オオヤマ　ゲンコウ   OYAMA Genko   大山　彦光    所属   埼玉医科大学  医学部 脳神経内科    職種   教授
論文種別	学術雑誌(原著)
言語種別	英語
査読の有無	査読あり
表題	A Retrospective Imaging Evaluation of Presynaptic Dopaminergic Degeneration in Multiple System Atrophy with Levodopa Induced Dyskinesia.
掲載誌名	正式名：Tremor and other hyperkinetic movements (New York, N.Y.)
掲載区分	国外
巻・号・頁	10,6-6頁
著者・共著者	Shin-Ichi Ueno,Genko Oyama,Kazuaki Kanai,Taku Hatano,Yasushi Shimo,Nobutaka Hattori
発行年月	2020/06/15
概要	Background: Multiple system atrophy (MSA) may develop levodopa-induced dyskinesia, which is dystonic and predominant in the orofacial region. We aimed to characterize the patterns of presynaptic dopaminergic degeneration in patients with MSA and dyskinesia using 123I-N-x-fluoropropyl-2b-carbo-methoxy-3b-(4-iodophenyl) nortropan single-photon emission computed tomography (123I-FP-CIT SPECT). Methods: A single center cross-sectional retrospective study was conducted using consecutive chart review of patients with probable MSA who underwent 123I-FP-CIT SPECT. The degeneration patterns were compared between the groups with and without dyskinesia via visual assessment of 123I-FP-CIT SPECT images. Results: Twenty-five patients with probable MSA who had undergone dopamine transporter imaging were identified (age [mean ± standard error], 62.5 ± 1.7 years; disease duration, 48.8 ± 7.0 months). Four of them presented dyskinesia and 21 of patients did not. Twenty-five patients with MSA were visually classified into five grades: one Grade 1 (normal), two Grade 2 (eagle wing), three Grade 3 (mixed), nine Grade 4 (egg shape), and ten Grade 5 (burst striatum). All patients with MSA and dyskinesia were classified into Grade 5. Visual grading significantly correlated with disease duration and levodopa responsiveness. Conclusions: Severe presynaptic dopaminergic dysfunction in 123I-FP-CIT SPECT images, higher doses of dopaminergic medication, and longer disease durations were associated with occurrence of levodopa-induced dyskinesia, even in MSA.
DOI	10.5334/tohm.58
PMID	32775020