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Klinische und bildgebende Diagnostik bei Morbus Parkinson und Multisystematrophie

Clinical and imaging diagnostics of Parkinson’s disease and multiple system atrophy

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Zusammenfassung

Die Diagnose des Morbus Parkinson (Parkinson’s disease, PD) und der Multisystematrophie (MSA) erfolgt primär klinisch, stellt jedoch mitunter auch einen erfahrenen Neurologen vor eine große Herausforderung. Die neuroradiologische Bildgebung kann bei der Diagnosefindung helfen, dient jedoch in erster Linie dazu, andere Erkrankungen wie Normaldruckhydrozephalus, Multiinfarktdemenz und zerebelläre Läsionen auszuschließen. Nuklearmedizinische Methoden können zusätzlich zur Diagnose und Differenzialdiagnose bei PD und MSA herangezogen werden.

Abstract

The diagnosis of Parkinson’s disease (PD) and multiple system atrophy (MSA) is primarily made by clinical symptoms, but might still remain challenging even for experienced neurologists. Neuroradiologic imaging may be a useful tool in the diagnostic work-up, particularly for excluding other diseases, such as normal pressure hydrocephalus, multi-infarct dementia and cerebellar lesions. Nuclear medicine methods can additionally support the diagnosis and differential diagnosis of PD and MSA.

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Literatur

  1. Antonini A, Benti R, De Notaris R et al (2003) 123I-Ioflupane/SPECT binding to striatal dopamine transporter (DAT) uptake in patients with Parkinson’s disease, multiple system atrophy, and progressive supranuclear palsy. Neurol Sci 24:149–150

    Article  PubMed  CAS  Google Scholar 

  2. Benamer TS, Patterson J, Grosset DG et al (2000) Accurate differentiation of parkinsonism and essential tremor using visual assessment of [123I]-FP-CIT SPECT imaging: the [123I]-FP-CIT study group. Mov Disord 15:503-510

    Article  PubMed  CAS  Google Scholar 

  3. Benamer HT, Oertel WH, Patterson J et al (2003) Prospective study of presynaptic dopaminergic imaging in patients with mild parkinsonism and tremor disorders: part 1. Baseline and 3-month observations. Mov Disord 18:977–984

    Article  PubMed  Google Scholar 

  4. Bernheimer H, Birkmayer W, Hornykiewicz O et al (1973) Brain dopamine and the syndromes of Parkinson and Huntington. J Neurol Sci 20:415–455

    Article  PubMed  CAS  Google Scholar 

  5. Booij J, Busemann Sokole E et al (1998) Human biodistribution and dosimetry of [123I]FP-CIT: a potent radioligand for imaging of dopamine transporters. Eur J Nucl Med Mol Imaging 25:24–30

    Article  CAS  Google Scholar 

  6. Braak H, Ghebremedhin E, Rüb U et al (2004) Stages in the development of Parkinson’s disease-related pathology. Cell Tissue Res 318:121–134

    Article  PubMed  Google Scholar 

  7. Braune S (2001) The role of cardiac metaiodobenzylguanidine uptake in the differential diagnosis of parkinsonian syndromes. Clin Auton Res 11:351–355

    Article  PubMed  CAS  Google Scholar 

  8. Deuschl G, Krack P (1999) Morbus Parkinson. In: Hopf HC, Deuschl G, Diener HC, Reichmann H (Hrsg) Neurologie in Praxis und Klinik, Bd 2. Thieme, Stuttgart New York, S 49–69

  9. Druschky A, Hilz MJ, Platsch G et al (2000) Differentiation of Parkinson’s disease and multiple system atrophy in early disease stages by means of I-123-MIBG-SPECT. J Neurol Sci 175:3–12

    Article  PubMed  CAS  Google Scholar 

  10. Eerola J, Tienari PJ, Kaakkola S et al (2005) How useful is [123I]beta-CIT SPECT in clinical practice? J Neurol Neurosurg Psychiatry 76:1211–1216

    Article  PubMed  CAS  Google Scholar 

  11. Filippi L, Manni C, Pierantozzi M et al (2005) 123I-FP-CIT semi-quantitative SPECT detects preclinical bilateral dopaminergic deficit in early Parkinson’s disease with unilateral symptoms. Nucl Med Commun 26:421–426

    Article  PubMed  CAS  Google Scholar 

  12. Hughes A, Daniel SE, Kilford L et al (1992) Accuracy of clinical diagnosis of idiopathic Parkinson‘s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 55:181–184

    Article  PubMed  CAS  Google Scholar 

  13. Hughes A, Ben-Shlomo Y, Daniel SE et al (1993) What feasures improve the accuracy of clinical diagnosis in Parkinson’s disease: a clinicopathologic study. Neurology 43:1629–1630

    Google Scholar 

  14. Ichise M, Kim YJ, Ballinger JR et al (1999) SPECT imaging of pre- and postsynaptic dopaminergic alterations in L-dopa-untreated PD. Neurology 52:1206–1214

    PubMed  CAS  Google Scholar 

  15. Innis RB, Marek KL, Sheff K et al (1999) Effect of treatment with L-dopa/carbidopa or L-selegiline on striatal dopamine transporter SPECT imaging with [123I]beta-CIT. Mov Disord 14:436–442

    Article  PubMed  CAS  Google Scholar 

  16. Khafagi FA, Shapiro B, Fischer M et al (1991) Phaeochromocytoma and functioning paraganglioma in childhood and adolescence: role of iodine 131 metaiodobenzylguanidine. Eur J Nucl Med Mol Imaging 18:191–198

    Article  CAS  Google Scholar 

  17. Kim GM, Kim SE, Lee WY (2000) Preclinical impairment of the striatal dopamine transporter system in sporadic olivopontocerebellar atrophy: studied with [123I] ß-CIT and SPECT. Eur Neurol 43:23–29

    Article  PubMed  CAS  Google Scholar 

  18. Kim YJ, Ichise M, Ballinger JR et al (2002) Combination of dopamine transporter and D2 receptor SPECT in the diagnostic evaluation of PD, MSA, and PSP. Mov Disord 17:303–312

    Article  PubMed  Google Scholar 

  19. Köllensperger M, Seppi K, Liener C et al (2007) Diffusion weighted imaging best discriminates PD from MSA-P: a comparison with tilt table testing and heart MIBG scintigraphy. Mov Disord 22:1771–1776

    Article  PubMed  Google Scholar 

  20. Lee PH, Yeo SH, Kim HJ, Youm HY (2006) Correlation between cardiac 123I-MIBG and odor identification in patients with Parkinson’s disease and multiple system atrophy. Mov Disord 21:1975–1977

    Article  PubMed  Google Scholar 

  21. Leung A, Shapiro B, Hattner R et al (1997) Specificity of radioiodinated MIBG for neural crest tumors in childhood. J Nucl Med 38:1352–1357

    PubMed  CAS  Google Scholar 

  22. Litvan I, Goetz CG, Jankovic J et al (1997) What is the accuracy of the clinical diagnosis of multiple system atrophy? A clinicopathologic study. Arch Neurol 54:937–944

    PubMed  CAS  Google Scholar 

  23. Lumbroso J, Hartmann O, Schlumberger M (1991) Therapeutic use of [131I]-metaiodo-benzylguanidine in neuroblastoma: a phase II study in 26 patients. „Société Francaise d’Oncologie Pediatrique“ and Nuclear Medicine Co-investigators. J Nucl Biol Med 35:220–223

    PubMed  CAS  Google Scholar 

  24. Mairs R (1999) Neuroblastoma therapy using radiolabelled [131I] meta-iodobenzylguanidine ([131I] MIBG) in combination with other agents. Eur J Cancer 35:1171–1173

    Article  PubMed  CAS  Google Scholar 

  25. Nagamachi S, Wakamatsu H, Kiyohara S et al (2008) Usefulness of rCBF analysis in diagnosing Parkinson’s disease: supplemental role with myocardial MIBG scintigraphy. Ann Nucl Med 22:557–564

    Article  PubMed  Google Scholar 

  26. Nagayama H, Hamamoto M, Ueda M et al (2005) Reliability of MIBG myocardial scintigraphy in the diagnosis of Parkinson’s disease. J Neurol Neurosurg Psychiatry 76:249–251

    Article  PubMed  CAS  Google Scholar 

  27. Nakajo M, Shapiro B, Copp J et al (1983) The normal and abnormal distribution of the adrenomedullary imaging agent m-[I-131]iodo-benzyl-guanidine (I-131 MIBG) in man: evaluation by scintigraphy. J Nucl Med 24:672–682

    PubMed  CAS  Google Scholar 

  28. Okada Y, Ito Y, Aida J et al (2004) Lewy bodies in the sinoatrial nodal ganglion: clinicopathological studies. Pathol Int 54:682–687

    Article  PubMed  Google Scholar 

  29. Orimo S, Ozawa E, Nakade S et al (1999) (123)I-metaiodobenzylguanidine myocardial scintigraphy in Parkinson’s disease. J Neurol Neurosurg Psychiatry 67:189–194

    Article  PubMed  CAS  Google Scholar 

  30. Orimo S, Takahashi A, Uchihara T et al (2007) Degeneration of cardiac sympathetic nerve begins in the early disease process of Parkinson’s disease. Brain Pathol 17:24–30

    Article  PubMed  CAS  Google Scholar 

  31. Orimo S (2008) Clinical and pathological study on early diagnosis of Parkinson’s disease and dementia with Lewy bodies. Rinsho Shinkeigaku 48:11–24

    PubMed  Google Scholar 

  32. Osborn AG, Salzman KL, Barkovich AJ (2010) Diagnostic imaging. Brain 10:78–85

    Google Scholar 

  33. Parkinson J (1817) An essay on the shaking palsy. London

  34. Pirker W, Asenbaum S, Bencsits G et al (2000) [123I]beta-CIT SPECT in multiple system atrophy, progressive supranuclear palsy, and corticobasal degeneration. Mov Disord 15:1158–1167

    Article  PubMed  CAS  Google Scholar 

  35. Plotkin M, Amthauer H, Klaffke S et al (2005) Combined 123I-FP-CIT and 123I-IBZM SPECT for the diagnosis of parkinsonian syndromes: study on 72 patients. J Neural Transm 112:677–692

    Article  PubMed  CAS  Google Scholar 

  36. Poewe W, Wenning GK, Gerlach M et al (1999) Nicht-idiopathische Parkinson-Syndrome. In: Hopf HC, Deuschl G, Diener HC, Reichmann H (Hrsg) Neurologie in Praxis und Klinik, Bd 2. Thieme, Stuttgart New York, S 69–78

  37. Reichmann H (2008) Neurodegenerative Erkrankungen. UNI-MED, Bremen

  38. Sawada H, Oeda T, Yamamoto K et al (2009) Diagnostic accuracy of cardiac metaiodobenzylguanidine scintigraphy in Parkinson’s disease. Eur J Neurol 16:174–182

    Article  PubMed  CAS  Google Scholar 

  39. Seibyl JP, Marek K, Sheff K et al (1998) Iodine-123-beta-CIT and iodine-123-FPCIT SPECT measurement of dopamine transporters in healthy subjects and Parkinson’s patients. J Nucl Med 39:1500–1508

    PubMed  CAS  Google Scholar 

  40. Shapiro B, Copp JE, Sisson JC et al (1985) Iodine-131 metaiodobenzylguanidine for the locating of suspected pheochromocytoma: experience in 400 cases. J Nucl Med 26:576–585

    PubMed  CAS  Google Scholar 

  41. Sisson J, Shulkin B (1999) Nuclear medicine imaging of pheochromocytoma and neuroblastoma. Q J Nucl Med 43:217–223

    PubMed  CAS  Google Scholar 

  42. Spiegel J, Hellwig D, Möllers MO et al (2006) Transcranial sonography and [123I]FP-CIT SPECT disclose complementary aspects of Parkinson’s disease. Brain 129:1188–1193

    Article  PubMed  Google Scholar 

  43. Spiegel J, Hellwig D, Samnick S et al (2007) Striatal FP-CIT uptake differs in the subtypes of early Parkinson’s disease. J Neural Transm 114:331–335

    Article  PubMed  CAS  Google Scholar 

  44. Spiegel J, Hellwig D, Farmakis G et al (2007) Myocardial sympathetic degeneration correlates with clinical phenotype of Parkinson’s disease. Mov Disord 22:1004–1008

    Article  PubMed  Google Scholar 

  45. Taki J, Nakajima K, Hwang EH et al (2000) Peripheral sympathetic dysfunction in patients with Parkinson’s disease without autonomic failure is heart selective and disease specific. Eur J Nucl Med Mol Imaging 27:566–573

    Article  CAS  Google Scholar 

  46. Turner B (1968) Pathology of paralysis agitans. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology. Vol 6: Parkinson’s disease. North-Holland Publishing Company, Amsterdam; Wiley & Sons, New York, pp 212–217

    Google Scholar 

  47. Van Laere K, Ceuninck L de, Dom R et al (2004) Dopamine transporter SPECT using fast kinetic ligands: 123I-FP-beta-CIT versus 99mTc-TRODAT-1. Eur J Nucl Med Mol Imaging 31:1119–1127

    Google Scholar 

  48. Varrone A, Marek KL, Jennings D et al (2001) [(123)I]beta-CIT SPECT imaging demonstrates reduced density of striatal dopamine transporters in Parkinson’s disease and multiple system atrophy. Mov Disord 16:1023–1032

    Article  PubMed  CAS  Google Scholar 

  49. Wieland DM, Wu J, Brown LE et al (1980) Radiolabeled adrenergic neuron-blocking agents: adrenomedullary imaging with [131I] iodobenzylguanidine. J Nucl Med 21:349–353

    PubMed  CAS  Google Scholar 

  50. Yoshita M (1998) Differentiation of idiopathic Parkinson’s disease from striatonigral degeneration and progressive supranuclear palsy using iodine-123 meta-iodobenzylguanidine myocardial scintigraphy. J Neurol Sci 155:60–67

    Article  PubMed  CAS  Google Scholar 

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  1. Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Kirrberger Str. 1, 66421, Homburg/Saar, Deutschland

    K. I. Schmidt & W. Reith

  2. Klinik für Neurologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Homburg/Saar, Deutschland

    J. Spiegel

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  1. K. I. Schmidt
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Correspondence to K. I. Schmidt.

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Schmidt, K., Spiegel, J. & Reith, W. Klinische und bildgebende Diagnostik bei Morbus Parkinson und Multisystematrophie. Radiologe 51, 273–277 (2011). https://doi.org/10.1007/s00117-010-2095-5

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