[18F]FDOPA PET and clinical features in parkinsonism due to manganism.
Manganese exposure reportedly causes a clinically and pathophysiologically distinct syndrome from idiopathic Parkinson's disease (PD). We describe the clinical features and results of positron emission tomography with 6-[18F]fluorodopa ([18F]FDOPA PET) of a patient with parkinsonism occurring in the setting of elevated blood manganese. The patient developed parkinsonism associated with elevated serum manganese from hepatic dysfunction. [18F]FDOPA PET demonstrated relatively symmetric and severely reduced [18F]FDOPA levels in the posterior putamen compared to controls. The globus pallidum interna had increased signal on T1-weighted magnetic resonance imaging (MRI) images. We conclude that elevated manganese exposure may be associated with reduced striatal [18F]FDOPA uptake, and MRI may reveal selective abnormality within the internal segment of the pallidum. This case suggests that the clinical and pathophysiological features of manganese-associated parkinsonism may overlap with that of PD.
Racette
Brad A
BA
Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.|American Parkinson Disease Association Advanced Center for Parkinson Research, Washington University School of Medicine, St. Louis, Missouri, USA.
Antenor
Jo Ann
JA
Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.
McGee-Minnich
Lori
L
Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.|American Parkinson Disease Association Advanced Center for Parkinson Research, Washington University School of Medicine, St. Louis, Missouri, USA.
Moerlein
Stephen M
SM
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA.
Videen
Tom O
TO
Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.|Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA.
Kotagal
Vikas
V
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA.
Perlmutter
Joel S
JS
Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.|American Parkinson Disease Association Advanced Center for Parkinson Research, Washington University School of Medicine, St. Louis, Missouri, USA.|Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA.|Department of Anatomy and Neurobiology, Washington University School of Medicine, St. Louis, Missouri, USA.
D000328:Adult; D000978:Antiparkinson Agents / Q000627:therapeutic use; D001921:Brain / Q000378:metabolism*; D002230:Carbidopa / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D019788:Fluorodeoxyglucose F18; D005684:Gait; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D020149:Manganese Poisoning / Q000097:blood* / Q000150:complications*; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals
D000978:Antiparkinson Agents; D004338:Drug Combinations; D019275:Radiopharmaceuticals; C009265:carbidopa, levodopa drug combination; D019788:Fluorodeoxyglucose F18; D007980:Levodopa; D002230:Carbidopa