Heterogeneity of Monosymptomatic Resting Tremor in a Prospective Study： Clinical Features, Electrophysiological Test, and Dopamine Transporter Positron Emission Tomography  

作　　者：Hua-Guang Zheng Rong Zhang Xin Li Fang-Fei Li Ya-Chen Wang Xue-Mei Wang Ling-Long Lu Tao Feng 

机构地区：[1]Clinical Trial and Clinical Research Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China [2]China National Clinical Research Center for Neurological Diseases, Beijing 100050, China [3]Department of Neurology, Zhang Jiagang City Hospital of Chinese Traditional Medicine, Zhangjiagang, Jiangsu 215600, China [4]Center of Neurodegenerative Disease, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China [5]Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116021, China [6]Parkinson's Disease Center, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100069, China

出　　处：《Chinese Medical Journal》2015年第13期1765-1771,共7页中华医学杂志（英文版）

摘　　要：Background： The relationship between monosymptomatic resting tremor （mRT） and Parkinson＇s disease （PD） Iemains controversial. In this study, we aimed to assess tile function ofpresynaptic dopaminergic neurons in patients with mRT by dopamine transporter positron emission tomography （DAT-PET） and to evaluate the utility of clinical features or electrophysioIogical studies in differential diagnosis. Methods： Thirty-three consecutive patients with toRT were enrolled prospectively. The Unified Parkinson＇s Disease Rating Scale and electromyography were tested before DAT-PET. Striatal asymmetry index （SAI） was calculated, and a normal DATPET was defined as a SAI of 〈15%. Scans without evidence of dopaminergic deficits （SWEDDs） were diagnosed in patients with a subsequent normal DAT-PET and structural magnetic resonance imaging. Results： Twenty-eight toRT patients with a significant reduction in uptake of DAT binding in the striatum were diagnosed with PD, while the remained 5 with a normal DAT-PET scan were SWEDDs. As for UPRDS, the dressing and hygiene score, walking m motor experiences of daily living （Part I1） and motor examination （Part Ill ） were significant different between two groups （P 〈 0.05 and P 〈 0.01, respectively）. Bilateral tremor was more frequent in the SWEDDs group （P 〈 0.05）. The frequency of resting tremor and the amplitude ofpostural tremor tend to be higher in the SWEDDs group （P = 0.08 and P= 0.05, respectively）. Conclusions： mRT is heterogeneous in presynaptic nigrostriatal dopaminergic degeneration, which can be determined by DAT-PET brain imaging. Clinical and electrophysiological features may provide clues to distinguish PD from SWEDDs.Background： The relationship between monosymptomatic resting tremor （mRT） and Parkinson＇s disease （PD） Iemains controversial. In this study, we aimed to assess tile function ofpresynaptic dopaminergic neurons in patients with mRT by dopamine transporter positron emission tomography （DAT-PET） and to evaluate the utility of clinical features or electrophysioIogical studies in differential diagnosis. Methods： Thirty-three consecutive patients with toRT were enrolled prospectively. The Unified Parkinson＇s Disease Rating Scale and electromyography were tested before DAT-PET. Striatal asymmetry index （SAI） was calculated, and a normal DATPET was defined as a SAI of 〈15%. Scans without evidence of dopaminergic deficits （SWEDDs） were diagnosed in patients with a subsequent normal DAT-PET and structural magnetic resonance imaging. Results： Twenty-eight toRT patients with a significant reduction in uptake of DAT binding in the striatum were diagnosed with PD, while the remained 5 with a normal DAT-PET scan were SWEDDs. As for UPRDS, the dressing and hygiene score, walking m motor experiences of daily living （Part I1） and motor examination （Part Ill ） were significant different between two groups （P 〈 0.05 and P 〈 0.01, respectively）. Bilateral tremor was more frequent in the SWEDDs group （P 〈 0.05）. The frequency of resting tremor and the amplitude ofpostural tremor tend to be higher in the SWEDDs group （P = 0.08 and P= 0.05, respectively）. Conclusions： mRT is heterogeneous in presynaptic nigrostriatal dopaminergic degeneration, which can be determined by DAT-PET brain imaging. Clinical and electrophysiological features may provide clues to distinguish PD from SWEDDs.

关 键 词：Dopamine Transporter Positron Emission Tomography HETEROGENEITY Monosymptomatic Resting Tremor Parkinson＇s Disease： Scans Without Evidence of Dopaminergic Deficit 

分 类 号：Q813.11[生物学—生物工程] TL411.4[核科学技术—核技术及应用]