCharCount>1736</abstractCharCount><pdfWordCount>4977</pdfWordCount><pdfCharCount>33379</pdfCharCount><pdfPageCount>6</pdfPageCount><abstractWordCount>245</abstractWordCount></qualityIndicators><title>How useful is [123I]β-CIT SPECT in clinical practice?</title><pmid><json:string>16107353</json:string></pmid><genre><json:string>research-article</json:string></genre><host><volume>76</volume><pages><first>1211</first></pages><issn><json:string>0022-3050</json:string></issn><issue>9</issue><genre></genre><language><json:string>unknown</json:string></language><eissn><json:string>1468-330X</json:string></eissn><title>Journal of Neurology, Neurosurgery & Psychiatry</title></host><publicationDate>2005</publicationDate><copyrightDate>2005</copyrightDate><doi><json:string>10.1136/jnnp.2004.045237</json:string></doi><id>D5A4864F8C615DA696A0852513585210BA4D8462</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/D5A4864F8C615DA696A0852513585210BA4D8462/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/D5A4864F8C615DA696A0852513585210BA4D8462/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/D5A4864F8C615DA696A0852513585210BA4D8462/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">How useful is [123I]β-CIT SPECT in clinical practice?</title><respStmt xml:id="ISTEX-API" resp="Références bibliographiques récupérées via GROBID" name="ISTEX-API (INIST-CNRS)"></respStmt></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>BMJ Publishing Group Ltd</publisher><availability><p>BMJ</p></availability><date>2005-08-16</date></publicationStmt><notesStmt><note>Correspondence to:
Dr Johanna Eerola
Department of Neurology, HUCH, PO Box 340, FIN-00029 HUS, Helsinki, Finland; johanna.eerola@hus.fi</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">How useful is [123I]β-CIT SPECT in clinical practice?</title><author><persName><forename type="first">J</forename><surname>Eerola</surname></persName><affiliation>Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland</affiliation></author><author><persName><forename type="first">P J</forename><surname>Tienari</surname></persName><affiliation>Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland</affiliation></author><author><persName><forename type="first">S</forename><surname>Kaakkola</surname></persName><affiliation>Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland</affiliation></author><author><persName><forename type="first">P</forename><surname>Nikkinen</surname></persName><affiliation>HUSLAB, Division of Clinical Physiology and Nuclear Medicine, Helsinki University Central Hospital</affiliation></author><author><persName><forename type="first">J</forename><surname>Launes</surname></persName><affiliation>Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland</affiliation></author></analytic><monogr><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="pISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2005-09"></date><biblScope unit="volume">76</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1211">1211</biblScope></imprint></monogr><idno type="istex">D5A4864F8C615DA696A0852513585210BA4D8462</idno><idno type="DOI">10.1136/jnnp.2004.045237</idno><idno type="href">jnnp-76-1211.pdf</idno><idno type="PMID">16107353</idno><idno type="local">0761211</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2005-08-16</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Objective: To assess the accuracy and clinical usefulness of [123I]β-CIT (2β-carbomethoxy-3β-(4-iodophenyl)tropane) SPECT in the differential diagnosis of Parkinson’s disease. Subjects: 185 consecutive patients with symptoms of movement disorder were studied. The diagnoses were Parkinson’s disease (92), essential tremor (16), vascular parkinsonism (15), various Parkinson plus syndromes (P+) (12), dementia with Lewy bodies (DLB) (5), dystonia (5), drug induced movement disorder (12), and other diagnoses (8). A reference group (psychogenic parkinsonism) comprised 20 subjects with complaints suggesting extrapyramidal disease but with no unequivocal signs on clinical examination and no abnormalities on brain imaging. Results: β-CIT uptake was significantly lower in the whole striatum as well as separately in the putamen and in the caudate nucleus in Parkinson’s disease than in the reference group or in drug induced movement disorder, essential tremor, or dystonia. The uptake of β-CIT in the vascular parkinsonism group was heterogeneous and mean β-CIT uptake fell between the reference group and the Parkinson’s disease group. In the P+ and DLB groups the striatal uptake ratios overlapped those of the Parkinson’s disease group. Conclusions: [123I]β-CIT SPECT may not be as useful a tool in the clinical differential diagnosis of Parkinson’s disease as was previously believed, but it was 100% sensitive and specific for the diagnosis in younger patients (age <55 years). In older patients (age >55 years) specificity was substantially lower (68.5%). This differential specificity reflected the different distribution of differential diagnostic disorders (P+, DLB, vascular parkinsonism) in the older and younger age groups.</p></abstract><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Memory disorders (neurology)</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Movement disorders (other than Parkinsons)</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Neuroimaging</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Parkinson's disease</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Memory disorders (psychiatry)</term></item></list></keywords></textClass><textClass xml:lang="en"><keywords scheme="keyword"><list><head>ABR</head><item><term>CIT, carbomethoxy-3β-(4-iodophenyl)tropane</term></item><item><term>DAT, dopamine transporters</term></item><item><term>DLB, dementia with Lewy bodies</term></item><item><term>MSA, multiple system atrophy</term></item><item><term>PSP, progressive supranuclear palsy</term></item><item><term>ROC, receiver operating characteristic</term></item><item><term>ROI, region of interest</term></item><item><term>SPECT, single photon emission computed tomography</term></item></list></keywords></textClass><textClass xml:lang="en"><keywords scheme="keyword"><list><head>KWD</head><item><term>Parkinson’s disease</term></item><item><term>dopamine transporter</term></item><item><term>SPECT</term></item><item><term>β-CIT</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2005-08-16">Created</change><change when="2005-09">Published</change><change xml:id="refBibs-istex" who="#ISTEX-API" when="2016-3-14">References added</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/D5A4864F8C615DA696A0852513585210BA4D8462/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article xml:lang="en" article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">jnnp</journal-id><journal-id journal-id-type="nlm-ta">J Neurol Neurosurg Psychiatry</journal-id><journal-title>Journal of Neurology, Neurosurgery & Psychiatry</journal-title><abbrev-journal-title abbrev-type="publisher">J Neurol Neurosurg Psychiatry</abbrev-journal-title><issn pub-type="ppub">0022-3050</issn><issn pub-type="epub">1468-330X</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="other">0761211</article-id><article-id pub-id-type="doi">10.1136/jnnp.2004.045237</article-id><article-id pub-id-type="other">jnnp;76/9/1211</article-id><article-id pub-id-type="pmid">16107353</article-id><article-id pub-id-type="other">1211</article-id><article-id pub-id-type="other">jnnp.2004.045237</article-id><article-categories><subj-group subj-group-type="heading"><subject content-type="original">Papers</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Memory disorders (neurology)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Movement disorders (other than Parkinsons)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Neuroimaging</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Parkinson's disease</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Memory disorders (psychiatry)</subject></subj-group></article-categories><title-group><article-title>How useful is [<sup>123</sup>I]β-CIT SPECT in clinical practice?</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Eerola</surname><given-names>J</given-names></name><xref rid="AFF1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Tienari</surname><given-names>P J</given-names></name><xref rid="AFF1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Kaakkola</surname><given-names>S</given-names></name><xref rid="AFF1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Nikkinen</surname><given-names>P</given-names></name><xref rid="AFF2">2</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Launes</surname><given-names>J</given-names></name><xref rid="AFF1">1</xref></contrib><aff id="AFF1"><label>1</label>Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland</aff><aff id="AFF2"><label>2</label>HUSLAB, Division of Clinical Physiology and Nuclear Medicine, Helsinki University Central Hospital</aff></contrib-group><author-notes><corresp>Correspondence to:
Dr Johanna Eerola
Department of Neurology, HUCH, PO Box 340, FIN-00029 HUS, Helsinki, Finland; <ext-link xlink:href="johanna.eerolahus.fi" ext-link-type="email" xlink:type="simple">johanna.eerola@hus.fi</ext-link></corresp></author-notes><pub-date pub-type="ppub"><month>9</month><year>2005</year></pub-date><pub-date pub-type="epub"><day>16</day><month>8</month><year>2005</year></pub-date><volume>76</volume><volume-id pub-id-type="other">76</volume-id><volume-id pub-id-type="other">76</volume-id><issue>9</issue><issue-id pub-id-type="other">jnnp;76/9</issue-id><issue-id pub-id-type="other">9</issue-id><issue-id pub-id-type="other">76/9</issue-id><fpage>1211</fpage><history><date date-type="accepted"><day>18</day><month>12</month><year>2004</year></date><date date-type="received"><day>10</day><month>05</month><year>2004</year></date><date date-type="rev-recd"><day>16</day><month>12</month><year>2004</year></date></history><permissions><copyright-statement>Copyright 2005 Journal of Neurology Neurosurgery and Psychiatry</copyright-statement><copyright-year>2005</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="jnnp-76-1211.pdf"></self-uri><abstract xml:lang="en"><p><bold>Objective:</bold> To assess the accuracy and clinical usefulness of [<sup>123</sup>I]β-CIT (2β-carbomethoxy-3β-(4-iodophenyl)tropane) SPECT in the differential diagnosis of Parkinson’s disease.</p><p><bold>Subjects:</bold> 185 consecutive patients with symptoms of movement disorder were studied. The diagnoses were Parkinson’s disease (92), essential tremor (16), vascular parkinsonism (15), various Parkinson plus syndromes (P+) (12), dementia with Lewy bodies (DLB) (5), dystonia (5), drug induced movement disorder (12), and other diagnoses (8). A reference group (psychogenic parkinsonism) comprised 20 subjects with complaints suggesting extrapyramidal disease but with no unequivocal signs on clinical examination and no abnormalities on brain imaging.</p><p><bold>Results:</bold> β-CIT uptake was significantly lower in the whole striatum as well as separately in the putamen and in the caudate nucleus in Parkinson’s disease than in the reference group or in drug induced movement disorder, essential tremor, or dystonia. The uptake of β-CIT in the vascular parkinsonism group was heterogeneous and mean β-CIT uptake fell between the reference group and the Parkinson’s disease group. In the P+ and DLB groups the striatal uptake ratios overlapped those of the Parkinson’s disease group.</p><p><bold>Conclusions:</bold> [<sup>123</sup>I]β-CIT SPECT may not be as useful a tool in the clinical differential diagnosis of Parkinson’s disease as was previously believed, but it was 100% sensitive and specific for the diagnosis in younger patients (age <55 years). In older patients (age >55 years) specificity was substantially lower (68.5%). This differential specificity reflected the different distribution of differential diagnostic disorders (P+, DLB, vascular parkinsonism) in the older and younger age groups.</p></abstract><kwd-group kwd-group-type="ABR" xml:lang="en"><kwd>CIT, carbomethoxy-3β-(4-iodophenyl)tropane</kwd><kwd>DAT, dopamine transporters</kwd><kwd>DLB, dementia with Lewy bodies</kwd><kwd>MSA, multiple system atrophy</kwd><kwd>PSP, progressive supranuclear palsy</kwd><kwd>ROC, receiver operating characteristic</kwd><kwd>ROI, region of interest</kwd><kwd>SPECT, single photon emission computed tomography</kwd></kwd-group><kwd-group kwd-group-type="KWD" xml:lang="en"><kwd>Parkinson’s disease</kwd><kwd>dopamine transporter</kwd><kwd>SPECT</kwd><kwd>β-CIT</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>How useful is [123I]β-CIT SPECT in clinical practice?</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>How useful is [123I]β-CIT SPECT in clinical practice?</title></titleInfo><name type="personal"><namePart type="given">J</namePart><namePart type="family">Eerola</namePart><affiliation>Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">P J</namePart><namePart type="family">Tienari</namePart><affiliation>Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S</namePart><namePart type="family">Kaakkola</namePart><affiliation>Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">P</namePart><namePart type="family">Nikkinen</namePart><affiliation>HUSLAB, Division of Clinical Physiology and Nuclear Medicine, Helsinki University Central Hospital</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J</namePart><namePart type="family">Launes</namePart><affiliation>Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><subject><genre>hwp-journal-coll</genre><topic>Memory disorders (neurology)</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Movement disorders (other than Parkinsons)</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Neuroimaging</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Parkinson's disease</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Memory disorders (psychiatry)</topic></subject><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2005-09</dateIssued><dateCreated encoding="w3cdtf">2005-08-16</dateCreated><copyrightDate encoding="w3cdtf">2005</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Objective: To assess the accuracy and clinical usefulness of [123I]β-CIT (2β-carbomethoxy-3β-(4-iodophenyl)tropane) SPECT in the differential diagnosis of Parkinson’s disease. Subjects: 185 consecutive patients with symptoms of movement disorder were studied. The diagnoses were Parkinson’s disease (92), essential tremor (16), vascular parkinsonism (15), various Parkinson plus syndromes (P+) (12), dementia with Lewy bodies (DLB) (5), dystonia (5), drug induced movement disorder (12), and other diagnoses (8). A reference group (psychogenic parkinsonism) comprised 20 subjects with complaints suggesting extrapyramidal disease but with no unequivocal signs on clinical examination and no abnormalities on brain imaging. Results: β-CIT uptake was significantly lower in the whole striatum as well as separately in the putamen and in the caudate nucleus in Parkinson’s disease than in the reference group or in drug induced movement disorder, essential tremor, or dystonia. The uptake of β-CIT in the vascular parkinsonism group was heterogeneous and mean β-CIT uptake fell between the reference group and the Parkinson’s disease group. In the P+ and DLB groups the striatal uptake ratios overlapped those of the Parkinson’s disease group. Conclusions: [123I]β-CIT SPECT may not be as useful a tool in the clinical differential diagnosis of Parkinson’s disease as was previously believed, but it was 100% sensitive and specific for the diagnosis in younger patients (age <55 years). In older patients (age >55 years) specificity was substantially lower (68.5%). This differential specificity reflected the different distribution of differential diagnostic disorders (P+, DLB, vascular parkinsonism) in the older and younger age groups.</abstract><note type="author-notes">Correspondence to:
Dr Johanna Eerola
Department of Neurology, HUCH, PO Box 340, FIN-00029 HUS, Helsinki, Finland; johanna.eerola@hus.fi</note><subject lang="en"><genre>ABR</genre><topic>CIT, carbomethoxy-3β-(4-iodophenyl)tropane</topic><topic>DAT, dopamine transporters</topic><topic>DLB, dementia with Lewy bodies</topic><topic>MSA, multiple system atrophy</topic><topic>PSP, progressive supranuclear palsy</topic><topic>ROC, receiver operating characteristic</topic><topic>ROI, region of interest</topic><topic>SPECT, single photon emission computed tomography</topic></subject><subject lang="en"><genre>KWD</genre><topic>Parkinson’s disease</topic><topic>dopamine transporter</topic><topic>SPECT</topic><topic>β-CIT</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Neurology, Neurosurgery & Psychiatry</title></titleInfo><titleInfo type="abbreviated"><title>J Neurol Neurosurg Psychiatry</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0022-3050</identifier><identifier type="eISSN">1468-330X</identifier><identifier type="PublisherID-hwp">jnnp</identifier><identifier type="PublisherID-nlm-ta">J Neurol Neurosurg Psychiatry</identifier><part><date>2005</date><detail type="volume"><caption>vol.</caption><number>76</number></detail><detail type="issue"><caption>no.</caption><number>9</number></detail><extent unit="pages"><start>1211</start></extent></part></relatedItem><identifier type="istex">D5A4864F8C615DA696A0852513585210BA4D8462</identifier><identifier type="DOI">10.1136/jnnp.2004.045237</identifier><identifier type="href">jnnp-76-1211.pdf</identifier><identifier type="PMID">16107353</identifier><identifier type="local">0761211</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright 2005 Journal of Neurology Neurosurgery and Psychiatry</accessCondition><recordInfo><recordContentSource>BMJ</recordContentSource></recordInfo></mods></metadata><annexes><json:item><original>true</original><mimetype>image/jpeg</mimetype><extension>jpeg</extension><uri>https://api.istex.fr/document/D5A4864F8C615DA696A0852513585210BA4D8462/annexes/jpeg</uri></json:item></annexes><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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