Niimi Yoshiki, Ito Shinji, Murate Kenichiro, Hirota Seiko, Hikichi Chika, Ishikawa Tomomasa, Maeda Toshiki, Nagao Ryunosuke, Shima Sayuri, Mizutani Yasuaki, Ueda Akihiro, Mutoh Tatsuro
Department of Neurology, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan.
Department of Neurology, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan.
J Neurol Sci. 2017 Jun 15;377:174-178. doi: 10.1016/j.jns.2017.04.026. Epub 2017 Apr 17.
Although single-photon emission computerized tomography of the dopamine transporter (DAT-SPECT) is useful for diagnosing parkinsonian syndrome, its applicability toward the early phase of Parkinson's disease remains unknown.
We enrolled 32 patients showing parkinsonism with normal cardiac I-metaiodobenzylguanidine (MIBG) uptake and abnormal DAT-SPECT findings among 84 consecutive patients with parkinsonism. We divided these patients into two groups (group 1: Parkinson's disease, group 2: corticobasal degeneration, progressive supranuclear palsy, multiple system atrophy), and compared their clinical characteristics, specific binding ratios, and striatal asymmetry indexes on DAT-SPECT examinations.
The striatal asymmetry indexes were significantly lower in group 1 than in group 2 (p<0.05), but there were no differences in the specific binding ratios between the two groups.
The combined use of striatal asymmetry index on DAT-SPECT and cardiac MIBG scintigraphy might offer useful clues for the differential diagnosis of the early phase Parkinson's disease from other parkinsonian syndromes.
尽管多巴胺转运体单光子发射计算机断层扫描(DAT-SPECT)对帕金森综合征的诊断有用,但其在帕金森病早期阶段的适用性仍不清楚。
我们在84例连续的帕金森综合征患者中纳入了32例表现为帕金森症且心脏I-间碘苄胍(MIBG)摄取正常但DAT-SPECT检查结果异常的患者。我们将这些患者分为两组(第1组:帕金森病,第2组:皮质基底节变性、进行性核上性麻痹、多系统萎缩),并比较了他们的临床特征、特异性结合率以及DAT-SPECT检查中的纹状体不对称指数。
第1组的纹状体不对称指数显著低于第2组(p<0.05),但两组之间的特异性结合率没有差异。
DAT-SPECT上的纹状体不对称指数与心脏MIBG闪烁显像联合使用可能为帕金森病早期与其他帕金森综合征的鉴别诊断提供有用线索。