Session Time: 1:45pm-3:15pm
Location: Agora 2 West, Level 2
Objective: We discontinued offending medications in DIP or unmasked parkinsonism patients and delayed taking DAT images for one month.
Background: Drug induced parkinsonism (DIP) may develop in individuals treated with dopamine receptor blocking agents. Dopamine transporter (DAT) images are considered a tool to distinguish pure DIP and unmasked Parkinson’s disease (PD) and tended to apply early in distinguishing DIP from parkinsonism. However, DIP symptoms usually recover in up to 70% of patients within a few months after medication withdrawal.
Method: We enrolled parkinsonism patients who were taking offending medication in their first outpatient clinics and we withdrew their offending medications. We examined their Unified Parkinson Disease Rating Scale (UPDRS) in their first visit, 1-month follow-up visits and 6-month follow-up visits. We performed DAT images only patients with parkinsonism in the one-month follow-up visit. We tried to examine the value of DAT images in differentiation between DIP and unmasked PD.
Results: Totally 135 parkinsonism patients were taking offending medications. In the 1-month, 85 patients were followed and 68 patients were finished all visits (M:F = 16:52, Age = 72.5 ± 8.6, baseline UPDRS 29.1 ± 14.1). Parkinsonism was showed in 61 of 85 (72%) patients in the one-month visits and 21 of 68 (31%) in the 6-month visits, respectively. In the 1-month visits, 50 of 61 patients who had parkinsonism agreed to taking DAT images, and 36 of 50 (70%) showed normal findings and 14 patients (30%) showed decreased uptake. 12 of 14 patients who had decreased DAT uptake were followed-up in the six-month visits and all of them showed parkinsonism (UPDRS 17.8 ± 10.1). Among 54 patients who had normal DAT findings, 4 patients still had parkinsonism: diffuse white matter changes in one patient, and still taking levosulpride in one patient. Although two patients had normal DAT images, however they still showed parkinsonism in the 6-month visits and response to levodopa.
Conclusion: Our findings suggest that we need to delay taking DAT images in DIP patients. With clinical observation after medication withdrawal, we can reduce unnecessary test in patients.
To cite this abstract in AMA style:JY. Yun, CY. Lee, MY. Chun, B. Jeon. Waiting and waiting on Dopamine transporter imaging in drug induced parkinsonism [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/waiting-and-waiting-on-dopamine-transporter-imaging-in-drug-induced-parkinsonism/. Accessed December 5, 2023.
« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/waiting-and-waiting-on-dopamine-transporter-imaging-in-drug-induced-parkinsonism/