Session Information
Date: Wednesday, June 22, 2016
Session Title: Parkinson's disease: Neuroimaging and neurophysiology
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To describe the diagnostic reliability of the triad of clinical symptoms compared to the uptake of 18 F-DOPA PET-CT fusion MRI scan. To compare the match between the visual and quantitative interpretation of the 18 F-DOPA uptake in putamen and caudate.
Background: The differential diagnosis of Parkinson’s disease in cases of incomplete manifestation of the triad of bradykinesia (B), rigidity (R) and tremor (T) includes essential/dystonic tremor and parkinsonism unrelated to striatal dopaminergic deficiency.
Methods: Patients who presented incomplete/atypical presentation of the clinical triad (2/2 or 3/3 and/or unresponsive to dopaminergic therapy) underwent 18F -DOPA PET-CT fusion MRI scan. Neurologists examined the patients and ranked the clinical suspicion, masked to the 18F-DOPA PET-CT results.
Results: There were 14 patients, mean age= 62 ys old (41–79); male/female=9/5; mean symptoms duration=3.6 y (1–10), clinical triad: TR=3, TBR=9, BR=1, TB=1. Out of 14 patients with clinical suspicion of parkinsonism, 6 had dopaminergic deficit in 18F-DOPA PET-CT (42.86%). 2/2 clinical symptons were not associated with low putaminal uptake, as opposed to 3/3 symptoms in which 6/9 patients presented reduced putaminal uptake (67%). The correlation between low 18F-DOPA putaminal uptake and higher UPDRS scores was stronger than in caudate (p=0.05). Higher UPDRS scores were associated with reduced putaminal uptake in correlation coefficients (-0.63 (right), -0.73 (left)). There was no association in caudate (-0.27 (right) -0.50 (left)). In the visual analysis, 8 patients had low putaminal uptake and 7 were confirmed by the quantitative analysis, while 6 had normal uptake confirmed by quantitative analysis (13/14 correctly diagnosed).
Conclusions: This exploratory analysis showed that 2/2 symptoms were not associated with a decrease in putaminal uptake, while 3/3 symptoms showed low putaminal uptake in 67% of cases. Higher UPDRS scores were more frequently associated with a decrease in putaminal uptake. Accuracy for detection of 18F-DOPA uptake was similar for visual and quantitative analysis.
To cite this abstract in AMA style:
C. Peralta, T. Soto Depetris, A. Perez, F. Biafore, J. Gili, A. Valda, D. Menna, M. Aguilar, H. Corradini, M. Bastianello. Diagnostic reliability of clinical symptoms in patients with incomplete manifestation of the triad of parkinsonism compared to 18F-DOPA PET-CT MRI imaging [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/diagnostic-reliability-of-clinical-symptoms-in-patients-with-incomplete-manifestation-of-the-triad-of-parkinsonism-compared-to-18f-dopa-pet-ct-mri-imaging/. Accessed December 9, 2024.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/diagnostic-reliability-of-clinical-symptoms-in-patients-with-incomplete-manifestation-of-the-triad-of-parkinsonism-compared-to-18f-dopa-pet-ct-mri-imaging/