Abstract
Background: The characteristics of clinical features and nigrostriatal dopaminergic dysfunction in patients with combined postural and resting tremors have been less clearly reported. Methods: The present study examined 43 patients with a visible persistent bilateral postural tremor and a unilateral/bilateral resting tremor involving the hands and forearms. The patients had experienced tremors for more than 3 years, with no evidence of Parkinson's disease or other parkinsonian disorders. Visual and quantitative analyses of [18F] N-(3-fluoropropyl)-2beta-carbon ethoxy-3beta-(4-iodophenyl) nortropane (FP-CIT) PET in 36 patients were performed. Seventeen age-matched normal controls were also studied. Results: On visual analysis, 28 patients (78%) showed normal [18F] FP-CIT uptake and eight (22%) showed significantly reduced uptake, suggesting nigrostriatal dopaminergic neuronal degeneration. The reduced [18F] FP-CIT uptake was significantly associated with earlier age-at-onset of tremor and asymmetric presentation of resting tremor. On quantitative analysis, there were statistically significant differences in the [18F] FP-CIT uptake ratio in the posterior putamen between patients with reduced uptake (2.37±1.83) and patients with normal uptake (6.39±1.35) (P<0.001). However, posterior putamen uptake levels in patients with normal [18F] FP-CIT uptake on visual analysis were similar to those in normal controls (7.22±1.29) (P=0.291). Conclusion: The nigrostriatal dopaminergic dysfunction in patients with combined postural and resting tremors may be associated with earlier age-at-onset of tremor and asymmetric pattern of resting tremor, which might help to correctly diagnose patients with mixed tremors.
Original language | English |
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Pages (from-to) | 1118-1122 |
Number of pages | 5 |
Journal | Parkinsonism and Related Disorders |
Volume | 19 |
Issue number | 12 |
DOIs | |
Publication status | Published - 2013 Dec |
Externally published | Yes |
Bibliographical note
Funding Information:This study was supported by a grant (2011-0416) from the Asan Institute for Life Sciences , Seoul, Korea.
Keywords
- Essential tremor
- Parkinson's disease
- Postural tremor
- Resting tremor
- [F] FP-CIT PET
ASJC Scopus subject areas
- Neurology
- Geriatrics and Gerontology
- Clinical Neurology