Clinical Significance of 123I-IPT SPECT for the Diagnosis of the Parkinson's Disease.

Chun, Hyoung Joon; Kim, Young Soo; Yi, Hyeong Joong; Ko, Yong; Oh, Seong Hoon; Choi, Yun Young

Original Article

Journal of Korean Neurosurgical Society 2003;34(2): 104-109.

Hyoung Joon Chun, Young Soo Kim, Hyeong Joong Yi, Yong Ko, Seong Hoon Oh, Yun Young Choi

¹Department of Neurosurgery, School of Medicine, Hanyang University, Seoul, Korea. ksy84982hanyang.ac.kr
²Department of Nuclear Medicine, School of Medicine, Hanyang University, Seoul, Korea.

ABSTRACT

OBJECTIVE
N-(3-iodopropene-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl)tropane(IPT) is a cocaine analogue which allows the presynaptic dopamine transporters. The aim of this study is to assess the imaging of dopamine transporters using 123I-IPT SPECT and its correlation with several clinical features of Parkinson's disease and Parkinson Plus syndrome. METHODS: Forty-two patients with Parkinson's disease(14 bilateral, 28 unilateral clinical features), three Parkinson Plus syndrome and five normal controls were studied. All patients with Parkinson's disease were evaluated with Hoehn-Yahr scale, UPDRS(on/off stage), duration, main symptoms(rigidity, tremor, bradykinesia), unilaterality and operation. The two statistical parameters were assessed with 123I-IPT SPECT. One is uptake ratio of basal ganglia and occipital cortex, basal ganglia and cerebellum. The other is three graded visual assessment.
RESULTS
The uptake ratio of 123I-IPT SPECT in patients with Parkinson's disease were decreased with higher grade of Hoehn-Yahr scale, and more decreased in 2 hours than in 1 hour. But there was no statistical significance. The visual assessment was significantly correlated with Hoehn-Yahr scale(p<0.045). The early differential diagnosis between Parkinson's disease and Parkinson Plus syndrome could be allowed with visual assessment. But other clinical features of Parkinson's disease was not correlated with finding of 123I-IPT SPECT.
CONCLUSION
The visual assessment of 123I-IPT SPECT imaging is useful in the early differential diagnosis and in confirming a clinical severity of Parkinson's disease.