title: Decreased dopamine transporter and receptor ligand binding in Parkinsonism with diabetic uremic syndrome.
abstract: Here, we describe the case of a 47-year-old man with bilateral striatal lesions with diabetic uremia. Following 4 years of hemodialysis, the patient experienced sudden onset of rigidity, bradykinesia, gait disorder, and postural instability. Symptoms were remediated 2 months later, and were no longer responsive to levodopa approximately 1 year after the onset. Brain magnetic resonance imaging (MRI) during the acute phase showed T 2-weighted high signal edematous lesions in the bilateral striatum, subsequently developing into vacuolated lesions. A positron emission tomography (PET) scan using ((11)C)-labeled 2-carbomethoxy-3-(4-fluorophenyl) tropane [((11)C) CFT] and ((11)C)-labeled raclopride [((11)C) RAC] revealed significant decreases bilaterally in pre- and postsynaptic functions of the dopaminergic neurons. When we experience a case with bilateral putaminal destruction resulting in Parkinsonism, examination of the function of doperminergic neurons and dopamine receptors using molecular imaging is useful to predict levodopa response and prognosis.
authors.affiliation: Department of Neurology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1,Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan. kazishii@md.tsukuba.ac.jp.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ishii
authors.affiliation: Positron Medical Center, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakaecho Itabashi-ku, Tokyo, 173-0015, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Ishii
authors.affiliation: Department of Neurology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1,Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Shioya
authors.affiliation: Department of Psychiatry, Institute of Clinical Medicine, University of Tsukuba, 1-1-1,Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Nemoto
authors.affiliation: Department of Neurology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1,Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Tamaoka
mesh_terms: D000328:Adult; D048909:Diabetes Complications / Q000150:complications* / Q000378:metabolism; D050483:Dopamine Plasma Membrane Transport Proteins / Q000378:metabolism*; D006801:Humans; D008024:Ligands; D008297:Male; D057054:Molecular Imaging; D020734:Parkinsonian Disorders / Q000150:complications* / Q000000981:diagnostic imaging / Q000378:metabolism*; D011485:Protein Binding; D011954:Receptors, Dopamine / Q000378:metabolism*; D014511:Uremia / Q000150:complications* / Q000378:metabolism
chemical_list: D050483:Dopamine Plasma Membrane Transport Proteins; D008024:Ligands; D011954:Receptors, Dopamine
keywords: Diabetic uremic syndrome; Osmotic demyelination syndrome; Positron emission tomography; Striatum