[Case of a 30-year history of PARK6 --findings from functional imaging of the brain]

Rinsho Shinkeigaku. 2008 Sep;48(9):662-5. doi: 10.5692/clinicalneurol.48.662.
[Article in Japanese]

Abstract

We have reported a case of autosomal recessive juvenile parkinsonism PARK6 with a 30-year history. She developed tremor of right lower limb at the age of 23. At the age of 28, she received a clinical diagnosis of early-onset Parkinson's disease. She showed clinical improvements by the treatment with trihexyphenidyl, but symptoms showed slow progression over the subsequent years. L-DOPA therapy was introduced at the age of 42, and five years later, L-DOPA-induced dyskinesia developed. Dystonia, diurnal fluctuation and sleep benefit were absent. She carried a homozygous missense mutation in PINK1 gene, and was diagnosed as PARK6. The brain MRI did not show apparent abnormality. 18F-FDG-positron emission topography (PET) displayed normal uptake in the brain, suggesting normal glucose metabolism. PET imaging with a dopamine D2 receptor ligand 11C-raclopride revealed that postsynaptic 11C-raclopride uptake was normal in the bilateral putamen. After the introduction of pramipexisol, she showed clinical improvements. L-DOPA-induced dyskinesia disappeared with the gradual tapering and withdrawal of L-DOPA. In this PARK6 case, postsynaptic D2 receptors of the nigro-striatal dopaminergic neurons were thought to be maintained despite a long disease history.

Publication types

  • Case Reports

MeSH terms

  • Antiparkinson Agents / therapeutic use
  • Benzothiazoles / therapeutic use
  • Diagnostic Imaging
  • Female
  • Humans
  • Levodopa / therapeutic use
  • Middle Aged
  • Mutation, Missense*
  • Parkinsonian Disorders / diagnosis
  • Parkinsonian Disorders / drug therapy
  • Parkinsonian Disorders / genetics*
  • Pramipexole
  • Protein Kinases / genetics*
  • Receptors, Dopamine D2
  • Time Factors

Substances

  • Antiparkinson Agents
  • Benzothiazoles
  • Receptors, Dopamine D2
  • Levodopa
  • Pramipexole
  • Protein Kinases
  • PTEN-induced putative kinase