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Image Acquisition Protocols
Published in Michael Ljungberg, Handbook of Nuclear Medicine and Molecular Imaging for Physicists, 2022
A clinical example that requires SPECT imaging is dopamine imaging, used to aid in the diagnosis of Parkinson’s disease. [123I]N-ω-fluoropropyl-2β-carbomethoxy-3β(4-iodophenyl)nortropane (123I-FP-CIT), is a radiopharmaceutical derived from cocaine and which binds to dopamine transporters (DaT) within the striatum [6]. A SPECT scan allows for visualization of the dopamine transporter function in the caudate and putamen. The main use of DaT scanning is in patients with a movement disorder to help differentiate essential tremors from tremor due to Parkinson’s disease. A patient with an essential tremor will demonstrate high symmetric uptake in both caudate and putamen regions. A patient with Parkinson’s disease will demonstrate reduced putamen activity and asymmetric caudate activity. An illustration of the relevant brain and striatum anatomy is given in Figure 15.21a, normal and abnormal uptake distributions are shown in Figures 15.21b and c.
Degenerative Diseases of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
James A. Mastrianni, Elizabeth A. Harris
Subtypes of PD have emerged based on distinct clinic features. They include: Tremor-dominant: in which tremor is an early and prominent feature. This is often misdiagnosed as essential tremor, and there may be a pathological link between the two disorders. There is a related entity called ‘benign tremulous parkinsonism’ in patients who have prominent rest tremor in the absence of other nontremor signs and gait disorder, and lack of progression.Postural instability with gait difficulty (PIGD): in which patients demonstrate early gait abnormalities; and there is prominent bradykinesia and rigidity (sometimes referred to as ‘akinetic rigid subtype’).Young-onset PD (age < 50).Late-onset PD (age > 50).
Titubation
Published in K. Gupta, P. Carmichael, A. Zumla, 100 Short Cases for the MRCP, 2020
K. Gupta, P. Carmichael, A. Zumla
These so-called benign essential tremors usually appear in early adult life and tend to be hereditary in origin. They are not present at rest, occurring with movement and being aggravated by emotion. If severe, beta blockers such as propranolol may be of use; alcohol also gives relief. There is no sinister underlying pathology.
Calpain activity in plasma of patients with essential tremor and Parkinson’s disease: a pilot study
Published in Neurological Research, 2021
Zamira M Muruzheva, Dmitry S Traktirov, Alexander S Zubov, Nina S Pestereva, Maria S Tikhomirova, Marina N Karpenko
Essential tremor (ET) and Parkinson’s disease (PD) are the two most common movement disorders in adults. Despite having distant clinical and pathomorphological signs these diseases have very similar clinical symptoms such as tremor, bradykinesia, gait and balance disorders, as well as some non-motor signs (depression, cognitive impairment) [1,2]. Moreover, it has been shown that patients diagnosed with ET are at increased risk of developing PD years or decades after the onset of the disease [3,4]. This leaves no doubt that the diseases are interconnected, but the relationship between the possible pathogenic mechanisms is not quite clear. At the same time, it is precisely established that the pathological sign of PD is the degeneration of the neurons in substantianigra (SN) [5]. Calpain, a calcium-activated cysteine neutral protease, plays a pivotal role in neurons degeneration in PD. It was shown that calpain activity increases in SN, striatum and in spinal cord in animal models of PD and in patients with PD [6–9]. Elevated activity of calpains is linked to several pathways of cell death [10], as well as to α-synuclein cleavage and aggregation, which is toxic to neurons [11,12]. Also expression of a subset of CD4+ receptors on сytotoxic T cells is connected to calpain activation [9]. Therefore, calpain activation is an important step in the PD pathogenesis and increase in the calpain activity can be considered a diagnostic and forecasting marker of the disease. However, until now, there have not been any studies on the activity of calpain in the body fluids of PD patients, which is important for diagnostic models.
Post-diagnostic lived experiences of individuals with essential tremor
Published in Disability and Rehabilitation, 2020
Jessica Moore, Fiona J. R. Eccles, Jane Simpson
Essential tremor was once previously viewed as a solely motor disorder but psychological difficulties are increasingly being recognized [10]. Furthermore, quality of life is also found to be impaired for individuals with a diagnosis of essential tremor [11]. In common with other neurological conditions such as Parkinson’s disease [12] the main predictors of quality of life are psychological and psychosocial factors, such as emotional well-being and social withdrawal, rather than illness severity [11]. It has also been found that ability to perform at work, and during leisure activity, impacts upon levels of depression for individuals with essential tremor [13]. As a result of the overlap in essential tremor and Parkinson’s disease, previous research has not only explored the relationship between the two conditions [14] but has also compared quality of life [15]. In particular this comparison identified that individuals with essential tremor experienced more impairment in relation to writing, eating, drinking, embarrassment, and concentration [15] in comparison to individuals with Parkinson’s disease. In addition, individuals with essential tremor were also found to have higher self- ratings of tremor severity in their arms, and drink alcohol more frequently than they would like, compared to individuals with Parkinson’s disease, whereas the latter were noted to have higher levels of speech impairment and higher self-ratings of tremor severity in their legs compared to individuals with essential tremor [15].
Dapagliflozin modulates neuronal injury via instigation of LKB1/p-AMPK/GABAB R2 signaling pathway and suppression of the inflammatory cascade in an essential tremor rat model
Published in Expert Opinion on Therapeutic Targets, 2023
Ahmed S. Kamel, Sama M. Farrag, Heba M. Mansour, Noha N. Nassar, Muhammed A. Saad
Essential tremor (ET) is being lately linked to cognitive, psychiatric, and other nonmotor anomalies, accordingly, the quest for efficient treatment is inevitable. Hereby, the current study stipulates a potential for the prospective use of dapagliflozin (DAPA) in a model of ET induced by harmaline (HAR). Indeed, these findings comprise the interplay of behavioral, electroencephalographic as well as histopathological findings congruent to the instigation of the LKB1/p-AMPK/BDNF/GABAB R2 signaling pathway and suppression of the excitotoxic GLU/IL-1β/6/8/p53 apoptotic cascade.