Objective: To investigate the role of dopamine denervation in the globus pallidus in PD patients with postural and kinetic tremor (PT/KT) in Parkinson’s disease(PD) using [18F]FP-CIT PET (ligand for DAT).

Background: Patients with PD may present with postural and kinetic tremor, the phenotype of which is indistinguishable from essential tremor. It has been suggested that Parkinsonian tremor results from the combined actions of the basal ganglia and the cerebello-thalamo-cortical circuit (Dimmer-Switch Model).

Method: We studied 15 PD patients with PT/KT(PD-PT/KT, age= 61.1±10.0 years, mean±SD) and 12 PD patients without tremor(PD-NT, age= 62.1±9.7). Severity of Parkinsonism and tremor were assessed using UPDRS III at med-off and med-on states. All subjects underwent [18F]FP-CIT PET after clinical assessment. The binding ratios of the ligand were obtained in the caudate, the putamen and the globus pallidus(GP) using the occipital cortex as reference. Twelve healthy control subjects were used for comparison(HC, age=62.2±5.3).

Results: Disease duration were 8.73±4.86 year in PD-PT/KT and 7.58±1.68 in PD-NT (p=0.442); UPDRS III scores were 49.8±19.9 and 44.667±11.6 in each group respectively(p=0.437). Tremor subscores were 5.00±2.00 in limb with more tremor and 2.14±2.07 in limb with less tremor(p=0.006). [18F]FP-CIT binding in the globus pallidus was significantly lower in PD-PT/KT than PD-NT (p=0.017). In PD-PT/KT group, bilateral comparisons of the [18F]FP-CIT binding between the two globus pallidus, each corresponding to the limbs with more PT/KT and less PT/KT showed significant differences between the two sides – lower in the globus pallidus corresponding to the limb with more PT/KT (p=0.003).

Conclusion: Our data indicate that pallidal dopaminergic denervation is associated with the manifestation of PT/KT in PD patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/postural-and-kinetic-tremor-is-associated-with-pallidal-dopamine-denervation-in-patients-with-parkinsons-disease/