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NEUROLOGY 1992;42:556
© 1992 American Academy of Neurology

123I-iodobenzamide-SPECT predicts dopaminergic responsiveness in patients with de novo parkinsonism

J. Schwarz, MD, K. Tatsch, MD, G. Arnold, MD, T. Gasser, MD, C. Trenkwalder, MD, C. M. Kirsch, MD and W. H. Oertel, MD

Department of Neurology, Klinikum Grosshadern, Ludwig-Maximilians-University, Munich, Germany (Drs. Schwarz, Arnold, Gasser, Trenkwalder, and Oertel)
Division of Nuclear Medicine, Department of Radiology, Klinikum Grosshadern, Ludwig-Maximilians-University, Munich, Germany (Drs. Tatsch and Kirsch).

We used 123I-iodobenzamide-single photon emission computed tomography (IBZM-SPECT) in a prospective study to investigate 38 patients with parkinsonism (Hoehn and Yahr stage I to III) not previously treated with dopamimetic drugs. Thirty-four patients only showed symptoms of Parkinson's disease, and four patients showed, in addition, subtle clinical signs of progressive supranuclear palsy or multisystem atrophy. IBZM is a dopamine D2 receptor antagonist detectable by SPECT. We compared IBZM-SPECT results with clinical response to subcutaneous injections of the D1/D2 dopamine receptor agonist apomorphine (38 patients) and long-term dopamimetic therapy (31 patients). IBZM-SPECT results predicted a positive or negative response to apomorphine in 30 of 34 patients (apomorphine response in four patients was equivocal) and response to dopamimetic therapy in 27 of 31 patients. Thus, imaging of dopamine D2 receptors using readily available IBZM-SPECT seems to distinguish between L-dopa-responsive (most likely Parkinson's disease of Lewy body type) and L-dopa-unresponsive parkinsonism in patients not previously treated with dopamimetic drugs.

Address correspondence and reprint requests to Dr. Johannes Schwarz, Department of Neurology, Klinikum Großhadern, Ludwig-Maximilians-Universität München, Marchionini Str. 15, 8000 München 70, Germany.

Supported by the BMFT Research Program Munich "Parkinson's disease and other basal ganglia disorders" (BMFT 01KL9001).

Received June 4, 1991. Accepted for publication in final form August 9, 1991.




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