[18F]FDOPA PET and clinical features in parkinsonism due to manganism
Manganese exposure reportedly causes a clinically and pathophysiologically distinct syndrome from idiopathic Parkinson's disease (PD). We describe the clinical features and results of positron emission tomography with 6-[18F]fluorodopa ([18F]FDOPA PET) of a patient with parkinsonism occurring in the setting of elevated blood manganese. The patient developed parkinsonism associated with elevated serum manganese from hepatic dysfunction. [18F]FDOPA PET demonstrated relatively symmetric and severely reduced [18F]FDOPA levels in the posterior putamen compared to controls. The globus pallidum interna had increased signal on T1-weighted magnetic resonance imaging (MRI) images. We conclude that elevated manganese exposure may be associated with reduced striatal [18F]FDOPA uptake, and MRI may reveal selective abnormality within the internal segment of the pallidum. This case suggests that the clinical and pathophysiological features of manganese-associated parkinsonism may overlap with that of PD.
Medical Subject Headings
Adult; Antiparkinson Agents (therapeutic use); Brain (metabolism); Carbidopa (therapeutic use); Drug Combinations; Female; Fluorodeoxyglucose F18; Gait; Humans; Levodopa (therapeutic use); Magnetic Resonance Imaging; Manganese Poisoning (blood, complications); Middle Aged; Parkinson Disease (drug therapy, etiology, pathology); Positron-Emission Tomography; Radiopharmaceuticals
Movement disorders : official journal of the Movement Disorder Society
Digital Object Identifier (DOI)
Racette, Brad A.; Antenor, Jo Ann; McGee-Minnich, Lori; Moerlein, Stephen M.; Videen, Tom O.; Kotagal, Vikas; and Perlmutter, Joel S., "[18F]FDOPA PET and clinical features in parkinsonism due to manganism" (2005). Neurology. 1089.