Longitudinal evaluation using FP-CIT in patients with parkinsonism

Abstract

Objective: To assess a group of patients with parkinsonism using serial studies with FP-CIT, basically the initial false negative results.

Methods: Restrospective study of 92 patients (55 men and 37 women) who had undergone 2 different FP-CIT studies because of discrepancies between study results and clinical progression. The mean elapsed time between the studies was 26 months (SD: 6). We performed a semi-quantitative study using the patient's clinical history and the available literature to analyse discrepant cases with a normal initial study and subsequent pathological findings.

Results: A total of 184 studies were completed for 92 patients; 11 of those 92 showed discrepancies between initial and subsequent studies. Among the 11 discrepant cases, 7 showed a normal initial study and pathological findings at a later date. Analysis of the predominant clinical features that might explain this behaviour revealed that 4 of these 7 subjects presented tremor-dominant parkinsonism. Regarding the rest, 1 presented early stage parkinsonism and was treated with antidopaminergic agents; 1 was classified as probable multisystem atrophy type C, and the third showed clinical signs of atypical parkinsonism without any causes of those signs being identified.

Conclusions: Serial FP-CIT studies are unnecessary in the large majority of cases, but they may be justifiable in certain clinical situations.

Keywords: Dopamine transporters; False negatives; Falsos negativos; I123-Ioflupane; I123-Ioflupano; Parkinsonism; Parkinsonismo; Transportadores de dopamina.