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Dopaminergic deficit is not the rule in orthostatic tremor |
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| Authors: | Jean‐Marc Trocello MD Paolo Zanotti‐Fregonara MD Emmanuel Roze MD PhD Emmanuelle Apartis MD PhD André‐Pierre Legrand PhD Marie‐Odile Habert MD Jean‐Yves Devaux MD PhD Marie Vidailhet MD |
| Institution: | 1. Department of Neurology, Lariboisière Hospital, AP‐HP, Paris, France;2. INSERM U732, Pierre et Marie Curie‐Paris 6 University, Paris, France;3. DSV/I2BM/SHFJ/LIME, CEA, Orsay, France;4. Department of Neurology, Salpêtrière Hospital, AP‐HP, Paris, France;5. CNRS UMR 7102, Pierre et Marie Curie‐Paris 6 University, Paris, France;6. Department of Physiology, Saint‐Antoine Hospital, AP‐HP, Paris, France;7. Quantum Physics Laboratory, ESPCI, Paris, France;8. Department of Nuclear Medicine, CHU Pitié‐Salpêtrière, AP‐HP, Université Pierre et Marie Curie‐Paris 6, INSERM U678, Paris, France;9. Department of Nuclear Medicine, Saint‐Antoine Hospital, AP‐HP, Paris, France;10. INSERM U679, Pierre et Marie Curie‐Paris 6 University, Paris, France |
| Abstract: | Involvement of the dopaminergic system in orthostatic tremor is controversial. The aim of this study was to detect possible dopaminergic denervation in primary orthostatic tremor (OT). Twelve consecutive patients with a firm diagnosis of primary orthostatic tremor were compared with age‐matched normal controls. All the patients had a neurological examination, surface polymyography, and quantification of striatal dopamine transporters with 123I‐FP‐CIT SPECT imaging. There was no significant difference in 123I‐FP‐CIT SPECT findings between controls and patients with OT. Longstanding primary orthostatic tremor is not necessarily associated with 123I‐FP‐CIT SPECT abnormalities, as 8 of our patients had more than a 10‐year history of OT. Primary orthostatic tremor without dopaminergic denervation remains a valid entity, although representing only a subtype of high‐frequency OT. A new role may emerge for 123I‐FP‐CIT SPECT in distinguishing between patients whose symptoms will be restricted to OT throughout the disease course and patients at an increased risk of developing PD. © 2008 Movement Disorder Society |
| Keywords: | orthostatic tremor Parkinson's disease SPECT prognosis neurophysiology pathophysiology |