Imaging of dopamine receptors with [123I]iodobenzamide single-photon emission-computed tomography in neuroleptic malignant syndrome.
With the tracer [123I]iodobenzamide ([123I]-IBZM), it is possible to image dopamine receptor occupancy with single-photon emission-computed tomography (SPECT). We report follow-up examinations with IBZM-SPECT in neuroleptic malignant syndrome (NMS) to display D2-receptor availability in the acute phase and during the course of remission. A 27-year-old man was admitted with severe akinesia, rigor, tachycardia, fever, and elevated creatine phosphokinase level (CK) after neuroleptic medication. NMS was diagnosed, and treatment was started with dantrolene, amantadine, and dopamine agonists. IBZM-SPECT examination was performed on days 6, 34, 90, 107, 131, and 201. In the acute state of NMS, there was no binding of IBZM to D2-receptors. SPECT reached almost normal values on day 131, but clinical examination still showed a mild parkinsonian syndrome. With SPECT, the D2-receptor occupancy in NMS could be successfully shown in correlation with extrapyramidal signs. IBZM-SPECT may therefore serve to monitor D2-receptor occupancy in patients at risk for NMS.
Department of Neurology, University of Giessen, F.R.G.
M
M
Jauss
P
P
Krack
M
M
Franz
R
R
Klett
R
R
Bauer
B
B
Gallhofer
W
W
Dorndorf
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001479:Basal Ganglia / Q000000981:diagnostic imaging / Q000187:drug effects; D001544:Benperidol / Q000009:adverse effects* / Q000627:therapeutic use; D001549:Benzamides; D018492:Dopamine Antagonists; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000187:drug effects; D006220:Haloperidol / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D009459:Neuroleptic Malignant Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology; D009460:Neurologic Examination / Q000187:drug effects; D011618:Psychotic Disorders / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011759:Pyrrolidines; D017448:Receptors, Dopamine D2 / Q000187:drug effects* / Q000502:physiology; D015899:Tomography, Emission-Computed, Single-Photon
D014150:Antipsychotic Agents; D001549:Benzamides; D018492:Dopamine Antagonists; D007457:Iodine Radioisotopes; D011759:Pyrrolidines; D017448:Receptors, Dopamine D2; C055743:3-iodo-2-hydroxy-6-methoxy-N-((1-ethyl-2-pyrrolidinyl)methyl)benzamide; D001544:Benperidol; D006220:Haloperidol