Peduncular 'rubral' tremor and dopaminergic denervation: a PET study.
Lesions causing so-called rubral tremors frequently involve the substantia nigra or the nigrostriatal fibers, suggesting dopaminergic denervation as possibly contributory. We examined this hypothesis using PET and [18F]-fluorodopa in six patients with a contralateral tremor following a peduncular lesion. The denervation revealed by PET was even more marked than in severe parkinsonian patients. All patients showed partial to complete improvement with levodopa therapy. PET evaluation of D2-receptors with [76Br]bromolisuride showed no asymmetry of the D2 binding despite the important asymmetry of 18F-fluorodopa uptake. Our results indicate an important involvement of the nigral dopaminergic system in peduncular tremors that appears to be independent of postsynaptic dopamine receptors.
Remy
P
P
Service Hospitalier Frédéric Joliot, Orsay, France.
de Recondo
A
A
Defer
G
G
Loc'h
C
C
Amarenco
P
P
Planté-Bordeneuve
V
V
Dao-Castellana
M H
MH
Bendriem
B
B
Crouzel
C
C
Clanet
M
M
D000328:Adult; D000704:Analysis of Variance; D001930:Brain Injuries / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000000981:diagnostic imaging*; D011954:Receptors, Dopamine / Q000378:metabolism / Q000502:physiology*; D012012:Red Nucleus / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D013378:Substantia Nigra / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D014055:Tomography, Emission-Computed; D014202:Tremor / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*
D011954:Receptors, Dopamine