BRAIN GLUCOSE-METABOLISM AND DOPAMINE-D(2) RECEPTOR ANALYSIS IN A PATIENT WITH HEMIPARKINSONISM-HEMIATROPHY SYNDROME

We report findings on brain glucose metabolism and dopamine D2 recepto rs generated by positron emission tomography (PET) in a 67-year-old wo man with right hemiparkinsonism-hemiatrophy syndrome (HP-HA). PET with [F-18]-fluorodeoxyglucose (FDG) showed marked glucose metabolism asym metry. There were significant reductions in glucose uptake at the leve l of the basal ganglia and, to lesser extent, in the fronto-parietal c ortex contralateral to the clinically involved side. These changes wer e different from those found in a patient with hemi-Parkinson's diseas e who was scanned under similar conditions. Because the patient with H P-HA had only minimal response to levodopa therapy, we evaluated post- synaptic dopaminergic structures using PET with [F-18]-fluoroethylspip erone (FESP). No striatal binding asymmetry was found in FESP/PET, whi ch suggests a sparing of striatal dopamine D2 receptors. The changes i n FDG uptake which we found were in brain areas relevant to the clinic al features of HP-HA syndrome. In addition, our study provides evidenc e that FDG/PET may help to differentiate HP-HA syndrome from hemi-Park inson's disease. In most instances, since HP-HA is associated with a m ore benign clinical course than Parkinson's disease, this distinction is of clinical important.