title: Dopamine transporter binding study in differentiating carbon disulfide induced parkinsonism from idiopathic parkinsonism.
abstract: Long-term exposure to carbon disulfide (CS(2)) may induce parkinsonian features. There may be confusion in distinguishing between CS(2) parkinsonism and idiopathic parkinsonism, especially for workers who developed parkinsonian features in viscose rayon plants. We performed clinical examinations, and laboratory studies including magnetic resonance imaging (MRI) and dopamine transporter (DAT) studies with (99m)Tc-TRODAT-1 brain single photon emission computed tomography (SPECT) in three workers who had long-term exposure to CS(2). Patient 1 had polyneuropathy, and encephalopathy with tremor; patient 2 had polyneuropathy, and encephalopathy with parkinsonian features; and patient 3 had pure parkinsonian features without polyneuropathy or cerebellar signs. The treatment with l-dopa was effective in patient 3, but non-effective in patient 2. Brain MRI revealed multiple high signal intensities over the subcortical white matter, basal ganglia, and/or even the brainstem in patients 1 and 2, but normal in patient 3. In DAT studies, the bindings were normal in patients 1 and 2 and was decreased in patient 3. We conclude that CS(2) exposure may induce polyneuropathy, and cerebellar dysfunction in addition to parkinsonian features and that brain MRI may show multiple lesions in the cerebral white matter and basal ganglia. In addition, DAT with (99m)Tc-TRODAT-1 brain SPECT may provide a useful information in differential diagnosis between CS(2) parkinsonism and idiopathic parkinsonism.
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital and University, 199, Tung-Hwa North Road, Taipei, Taiwan. cch0537@adm.cgmh.org.tw
authors.forename: Chin-Chang
authors.initials: CC
authors.lastname: Huang
authors.forename: Tzu-Chen
authors.initials: TC
authors.lastname: Yen
authors.forename: Tung-Sheng
authors.initials: TS
authors.lastname: Shih
authors.forename: Ho-Yuan
authors.initials: HY
authors.lastname: Chang
authors.forename: Nai-Shin
authors.initials: NS
authors.lastname: Chu
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging / Q000187:drug effects / Q000378:metabolism*; D002246:Carbon Disulfide / Q000633:toxicity*; D003937:Diagnosis, Differential; D050483:Dopamine Plasma Membrane Transport Proteins; D006801:Humans; D008297:Male; D008562:Membrane Glycoproteins; D026901:Membrane Transport Proteins / Q000378:metabolism*; D008875:Middle Aged; D009419:Nerve Tissue Proteins; D016273:Occupational Exposure / Q000009:adverse effects*; D020734:Parkinsonian Disorders / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000378:metabolism*; D011485:Protein Binding / Q000187:drug effects / Q000502:physiology; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
chemical_list: D050483:Dopamine Plasma Membrane Transport Proteins; D008562:Membrane Glycoproteins; D026901:Membrane Transport Proteins; D009419:Nerve Tissue Proteins; C493214:SLC6A3 protein, human; D002246:Carbon Disulfide