The symptoms asymmetry of drug-induced parkinsonism is not related to nigrostriatal cell degeneration: a SPECT-DaTSCAN study

Drug-induced parkinsonism (DIP) is the most common form of parkinsonism after Parkinson's disease (PD) itself. It has been widely believed that DIP is characterised by symmetry of symptoms. Studies of patients with DIP in whom PD had been ruled out by SPECT-DaTSCAN have shown that symptom asymm...

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Published in:Neurologia i neurochirurgia polska 2019-01, Vol.53 (4), p.311-314
Main Authors: Gajos, Agata, Dąbrowski, Janusz, Bieńkiewicz, Małgorzata, Płachcińska, Anna, Kuśmierek, Jacek, Bogucki, Andrzej
Format: Article
Language:English
Subjects:
Asymmetry
Brain diseases
Disease
Dopamine
Drugs
Dyskinesia
Neurodegeneration
Neurological disorders
Nuclear medicine
Older people
Patients
Symmetry
Values
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Summary:Drug-induced parkinsonism (DIP) is the most common form of parkinsonism after Parkinson's disease (PD) itself. It has been widely believed that DIP is characterised by symmetry of symptoms. Studies of patients with DIP in whom PD had been ruled out by SPECT-DaTSCAN have shown that symptom asymmetry is a common element of DIP clinical presentation. The aim of our study was to determine whether the asymmetry of symptoms in DIP is related to any abnormality within the presynaptic part of the nigrostriatal dopaminergic system. Eleven patients with the diagnosis of DIP and asymmetric symptoms were studied. Their individual SPECT-DaTSCANs were normal. Indices calculated for the whole group of radiotracer uptake in the whole striatum, putamen and caudate contralateral to more severe DIP symptoms were compared to values obtained in the opposite hemisphere. We did not find significant differences in radiotracer uptake in structures contralateral to more severe clinical symptoms when compared to the homolateral hemisphere. Our results have not confirmed the presence of a presynaptic nigrostriatal deficit which could be related to asymmetry of DIP. The factors responsible for the asymmetry of DIP symptoms should be sought in the postsynaptic part of the nigrostriatal dopaminergic system.
ISSN:0028-3843
1897-4260
DOI:10.5603/PJNNS.A2019.0031