Clinical features and 123I-FP-CIT SPECT imaging in drug-induced parkinsonism and Parkinson's disease.
OBJECTIVE
To determine clinical predictors and accuracy of (123)I-FP-CIT SPECT imaging in the differentiation of drug-induced parkinsonism (DIP) and Parkinson's disease (PD).


METHODS
Several clinical features and (123)I-FP-CIT SPECT images in 32 patients with DIP, 25 patients with PD unmasked by antidopaminergic drugs (PDu) and 22 patients with PD without a previous history of antidopaminergic treatment (PDc) were retrospectively evaluated.


RESULTS
DIP and PD shared all clinical features except symmetry of parkinsonian signs which was more frequently observed in patients with DIP (46.9%) than in patients with PDu (16.0%, p<0.05) or PDc (4.5%, p<0.01). Qualitatively (123)I-FP-CIT SPECT images were normal in 29 patients with DIP (90.6%) and abnormal in all patients with PD, and this imaging technique showed high levels of accuracy.


CONCLUSIONS
DIP and PD are difficult to differentiate based on clinical signs. The precision of clinical diagnosis could be reliably enhanced by (123)I-FP-CIT SPECT imaging.
Unidad de Trastornos del Movimiento, Servicio de Neurología, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.
Francisco J
FJ
Diaz-Corrales
Salome
S
Sanz-Viedma
David
D
Garcia-Solis
Teresa
T
Escobar-Delgado
Pablo
P
Mir
D000368:Aged; D015331:Cohort Studies; D003937:Diagnosis, Differential; D050483:Dopamine Plasma Membrane Transport Proteins / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000378:metabolism; D020734:Parkinsonian Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000378:metabolism; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon; D014326:Tropanes / Q000378:metabolism
D050483:Dopamine Plasma Membrane Transport Proteins; D014326:Tropanes; C087552:2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane