Carbon Monoxide-induced Parkinsonism Clinical Trial
Official title:
Targeting Monoaminergic Neuronal Networks in the Parkinsonian Patients After Carbon Monoxide Intoxication
The study purpose is to determine the clinical values of 18F-FP-(+)-DTBZ in the diagnosis of Parkinsonism in patients with carbon monoxide intoxication, regional distribution and its correlation with clinical parameters. This study is expected to be completed in a period of 3 years.
With the urbanization of Taiwanese society, there are increasing numbers of people committing
suicide by charcoal burning, making carbon monoxide (CO) encephalopathy a new pandemic
phenomenon. In CO related parkinsonism, the clinical features included gait disturbances,
mask face, rigidities and small steps. From literature searches, the CO related parkinsonism
is related to white matter damages or decline in dopamine innervations. From our previous
research results, the CO related neuronal damages would started from reversible or
progressive white matter demyelination. For some patients, axonopathy or gray matter atrophy
developed and became irreversible. The neuronal networks in determining development of
Parkinsonism required to be established.
In terms of neurotransmitter, most of the clinical data for Parkinsonism came from studies of
idiopathic Parkinson's disease while the data of CO related Parkinsonism were limited to case
reports. From neuropathology studies in idiopathic Parkinson's disease, dopamine deficits and
decreased in monoamine transporters were observed well before the development of clinical
features. Although there is linkage between CO related Parkinsonism and dopamine deficits,
patients with CO intoxication had poor response to levodopa. The observation suggested the
critical networks and neurotransmitters were still not well understood.
18F-FP-(+)-DTBZ is a newly developed nuclear medicine tracer for monoamine transporter. The
study purpose is to determine the clinical values of 18F-FP-(+)-DTBZ in the diagnosis of
Parkinsonism in patients with carbon monoxide intoxication, regional distribution and its
correlation with clinical parameters. This is a three-year prospective research. For each
patient, the PET will be arranged twice, with an interval of 18 months. The regional
distribuation of 18F-FP-(+)-DTBZ in relation to Parkinsonism severity and regional reduction
patterns longitudially will be assessed in order to understand the regional neurotoxicity and
the functional progression.
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