123I-IBZM binding compared with long-term clinical follow up in patients with de novo parkinsonism.

Abstract

We performed a prospective clinical follow up (mean follow up, 36 months; range, 24-56 months) of 65 patients with de novo parkinsonism in whom imaging of dopamine D2 receptors was performed before the initiation of dopaminomimetic therapy by means of 123I-iodobenzamide-single-photon-emission computed tomography (IBZM-SPECT). The results of IBZM-SPECT were compared with the long-term response to dopaminomimetic drugs, the development of motor fluctuations, and the development of clinical signs incompatible with Parkinson's disease (PD). A total of 55 patients had normal and 10 patients had reduced IBZM binding; 45 patients showed a good response to levodopa (L-dopa), 11 showed an equivocal response, and nine did not respond; 31 patients developed a fluctuating response to dopaminomimetic drugs and seven patients developed clinical signs indicative of multiple-system atrophy (n = 5), progressive supranuclear palsy (n = 1), or corticobasal ganglionic degeneration (n = 1). Chi-squared analysis showed a significant correlation of the results of IBZM-SPECT with the long-term response to dopaminomimetic therapy (p < 0.0001) and the development of motor fluctuations (p < 0.001) or clinical signs incompatible with PD (p < 0.0001). We conclude that IBZM-SPECT can help to differentiate between patients who will show a good response to L-dopa and will develop motor fluctuations (most likely patients with PD) and those patients who will not respond to L-dopa and might develop clinical signs compatible with another hypokinetic disorder of the basal ganglia.

• Authors: J Schwarz, K Tatsch, T Gasser, G Arnold, O Pogarell, G Künig, W H Oertel
• Journal: Movement disorders : official journal of the Movement Disorder Society (Mov Disord) Vol. 13 Issue 1 Pg. 16-9 (Jan 1998) ISSN: 0885-3185 [Print] United States
• PMID: 9452320 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Benzamides
• Dopamine Agonists
• Iodine Radioisotopes
• Levodopa
• Apomorphine

Topics

• Adult
• Aged
• Aged, 80 and over
• Apomorphine
• Basal Ganglia Diseases (drug therapy, metabolism)
• Benzamides (metabolism)
• Chi-Square Distribution
• Disease Progression
• Dopamine Agonists (therapeutic use)
• Follow-Up Studies
• Humans
• Iodine Radioisotopes (metabolism)
• Levodopa (therapeutic use)
• Middle Aged
• Parkinson Disease (drug therapy, metabolism)
• Prognosis
• Prospective Studies
• Severity of Illness Index
• Tomography, Emission-Computed, Single-Photon
• Treatment Outcome