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Hemi-parkinsonism in multiple system atrophy: a PET and MRI study
A Kume1, M Shiratori, A Takahashi
1Department of Neurology, Nagoya University School of Medicine, Japan.
Journal of the Neurological Sciences
|July 1, 1992
Summary
Magnetic resonance imaging and PET/FDG scans reveal asymmetric nigrostriatal lesions in multiple system atrophy (MSA) patients with hemi-parkinsonism, aiding diagnosis.
Area of Science:
- Neuroimaging
- Neurology
Background:
- Multiple system atrophy (MSA) is a progressive neurodegenerative disorder.
- Hemi-parkinsonism is a clinical presentation characterized by parkinsonian symptoms predominantly on one side of the body.
Observation:
- This study investigated nigrostriatal lesions in 6 patients with probable MSA presenting with hemi-parkinsonism using MRI and PET/FDG.
- T2-weighted MRI showed decreased signal intensity in the putamen, more pronounced contralaterally in 5 patients.
- T1-weighted MRI revealed contralateral putamen atrophy, suggesting greater neuronal loss and iron deposition on that side.
Findings:
- Asymmetric nigrostriatal lesions were observed, correlating with the clinical hemi-parkinsonism presentation.
- Reduced 18F-labeled 2-deoxy-2-fluoro-D-glucose (FDG) uptake was noted in the contralateral putamen in 5 patients, indicating metabolic changes.
- These findings align with previous descriptions of nigrostriatal lesions in MSA.
Implications:
- MRI and PET/FDG are valuable tools for diagnosing MSA when patients present solely with hemi-parkinsonism.
- The study highlights the utility of neuroimaging in detecting asymmetric pathological changes in the nigrostriatal system related to clinical manifestations.
- Understanding these asymmetric lesions can improve diagnostic accuracy and potentially guide future therapeutic strategies for MSA.