Combined use of DAT‐SPECT and cardiac MIBG scintigraphy in mixed tremors
Identifieur interne : 000B31 ( Main/Exploration ); précédent : 000B30; suivant : 000B32Combined use of DAT‐SPECT and cardiac MIBG scintigraphy in mixed tremors
Auteurs : Fabiana Novellino [Italie] ; Gennarina Arabia [Italie] ; Antonio Bagnato [Italie] ; Giuseppe Lucio Cascini [Italie] ; Maria Salsone [Italie] ; Giuseppe Nicoletti [Italie] ; Demetrio Messina [Italie] ; Maurizio Morelli [Italie] ; Sandra Paglionico [Italie] ; Laura Giofrè [Italie] ; Antonino Restuccia [Italie] ; Giusi Torchia [Italie] ; Francesca Condino [Italie] ; Aldo Quattrone [Italie]Source :
- Movement Disorders [ 0885-3185 ] ; 2009-11-15.
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Abstract
The cooccurrence of rest and postural tremor (mixed tremor) as the predominant clinical manifestation in patients who do not fulfill diagnostic established criteria for essential tremor (ET) or Parkinson's disease (PD) poses a clinical diagnostic challenge. Twenty‐two patients with mixed tremor and additional mild extrapyramidal features, such as bradykinesia and rigidity, 20 patients with probable PD, 10 patients with probable ET, and 18 controls were investigated through the combined use of dopamine transporter 123I‐FP‐CIT‐single‐photon emission tomography (DAT‐SPECT) and cardiac 123metaiodobenzylguanidine (MIGB) scintigraphy. Six of the 22 mixed‐tremor patients had normal DAT‐SPECT, a condition usually found in patients with ET, whereas 16 patients showed damage to the nigrostriatal system. Cardiac MIBG allowed further differentiation between these 16 patients because eight of them had decreased tracer uptakes (heart/mediastinum [H/M] ratio in delayed image, H/M ratio delayed: 1.16 ± 0.11, P < 0.001 vs controls), indicating a PD, whereas the remaining eight had normal cardiac tracer uptakes, a finding suggestive of a parkinsonian syndrome (H/M ratio delayed: 1.90 ± 0.13). Both DAT‐SPECT and cardiac MIBG scintigraphies were abnormal in the 20 patients with probable PD, whereas these were normal in both the patients with probable ET as well as in the controls. Our study suggests that the combined use of both DAT‐SPECT and MIBG scintigraphy in mixed tremors with additional extrapyramidal features can help distinguish patients with ET from those with PD and parkinsonism. © 2009 Movement Disorder Society
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DOI: 10.1002/mds.22771
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Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2009-11-15">2009-11-15</date><biblScope unit="volume">24</biblScope><biblScope unit="issue">15</biblScope><biblScope unit="page" from="2242">2242</biblScope><biblScope unit="page" to="2248">2248</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">4F1CC614A0D1D1C6BF485611DC95B604255320EA</idno><idno type="DOI">10.1002/mds.22771</idno><idno type="ArticleID">MDS22771</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>DAT‐SPECT</term><term>MIBG scintigraphy</term><term>mixed tremors</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="fr">The cooccurrence of rest and postural tremor (mixed tremor) as the predominant clinical manifestation in patients who do not fulfill diagnostic established criteria for essential tremor (ET) or Parkinson's disease (PD) poses a clinical diagnostic challenge. Twenty‐two patients with mixed tremor and additional mild extrapyramidal features, such as bradykinesia and rigidity, 20 patients with probable PD, 10 patients with probable ET, and 18 controls were investigated through the combined use of dopamine transporter 123I‐FP‐CIT‐single‐photon emission tomography (DAT‐SPECT) and cardiac 123metaiodobenzylguanidine (MIGB) scintigraphy. Six of the 22 mixed‐tremor patients had normal DAT‐SPECT, a condition usually found in patients with ET, whereas 16 patients showed damage to the nigrostriatal system. Cardiac MIBG allowed further differentiation between these 16 patients because eight of them had decreased tracer uptakes (heart/mediastinum [H/M] ratio in delayed image, H/M ratio delayed: 1.16 ± 0.11, P < 0.001 vs controls), indicating a PD, whereas the remaining eight had normal cardiac tracer uptakes, a finding suggestive of a parkinsonian syndrome (H/M ratio delayed: 1.90 ± 0.13). Both DAT‐SPECT and cardiac MIBG scintigraphies were abnormal in the 20 patients with probable PD, whereas these were normal in both the patients with probable ET as well as in the controls. Our study suggests that the combined use of both DAT‐SPECT and MIBG scintigraphy in mixed tremors with additional extrapyramidal features can help distinguish patients with ET from those with PD and parkinsonism. © 2009 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Italie</li></country></list><tree><country name="Italie"><noRegion><name sortKey="Novellino, Fabiana" sort="Novellino, Fabiana" uniqKey="Novellino F" first="Fabiana" last="Novellino">Fabiana Novellino</name></noRegion><name sortKey="Arabia, Gennarina" sort="Arabia, Gennarina" uniqKey="Arabia G" first="Gennarina" last="Arabia">Gennarina Arabia</name><name sortKey="Bagnato, Antonio" sort="Bagnato, Antonio" uniqKey="Bagnato A" first="Antonio" last="Bagnato">Antonio Bagnato</name><name sortKey="Cascini, Giuseppe Lucio" sort="Cascini, Giuseppe Lucio" uniqKey="Cascini G" first="Giuseppe Lucio" last="Cascini">Giuseppe Lucio Cascini</name><name sortKey="Condino, Francesca" sort="Condino, Francesca" uniqKey="Condino F" first="Francesca" last="Condino">Francesca Condino</name><name sortKey="Giofre, Laura" sort="Giofre, Laura" uniqKey="Giofre L" first="Laura" last="Giofrè">Laura Giofrè</name><name sortKey="Messina, Demetrio" sort="Messina, Demetrio" uniqKey="Messina D" first="Demetrio" last="Messina">Demetrio Messina</name><name sortKey="Morelli, Maurizio" sort="Morelli, Maurizio" uniqKey="Morelli M" first="Maurizio" last="Morelli">Maurizio Morelli</name><name sortKey="Nicoletti, Giuseppe" sort="Nicoletti, Giuseppe" uniqKey="Nicoletti G" first="Giuseppe" last="Nicoletti">Giuseppe Nicoletti</name><name sortKey="Paglionico, Sandra" sort="Paglionico, Sandra" uniqKey="Paglionico S" first="Sandra" last="Paglionico">Sandra Paglionico</name><name sortKey="Quattrone, Aldo" sort="Quattrone, Aldo" uniqKey="Quattrone A" first="Aldo" last="Quattrone">Aldo Quattrone</name><name sortKey="Quattrone, Aldo" sort="Quattrone, Aldo" uniqKey="Quattrone A" first="Aldo" last="Quattrone">Aldo Quattrone</name><name sortKey="Restuccia, Antonino" sort="Restuccia, Antonino" uniqKey="Restuccia A" first="Antonino" last="Restuccia">Antonino Restuccia</name><name sortKey="Salsone, Maria" sort="Salsone, Maria" uniqKey="Salsone M" first="Maria" last="Salsone">Maria Salsone</name><name sortKey="Torchia, Giusi" sort="Torchia, Giusi" uniqKey="Torchia G" first="Giusi" last="Torchia">Giusi Torchia</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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