Individual parkinsonian motor signs and striatal dopamine transporter deficiency: a study with [I-123]FP-CIT SPECT

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Mäkinen , E , Joutsa , J , Jaakkola , E , Noponen , T , Johansson , J , Pitkonen , M , Levo , R , Mertsalmi , T , Scheperjans , F & Kaasinen , V 2019 , ' Individual parkinsonian motor signs and striatal dopamine transporter deficiency: a study with [I-123]FP-CIT SPECT ' , Journal of Neurology , vol. 266 , no. 4 , pp. 826-834 . https://doi.org/10.1007/s00415-019-09202-6

Title: Individual parkinsonian motor signs and striatal dopamine transporter deficiency: a study with [I-123]FP-CIT SPECT
Author: Mäkinen, Elina; Joutsa, Juho; Jaakkola, Elina; Noponen, Tommi; Johansson, Jarkko; Pitkonen, Miia; Levo, Reeta; Mertsalmi, Tuomas; Scheperjans, Filip; Kaasinen, Valtteri
Contributor: University of Helsinki, Clinicum
University of Helsinki, Clinicum
University of Helsinki, Department of Neurosciences
Date: 2019-04
Language: eng
Number of pages: 9
Belongs to series: Journal of Neurology
ISSN: 1432-1459
URI: http://hdl.handle.net/10138/301517
Abstract: IntroductionTotal parkinsonian motor symptom severity correlates with presynaptic striatal dopamine function in patients with Parkinson's disease. There is a lack of studies that have investigated the associations between parkinsonian motor signs and striatal dopaminergic deficiency in patients with parkinsonism of an unknown origin. Identification of specific motor signs associated with the highest likelihood of striatal dopamine deficiency could aid the differential diagnostics of parkinsonian and tremor syndromes.MethodsIn this cross-sectional clinical and imaging study, detailed motor examinations were performed for 221 patients with parkinsonism or tremor of an unknown origin immediately before dopamine transporter (DAT) [I-123]FP-CIT SPECT imaging. Region-of-interest and voxel-based methods were used to investigate striatal DAT deficiency in relation to individual motor signs.ResultsUpper extremity rigidity and facial expression were the only motor signs that differentiated patients with normal and abnormal striatal DAT function. The presence of any upper extremity rigidity showed the highest likelihood of DAT deficiency (OR 4.79, 95% CI 1.56-14.75, P=0.006) followed by reduced facial expression (OR 2.14, 95% CI 1.14-4.00, P=0.018). In patients with DAT deficits, reduced facial expression was associated with DAT deficiency specifically in the caudate nucleus, and increased upper extremity rigidity was associated with DAT loss in the dorsal putamen (FWE-corrected P
Subject: ACCURACY
CLINICAL-DIAGNOSIS
DISEASE
Dopamine
Facial expression
MOVEMENT
Parkinsonism
Rigidity
SCALE
SPECT
TREMOR
[I-123]FP-CIT
3112 Neurosciences
3124 Neurology and psychiatry
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