[Utility of 123-I ioflupane SPECT in the assessment of patients with Parkinsonian syndrome and cerebral vasculopathy].
OBJECTIVE
To assess the utility of 123-I Ioflupane SPECT (IS) in the identification of the origin of Parkinsonism (vascular or idiopathic) in patients with cerebral vasculopathy (CV) demonstrated by morphological imaging techniques. Also, to assess the therapeutic impact.


METHODS
42 patients (16 males and 26 females) with a Parkinsonian syndrome were studied. Average age was 78.7 years (50-88). A dose of 185 MBq of 123 I-Ioflupane was injected in all subjects. SPECT imaging was obtained 5 hours later. All patients had a CT and/or MRI. The final diagnoses, after a minimal follow-up of 12 months, was established by a neurologist expert in movement disorders, based on clinical and imaging features and response to treatment.


RESULTS
14 patients were diagnosed of functional vascular Parkinsonism by alteration of association pathways, 3 of structural vascular Parkinsonism (SVP) with anatomical and functional vascular lesion in striatum, 14 of Parkinson's disease (PD) with CV, 2 of mixed Parkinsonism (PD + SVP) and 9 with others diagnoses different to the previous. The result of IS changed the treatment in 7/42 patients.


CONCLUSIONS
The IS can have a complementary role to clarify the etiology of Parkinsonism in patients with cerebral vasculopathy. Interpretation of functional and anatomical images within the clinical context of each patient is necessary.
García Vicente
A M
AM
Servicio de Medicina Nuclear, Complejo Hospitalario de Ciudad Real. amgarcia@sescam.jccm.es
Vaamonde Cano
J
J
Soriano Castrejón
A
A
Martínez Delgado
C
C
Talavera Rubio
P
P
Poblete García
V M
VM
Ruiz Solís
S
S
Rodado Marina
S
S
Cortés Romera
M
M
D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000627:therapeutic use; D019090:Case Management; D002561:Cerebrovascular Disorders / Q000150:complications / Q000000981:diagnostic imaging*; D003342:Corpus Striatum / Q000098:blood supply / Q000000981:diagnostic imaging; D015140:Dementia, Vascular / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D050483:Dopamine Plasma Membrane Transport Proteins / Q000032:analysis; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D020734:Parkinsonian Disorders / Q000139:chemically induced / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D017729:Presynaptic Terminals / Q000000981:diagnostic imaging; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon; D014326:Tropanes
D000978:Antiparkinson Agents; D050483:Dopamine Plasma Membrane Transport Proteins; D019275:Radiopharmaceuticals; D014326:Tropanes; C087552:2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane; D007980:Levodopa