[Cerebral SPECT with iodine-123 IBZM in patients with extrapyramidal system disorders: the evaluation of its sensitivity in therapy with dopaminergic drugs].
The functional integrity of striatal post-synaptic dopamine D2 receptors is requested for an effective pharmacologic treatment in patients with extrapyramidal movement disorders. Iodine-123 IBZM Single Photon Emission Computed Tomography (SPECT) is a noninvasive radionuclide technique for the morpho-functional imaging of post-synaptic dopamine D2 receptors. In this study, the results of iodine-123 IBZM SPECT and those of apomorphine tests were compared in 32 patients with extrapyramidal movement disorders--22 patients with idiopathic Parkinson's disease (IPD) and 10 with Parkinson's plus syndrome (PPS). Iodine-123 IBZM uptake was measured as the ratio between striatum and frontal cortex activities. Twenty of 22 IPD patients (91%) responded to apomorphine administration, while in 8 of 10 PPS patients (80%) the apomorphine test was negative. Iodine-123 IBZM uptake was significantly higher (p < 0.01) in IPD patients (1.39 +/- 0.114) than in PPS patients (1.27 +/- 0.078). Similarly, iodine-123 IBZM uptake was significantly higher (p < 0.01) in the patients with positive than in those with negative apomorphine test (1.38 +/- 0.113 vs. 1.26 +/- 0.078). In conclusion, the results of this study demonstrate that iodine-123 IBZM SPECT is a radionuclide technique capable of characterizing the patients with extrapyramidal movement disorders and of selecting the subjects who may respond to pharmacological dopamine treatment.
Hierholzer
J
J
Röntgen-Diagnostik und Neurologie, Virchow-Klinikum, Medizinische Fakultät, Humboldt-Universität, Berlin, Germany.
Castelli
L
L
Cordes
M
M
Schelosky
L
L
Poewe
W
W
Felix
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001058:Apomorphine; D001480:Basal Ganglia Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy; D001549:Benzamides; D001921:Brain / Q000000981:diagnostic imaging*; D003287:Contrast Media; D018491:Dopamine Agonists / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000000981:diagnostic imaging / Q000188:drug therapy; D011759:Pyrrolidines; D015899:Tomography, Emission-Computed, Single-Photon / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data
D001549:Benzamides; D003287:Contrast Media; D018491:Dopamine Agonists; D007457:Iodine Radioisotopes; D011759:Pyrrolidines; C055743:3-iodo-2-hydroxy-6-methoxy-N-((1-ethyl-2-pyrrolidinyl)methyl)benzamide; D001058:Apomorphine