Degenerative parkinsonism in patients with psychogenic parkinsonism: A dopamine transporter imaging study.
OBJECTIVE
To evaluate patients with "clinically established" psychogenic parkinsonism (PsyP) using single-photon emission computer tomography (SPECT) with the technetium-99m labeled tracer TRODAT-1, a dopamine transporter (DAT) ligand, and investigate whether these patients have an underlying degenerative parkinsonism.


METHODS
Five patients with PsyP were assessed using demographic data, standard clinical scales for Parkinson's Disease (PD), and a neuropsychiatric interview. DAT imaging using SPECT with TRODAT-1 was performed, and values for caudate/putamen DAT binding potentials (BP) registered. Patients with PsyP were matched with PD (n=5) and healthy control subjects (n=5).


RESULTS
The mean age (years-old) at first evaluation in the PsyP group was 37.4+/-3.7, and the mean disease duration (years) was 3.9+/-1.2. DAT BPs (means+/-standard deviations) on right/left caudate were, respectively, 0.69+/-0.18 and 0.70+/-0.18 in the PD group versus 1.17+/-0.06 and 1.12+/-0.10 in the control group. DAT BPs on right/left putamen were, respectively, 0.48+/-0.10 and 0.45+/-0.06 in the PD group versus 1.10+/-0.10 and 1.21+/-0.43 in the control group. Two out of five patients from the PsyP group had values for DAT BP in the putamen under the cut-off (< or =0.70) for controls, implying pre-synaptic dopaminergic deficit.


CONCLUSIONS
Our data in this small group of patients suggest that DAT imaging is a tool that may help in the identification of underlying degenerative parkinsonism in PsyP.
Felicio
Andre C
AC
Movement Disorder Unit, Federal University of São Paulo, Sao Paulo, Brazil. cf.andre@gmail.com
Godeiro-Junior
Clecio
C
Moriyama
Tais S
TS
Shih
Ming C
MC
Hoexter
Marcelo Q
MQ
Borges
Vanderci
V
Silva
Sonia M A
SM
Aguiar
Patricia de Carvalho
Pde C
Andrade
Luiz A F
LA
Bressan
Rodrigo A
RA
Ferraz
Henrique B
HB
D000328:Adult; D002421:Caudate Nucleus / Q000000981:diagnostic imaging; D050483:Dopamine Plasma Membrane Transport Proteins / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D019636:Neurodegenerative Diseases / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D015609:Organotechnetium Compounds; D010300:Parkinson Disease / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D011699:Putamen / Q000000981:diagnostic imaging; D019275:Radiopharmaceuticals; D012959:Socioeconomic Factors; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D014326:Tropanes
D050483:Dopamine Plasma Membrane Transport Proteins; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D014326:Tropanes; C104196:technetium Tc 99m TRODAT-1