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Striatal patterns of DAT density in patients with essential tremor (ET): A prospective I-123 FP-CIT SPECT study

¹ Nuclear Medicine, Fondazione IRCCS-OMP-MA-RE, Milan, Italy; ² Parkinson Center, Az. Osp. Istituti Clinici di Perfezionamento, Milan, Italy

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Objectives: Although ET and Parkinson's Disease (PD) have distinct clinical features, occasionally ET may precede PD onset. Furthermore, recent autoptic studies demonstrated Lewy body pathology in some ET patients and neuroimaging suggests the possibility of dopaminergic deficit. We prospectively studied SDAT density with I-123 FP-CIT SPECT in 15 patients fulfilling ET diagnosis at baseline.

Methods: Ten males and 5 females with ET, age 70±7ys, disease duration 12±17ys were clinically followed and performed two SPECT studies (baseline and after 4±1ys). Quantitative SDAT density assessments (SSU) were obtained using a template of striatal and occipital ROIs in both SPECT series. We considered relevant SSU reduction in striata if >10% vs baseline.

Results: No significant differences were found in SSU baseline values(putamen 1.98±0.45; caudate 2.17±0.33) versus follow-up(putamen 1.88±0.38; caudate 2.03±0.36). One patient developed mild rigidity and bradikinesia, showing bilateral putaminal uptake loss (ipsilat. 37.5%, contralat. 36.4% vs SSU baseline values) and started dopaminergic therapy with benefit. 3 patients had bilateral SSU mild impairment in caudate(ipsilat. 15.6%± 10.6; contralat. 17.8%±7.8) and no dopaminergic treatment was attempted. Age, age at ET onset, disease duration and tremor severity did not relate with percentage loss of striatal FP-CIT uptake as assessed by SPECT.

Conclusions: One ET patient developed putaminal DAT impairment suggestive of early PD during follow-up and 3 more showed mild SSU reduction in the caudate. Overlap between ET and PD can occur but no statistical differences of SDAT density were assessed by FP-CIT SPECT in ET along a mid-range clinical follow-up.

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Isaias, I. Articles by Gerundini, P. PubMed Articles by Isaias, I. Articles by Gerundini, P.