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Abnormal dopamine transporter imaging in pure autonomic failure: a potential biomarker of central nervous system involvement.
Alnasser Alsukhni, Rana; Vichayanrat, Ekawat; Koay, Shiwen; Davis, Laura May; Ingle, Gordon; McNamara, Patricia; Panicker, Jalesh N; Bhatia, Kailash P; Mathias, Christopher; Bomanji, Jamshed; Iodice, Valeria.
Afiliación
  • Alnasser Alsukhni R; Autonomic Unit, National Hospital for Neurology and Neurosurgery, London, UK.
  • Vichayanrat E; Autonomic Unit, National Hospital for Neurology and Neurosurgery, London, UK.
  • Koay S; Autonomic Unit, National Hospital for Neurology and Neurosurgery, London, UK.
  • Davis LM; Institute of Nuclear Medicine, UCLH NHS Foundation Trust, London, UK.
  • Ingle G; Autonomic Unit, National Hospital for Neurology and Neurosurgery, London, UK.
  • McNamara P; Autonomic Unit, National Hospital for Neurology and Neurosurgery, London, UK.
  • Panicker JN; UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.
  • Bhatia KP; Department of Uro-Neurology, National Hospital for Neurology and Neurosurgery, London, UK.
  • Mathias C; Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, UK.
  • Bomanji J; UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.
  • Iodice V; Institute of Nuclear Medicine, UCLH NHS Foundation Trust, London, UK.
Eur J Neurol ; 31(3): e16169, 2024 Mar.
Article en En | MEDLINE | ID: mdl-38085264
BACKGROUND AND PURPOSE: Pure autonomic failure (PAF) is a rare progressive neurodegenerative disease characterized by neurogenic orthostatic hypotension at presentation, without other neurological abnormalities. Some patients may develop other central neurological features indicative of multiple system atrophy or a Lewy body disorder. There are currently no biomarkers to assess possible central nervous system involvement in probable PAF at an early stage. A possibility is to evaluate the nigrostriatal dopaminergic degeneration by imaging of dopamine transporter with DaTscan brain imaging. The objective was to evaluate subclinical central nervous system involvement using DaTscan in PAF. METHODS: We retreospectively reviewed pure autonomic failure patients who were evaluated at the Autonomic Unit between January 2015 and August 2021 and underwent comprehensive autonomic assessment, neurological examination, brain magnetic resonance imaging and DaTscan imaging. DaTscan imaging was performed if patients presented with atypical features which did not meet the criteria for Parkinson's disease or multiple system atrophy or other atypical parkinsonism. RESULTS: In this cohort, the median age was 49.5 years at disease onset, 57.5 years at presentation, and the median disease duration was 7.5 years. Five of 10 patients had an abnormal DaTscan without neurological features meeting the criteria of an alternative diagnosis. Patients with abnormal DaTscan were predominantly males, had shorter disease duration and had more severe genitourinary symptoms. DISCUSSION: Degeneration of nigrostriatal dopaminergic neurons measured using DaTscan imaging can present in patients with PAF without concurrent signs indicating progression to widespread α-synucleinopathy. It is advocated that DaTscan imaging should be considered as part of the workup of patients with emerging autonomic failure who are considered to have PAF.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades del Sistema Nervioso Autónomo / Atrofia de Múltiples Sistemas / Insuficiencia Autonómica Pura Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Neurol Asunto de la revista: NEUROLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades del Sistema Nervioso Autónomo / Atrofia de Múltiples Sistemas / Insuficiencia Autonómica Pura Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Neurol Asunto de la revista: NEUROLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido