Abstract
We recently found that patients with drug-induced parkinsonism (DIP) may have normal (group I) or abnormal (group II) putamen [123I]FP-CIT DAT (dopamine transporter) binding. In this study we reassessed clinical features and DAT binding in 19 of the original 32 patients (10 of group I and 9 of group II) after a 19–39-month follow-up period and tested the effects of chronic levodopa treatment in both cohorts of patients. In group I patients, [123I]FP-CIT SPET (single photon emission tomography) was still normal in all patients at follow-up; DAT binding and UPDRS (Unified Parkinson’s Disease Rating Scale) motor score values did not differ from baseline. In group II patients, [123I]FP-CIT SPET was still abnormal at follow-up; putamen DAT binding was significantly reduced and UPDRS III score higher compared to baseline. Levodopa treatment improved motor symptoms in three out of ten patients of group I and in eight out of nine patients of group II. No adverse psychiatric effects were observed in any of the patients. This study shows that DAT binding imaging may help to identify subjects with DIP secondary to a loss of dopamine nerve terminals in the context of a progressive degenerative parkinsonism. Patients with DIP may benefit from levodopa therapy, particularly when dopamine nerve terminal defects are present, and this should be considered in the therapeutic management of these patients.
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References
Alvarez MV, Evidente VG (2008) Understanding drug-induced parkinsonism: separating pearls from oy-sters. Neurology 70:32–34
Angrist B, Sathananthan G, Gershon S (1973) Behavioural effect of l-dopa in schizophrenic patients. Psychopharmacologia 31:1–11
Benamer HTS, Patterson J, Wyper D, Hadley DM, Macphee GJA, Grosset DG (2000) Correlation of Parkinson’s disease severity and duration with [123I]FP-CIT SPET striatal uptake. Mov Disord 15:692–698
Booij J, Speelman JD, Hornstinkm M, Wolters EC (2001) The clinical benefit of striatal dopamine transporters with [123I]FP-CIT SPET in differentiating patients with presynaptic parkinsonism from those with others forms of parkinsonism. Eur J Nucl Med 28:266–272
Bower JH, Maraganore DM, McDonnel SK, Rocca WA (1999) Incidence and distribution of parkinsonism in Olmsted County, Minnesota, 1976–1990. Neurology 52:1214–1220
Burn DJ, Brooks DJ (1993) Nigral dysfunction in drug-induced parkinsonism: an 18 F-dopa PET study. Neurology 43:552–556
Davidson M, Keefe RSE, Mohs RC, Siever LJ, Losonczy MF, Horvath TB, Davis KL (1987) l-Dopa challenge and relapse in schizophrenia. Am J Psychiatry 144:934–938
Fleming P, Makar H, Hunter KR (1970) Levodopa in drug-induced extrapyramidal disorders. Lancet 2:1186
Hardie RJ, Lees AJ (1988) Neuroleptic-induced Parkinson’s syndrome: clinical features and results of treatment with levodopa. J Neurol Neurosurg Psychiatry 51:850–854
Hassin-Baer S, Sirota P, Korczyn AD, Treves TA, Epstein B, Shabtai H, Martin T, Litvinjuk Y, Giladi N (2001) Clinical characteristics of neuroleptic-induced parkinsonism. J Neural Transm 108:1299–1308
Hausner RS (1983) Neuropleptic induced parkinsonism and Parkinson’s disease: differential diagnosis and treatment. J Clin Psychiatry 11:13–16
Hirose G (2006) Drug induced parkinsonism: a review. J Neurol 253(Suppl 3):III/22–III/24
Lorberboym M, Treves TA, Melamed E, Lampl Y, Hellmann M, Djaldetti R (2006) [123I] FP/CIT SPET imaging for distinguishing drug-induced parkinsonism from Parkinson’s disease. Mov Disord 21:510–514
Miller LG, Jankovic J (1990) Neurologic approach to drug-induced movement disorders: a study of 125 patients. South Med J 8:525–532
Morrish PK, Sawle GV, Brooks DJ (1996) Regional changes in [18F]dopa metabolism in the striatum in Parkinson’s disease. Brain 119:2097–2103
Ottaviani S, Tinazzi M, Pasquin I, Nothdurfter W, Tomelleri G, Fincati E, Nordera G, Moretto G, Fiaschi A, Smania N, Girogetti P, Antonini A (2006) Comparative analysis of visual and semi-quantitative assessment of striatal [123I] FP-CIT-SPET binding in Parkinson’s disease. Neurol Sci 27:397–401
Pirker W (2003) Correlation of dopamine transporter imaging with parkinsonian motor handicap: how close is it? Mov Disord 18(Suppl 7):43–51
Scherfler C, Schwarz J, Antonini A, Grosser D, Valldeoriola F, Marek K, Oertel W, Tolosa E, Lees AJ, Poewe W (2007) Role of DAT-SPECT in the diagnostic work up of parkinsonism. Mov Disord 22:1229–1238
Tatsch K, Asenbaum S, Bartenstein P, Catafau A, Haldin C, Pilowsky LS, Pupi A (2002) European Association of Nuclear Medicine procedure guidelines for brain neurotrasmission SPET using (123)I-labelled dopamine (D2) transporter ligands. Eur J Nucl Med 29:BP30–BP35
Tinazzi M, Ottaviani S, Isaias IU, Pasquin I, Steimayr M, Vampini C, Pilleri M, Moretto G, Fiaschi A, Smania N, Giorgetti P, Antonimi A (2008) [123I] FP-CIT SPET imaging in drug-induced parkinsonism. Mov Disord 23:1825–1829
Tolosa E, Coelho M, Gallardo M (2003) DAT imaging in drug induced and psychogenic parkinsonism. Mov Disord 18(Suppl 7):S28–S33
Yaryura-Tobias JA, Wolpert A, Dana L, Merlis S (1970) The action of l-dopa on schizophrenic patients, a preliminary report. Curr Ther Res 12:528–531
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The authors wish to thank Mr. Anthony Steele, former Verona University Senior Lecturer in Medical English, for his invaluable assistance with the linguistic revision of this paper.
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Tinazzi, M., Antonini, A., Bovi, T. et al. Clinical and [123I]FP-CIT SPET imaging follow-up in patients with drug-induced parkinsonism. J Neurol 256, 910–915 (2009). https://doi.org/10.1007/s00415-009-5039-0
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DOI: https://doi.org/10.1007/s00415-009-5039-0