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Parkinsonism spect

Manuela Cristina Matesan, Saeed Elojeimy, Satoshi Minoshima
Molecular brain imaging I-FP-CIT SPECT is an important tool in evaluation of patients with parkinsonism. However, various neurodegenerative etiologies cannot be differentiated by I-FP-CIT SPECT alone. We present a case of progressive supranuclear palsy with abnormal I-FP-CIT SPECT and abnormal Tc-HMPAO SPECT depicted by quantitative analyses but unremarkable MRI 16 months after the onset of symptoms. Brain autopsy demonstrated presence of neuronal and glial tau pathology in both cortical and subcortical regions confirming the diagnosis of progressive supranuclear palsy...
October 18, 2016: Clinical Nuclear Medicine
Robert S Miletich
PURPOSE OF REVIEW: Positron emission tomography (PET) and single-photon emission computed tomography (SPECT) are now available for routine clinical applications in neurology. This article discusses their diagnostic use in dementia, brain tumors, epilepsy, parkinsonism, cerebrovascular disease, and traumatic brain injury. RECENT FINDINGS: Neuromolecular imaging, also known as nuclear neurology, involves clinical imaging of both basal regional physiology (perfusion, metabolism, and transport mechanisms) and specific neurochemical physiology (currently, only the dopamine transporter)...
October 2016: Continuum: Lifelong Learning in Neurology
P Schwingenschuh, G Deuschl
Functional tremor is the commonest reported functional movement disorder. A confident clinical diagnosis of functional tremor is often possible based on the following "positive" criteria: a sudden tremor onset, unusual disease course, often with fluctuations or remissions, distractibility of the tremor if attention is removed from the affected body part, tremor entrainment, tremor variability, and a coactivation sign. Many patients show excessive exhaustion during examination. Other somatizations may be revealed in the medical history and patients may show additional functional neurologic symptoms and signs...
2017: Handbook of Clinical Neurology
Maria Salsone, Rita Nistico', Basilio Vescio, Fabiana Novellino, Maurizio Morelli, Angela Lupo, Gennarina Arabia, Aldo Quattrone
OBJECTIVE: To investigate heart rate variability (HRV) in patients with Essential Tremor (ET) in comparison with patients with Parkinson's Disease (PD). METHODS: This is a cross sectional control study including 10 patients with ET, 10 patients with PD and 10 age-sex-matched controls. In patients and controls, we measured the components of HRV analysis in the frequency domain during a daytime period of 12-h. Selected HRV variables were low-frequency (LF) and high-frequency (HF), conventionally considered to be influenced by the sympathetic system and the parasympathetic system respectively...
September 28, 2016: Parkinsonism & related Disorders
Tian-Sin Fan, Ruey-Meei Wu, Pei-Lung Chen, Ta-Fu Chen, Huei-Ying Li, Yin-Hung Lin, Chien-Yu Chen, Meng-Ling Chen, Chun-Hwei Tai, Hang-I Lin, Chin-Hsien Lin
INTRODUCTION: Leucine-rich repeat kinase 2 (LRRK2) mutations are the most common genetic cause of Parkinson's disease (PD). However, only few cases carrying LRRK2 mutations have been reported in Taiwanese PD patients. METHODS: We used targeted next generation sequencing (NGS), covering 24 candidate genes involved in neurodegenerative disorders, to analyze 40 probands with familial PD, and 10 patients with mixed neurodegenerative disorders. Sanger sequencing of the identified mutation in the first set of the study was performed in additional 270 PD patients, including 139 familial PD and 131 early-onset PD (onset age less than 50 years old), and 300 age/gender matched control subjects...
September 7, 2016: Parkinsonism & related Disorders
Allison K Graebner, Daniel Tarsy, Ludy C Shih, Veronique Vanderhorst, Omesh Kulkarni, Scott Kaplan, David K Simon
BACKGROUND/AIMS: The clinical diagnosis of degenerative forms of parkinsonism is imperfect, with past studies reporting a high rate of misdiagnosis by neurologists and movement disorder specialists, particularly early in the disease course. 123I-ioflupane SPECT (DaTscan) is a diagnostic neuroimaging tool used to distinguish essential tremor from tremor due to degenerative parkinsonisms. The present study expands upon prior studies of the clinical impact of DaTscan imaging in movement disorder centers by assessing quantitative estimates of diagnostic certainty, the impact on subsequent clinical decisions, and the degree to which the asymmetry in the results corresponds to laterality by clinical history and examination...
September 10, 2016: Neuro-degenerative Diseases
Ioannis U Isaias, Paula Trujillo, Paul Summers, Giorgio Marotta, Luca Mainardi, Gianni Pezzoli, Luigi Zecca, Antonella Costa
Parkinson's disease (PD) is a progressive neurodegenerative disorder in which the major pathologic substrate is a loss of dopaminergic neurons from the substantia nigra. Our main objective was to determine the correspondence between changes in the substantia nigra, evident in neuromelanin and iron sensitive magnetic resonance imaging (MRI), and dopaminergic striatal innervation loss in patients with PD. Eighteen patients and 18 healthy control subjects were included in the study. Using neuromelanin-MRI, we measured the volume of the substantia nigra and the contrast-to-noise-ratio between substantia nigra and a background region...
2016: Frontiers in Aging Neuroscience
Young-Do Kim, Hyeonseok S Jeong, In-Uk Song, Yong-An Chung, Eun Namgung, Yong-Duk Kim
OBJECTIVE: Although Parkinson's disease (PD) is frequently accompanied by depression, brain perfusion deficits in PD with depression remain unclear. This study aimed to assess alterations in regional cerebral blood flow (rCBF) in depressed PD patients using (99m)Tc hexamethyl-propylene-amine-oxime single-photon emission computed tomography (SPECT). METHODS: Among 78 patients with PD, 35 patients were classified into the depressed PD group, while the rest (43 patients) was assigned to the nondepressed PD group based on the scores of the Geriatric Depressive Scale (GDS)...
August 26, 2016: Annals of Nuclear Medicine
Wenyan Kang, Fangyi Dong, Dunhui Li, Thomas J Quinn, Shengdi Chen, Jun Liu
BACKGROUND: Dopamine transporter based imaging has high diagnostic performance in distinguishing patients with Parkinson's disease (PD) from patients with non-Parkinsonian syndromes. Our previous study indicated that the "Sniffin' Sticks" odor identification test (SS-16) acts as a valid instrument for olfactory assessment in Chinese PD patients. The aim of the study was to compare the efficacy of the two methods in diagnosing PD. METHODS: Fifty-two PD patients were involved in this study and underwent single photon emission computed tomography (SPECT) imaging using the labeled dopamine transporter radiotracer (99m)Tc-TRODAT-1 to assess nigrostriatal dopaminergic function...
2016: Translational Neurodegeneration
Kota Yokoyama, Etsuko Imabayashi, Kaoru Sumida, Daichi Sone, Yukio Kimura, Noriko Sato, Youhei Mukai, Miho Murata, Hiroshi Matsuda
PURPOSE: For the quantitative assessment of dopamine transporter (DAT) using [(123)I]FP-CIT single-photon emission computed tomography (SPECT) (DaTscan), anatomic standardization is preferable for achieving objective and user-independent quantification of striatal binding using a volume-of-interest (VOI) template. However, low accumulation of DAT in Parkinson's disease (PD) would lead to a deformation error when using a DaTscan-specific template without any structural information. To avoid this deformation error, we applied computed tomography (CT) data obtained using SPECT/CT equipment to anatomic standardization...
August 20, 2016: European Journal of Nuclear Medicine and Molecular Imaging
Axel Van Der Gucht, Laurent Cleret de Langavant, Ophélie Bélissant, Corentin Rabu, Anne-Ségolène Cottereau, Eva Evangelista, Julia Chalaye, Sophie Bonnot-Lours, Gilles Fénelon, Emmanuel Itti
A 67-year-old man was referred for fluctuating neuropsychiatric symptoms, featuring depression, delirious episodes, recurrent visual hallucinations and catatonic syndrome associated with cognitive decline. No parkinsonism was found clinically even under neuroleptic treatment. (18)F-FDG PET/CT showed hypometabolism in the posterior associative cortex including the occipital cortex, suggesting Lewy body dementia, but (123)I-FP-CIT SPECT was normal and cardiac (123)I-MIBG imaging showed no signs of sympathetic denervation...
September 2016: Nuclear Medicine and Molecular Imaging
Adriana P Hermida, A Umair Janjua, Oliver M Glass, Camille P Vaughan, Felicia Goldstein, Lynn Marie Trotti, Stewart A Factor
Lithium is a mood stabilizer rarely associated with drug-induced parkinsonism (DIP). We present a case of an elderly woman with bipolar disorder who developed parkinsonian symptoms after chronic lithium administration despite therapeutic serum levels. Upon evaluation, classic parkinsonian signs of muscle rigidity, tremor, bradykinesia, freezing of gait, and cognitive decline were observed. Initially, she was diagnosed with Parkinson's disease (PD); however, DaTscan SPECT imaging clarified the diagnosis as DIP...
August 12, 2016: International Psychogeriatrics
Zuzana Walker, Emilio Moreno, Alan Thomas, Fraser Inglis, Naji Tabet, Tim Stevens, Tim Whitfield, Dag Aarsland, Michael Rainer, Alessandro Padovani
OBJECTIVE: To test the hypothesis that core and suggestive features in possible dementia with Lewy bodies (DLB) would vary in their ability to predict an abnormal dopamine transporter scan and therefore a follow-up diagnosis of probable DLB. A further objective was to assess the evolution of core and suggestive features in patients with possible DLB over time depending on the (123)I-FP-CIT SPECT scan result. METHODS: A total of 187 patients with possible DLB (dementia plus one core or one suggestive feature) were randomized to have dopamine transporter imaging or to follow-up without scan...
September 6, 2016: Neurology
Thomas I Cochrane
While dopamine transporter single-photon emission computed tomography (DAT-SPECT) imaging is sensitive and specific when performed in patients with signs or symptoms of parkinsonism, its predictive value is uncertain in healthy subjects, even with patients who have first-degree relatives affected by Parkinson disease. In deciding whether to honor a patient's request for a DAT-SPECT, neurologists must balance a patient's autonomy rights with beneficence and nonmaleficence and also consider the distributive justice implications of ordering the test...
August 2016: Continuum: Lifelong Learning in Neurology
Simon Badoud, Dimitri Van De Ville, Nicolas Nicastro, Valentina Garibotto, Pierre R Burkhard, Sven Haller
(123)I-ioflupane single photon emission computed tomography (SPECT) is a sensitive and well established imaging tool in Parkinson's disease (PD) and atypical parkinsonian syndromes (APS), yet a discrimination between PD and APS has been considered inconsistent at least based on visual inspection or simple region of interest analyses. We here reappraise this issue by applying advanced image analysis techniques to separate PD from the various APS. This study included 392 consecutive patients with degenerative parkinsonism undergoing (123)I-ioflupane SPECT at our institution over the last decade: 306 PD, 24 multiple system atrophy (MSA), 32 progressive supranuclear palsy (PSP) and 30 corticobasal degeneration (CBD) patients...
2016: NeuroImage: Clinical
Hubert Tissot, Solene Frismand, Pierre-Yves Marie, Nicolaie Gospodaru, Antoine Verger
I-FP-CIT-SPECT is currently used to detect functional impairment of striatal structures. We report herein a case where I-FP-CIT abnormalities are seemingly related to an encephalitis involving substantia nigra. A few months after a documented encephalitis, a 19-year-old woman experienced a Parkinsonism with a right dominance. There was a reduction in the striatal binding of I-FP-CIT, especially on the left side, in accordance with the right dominance of the Parkinsonism.
October 2016: Clinical Nuclear Medicine
Mi-Ae Park, Marie Foley Kijewski, Ronnie Keijzers, Mark Keijzers, Morgan C Lyon, Laura Horky, Stephen C Moore
PURPOSE: Noise levels of brain SPECT images are highest in central regions, due to preferential attenuation of photons emitted from deep structures. To address this problem, the authors have designed a novel collimator for brain SPECT imaging that yields greatly increased sensitivity near the center of the brain without loss of resolution. This hybrid collimator consisted of ultrashort cone-beam holes in the central regions and slant-holes in the periphery (USCB). We evaluated this collimator for quantitative brain imaging tasks...
August 2016: Medical Physics
Karolien Goffin, Koen van Laere
Single-photon emission computed tomography (SPECT) is a functional nuclear imaging technique that allows visualization and quantification of different in vivo physiologic and pathologic features of brain neurobiology. It has been used for many years in diagnosis of several neurologic and psychiatric disorders. In this chapter, we discuss the current state-of-the-art of SPECT imaging of brain perfusion and dopamine transporter (DAT) imaging. Brain perfusion SPECT imaging plays an important role in the localization of the seizure onset zone in patients with refractory epilepsy...
2016: Handbook of Clinical Neurology
A Jon Stoessl, Martin J Mckeown
Movement disorders can be hypokinetic (e.g., parkinsonism), hyperkinetic, or dystonic in nature and commonly arise from altered function in nuclei of the basal ganglia or their connections. As obvious structural changes are often limited, standard imaging plays less of a role than in other neurologic disorders. However, structural imaging is indicated where clinical presentation is atypical, particularly if the disorder is abrupt in onset or remains strictly unilateral. More recent advances in magnetic resonance imaging (MRI) may allow for differentiation between Parkinson's disease and atypical forms of parkinsonism...
2016: Handbook of Clinical Neurology
Nicolas Nicastro, Valentina Garibotto, Simon Badoud, Pierre R Burkhard
INTRODUCTION: (123)I-ioflupane SPECT is a powerful method to assess nigrostriatal dopamine system integrity. Several independent studies have shown that 1-15% of patients with suspected degenerative parkinsonism, mainly PD, have scans without evidence of dopaminergic deficit (SWEDD). It has been proposed that most SWEDD patients either present with a non-degenerative condition mimicking PD, such as atypical tremor or dystonia, or demonstrate an abnormal scan when repeated later. We here hypothesized that scan interpretation methods may also play a crucial yet underestimated role in this issue...
July 7, 2016: Parkinsonism & related Disorders
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