Clinical features and nigrostriatal dysfunction in patients with combined postural and resting tremors

Sooyeoun You, Mi Jung Kim, Sung Reul Kim, Mi Jung Kim, Minyoung Oh, Jae Seung Kim, Sun Ju Chung

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Background: The characteristics of clinical features and nigrostriatal dopaminergic dysfunction in patients with combined postural and resting tremors have been less clearly reported. Methods: The present study examined 43 patients with a visible persistent bilateral postural tremor and a unilateral/bilateral resting tremor involving the hands and forearms. The patients had experienced tremors for more than 3 years, with no evidence of Parkinson's disease or other parkinsonian disorders. Visual and quantitative analyses of [18F] N-(3-fluoropropyl)-2beta-carbon ethoxy-3beta-(4-iodophenyl) nortropane (FP-CIT) PET in 36 patients were performed. Seventeen age-matched normal controls were also studied. Results: On visual analysis, 28 patients (78%) showed normal [18F] FP-CIT uptake and eight (22%) showed significantly reduced uptake, suggesting nigrostriatal dopaminergic neuronal degeneration. The reduced [18F] FP-CIT uptake was significantly associated with earlier age-at-onset of tremor and asymmetric presentation of resting tremor. On quantitative analysis, there were statistically significant differences in the [18F] FP-CIT uptake ratio in the posterior putamen between patients with reduced uptake (2.37±1.83) and patients with normal uptake (6.39±1.35) (P<0.001). However, posterior putamen uptake levels in patients with normal [18F] FP-CIT uptake on visual analysis were similar to those in normal controls (7.22±1.29) (P=0.291). Conclusion: The nigrostriatal dopaminergic dysfunction in patients with combined postural and resting tremors may be associated with earlier age-at-onset of tremor and asymmetric pattern of resting tremor, which might help to correctly diagnose patients with mixed tremors.

Original languageEnglish
Pages (from-to)1118-1122
Number of pages5
JournalParkinsonism and Related Disorders
Volume19
Issue number12
DOIs
Publication statusPublished - 2013 Dec
Externally publishedYes

Keywords

  • Essential tremor
  • Parkinson's disease
  • Postural tremor
  • Resting tremor
  • [F] FP-CIT PET

ASJC Scopus subject areas

  • Neurology
  • Geriatrics and Gerontology
  • Clinical Neurology

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