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. MATERIALS AND 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. CONCLUSION: 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.
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. MATERIALS AND 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. CONCLUSION: 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.
Authors: Marina Garriga; Marta Milà; Manzoor Mir; Raid Al-Baradie; Sonia Huertas; Cesar Castejon; Laura Casas; Dolors Badenes; Nuria Giménez; M Angels Font; Jose M Gonzalez; Maria Ysamat; Miguel Aguilar; Mark Slevin; Jerzy Krupinski Journal: Front Syst Neurosci Date: 2015-07-01