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Dopamine transporter brain image- need help interpret results


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#1 JuggernautTCW

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Posted 19 October 2013 - 06:59 PM

This question is for my 60-yr old mother who started taking PD meds in 2002.  She recently got the dopamine transporter brain image done and the only comment that the doctor had was that "it seemed OK".  She would like to find out more about her condition and speed of progression after taking meds for over 11 years.
 
Would love to hear your opinions based on her test results below- thank you in advance for the help!!!!
 
===========Page 1=============
Report:
The dopamine transporter brain image was performed 4 hours after given 25.7 mCi of Tc-99m TRODAT (iv).  The Tc-99m TRODAT-1 was obtained in a 1-vial kit formulation from the INER.  The final sterilized product was produced by autoclaving the mixture for 30 min.
1.  The SPECT image set showed little background noise, and the quality is adequate for interpretation.  Moderate dilated ventricle was noted.
2.  There was moderate decreased uptake of radioactivity involving the bilateral straitum.  The images showed uniform loss of radioactivity in the straitum.
3.  There was predominant loss of dopaminergic radioactivity over left straitum.
4.  The visual scores of right and left caudate were 5 and 5.  Those of the right and left putamen were 5 and 5.
 
Impression:
1. Left side predominant asymmetric presynaptic dopaminergic lesions, PD or Parkinsonism with presynaptic dopaminergic lesion may show this picture.
2. Ventricle dilation was noted.
 
Comment:
Score 1 as red (healthy), 2 as yellow, 3 as green-yellow, 4 as green, 5 as blue-green, 6 as blue.
 
===========Page 2=============
Data:
Upper Limb: Medium
 
R N9=12.3 N13=14.3 N20=19.0 N9-N13=2.0 N13-N20=4.7
L N(=12.8 N13=14.8 N20=19.1 N9-N13=2.0 N13-N20=4.3
 
Comment:
These somatosensory evoked potentials showed the latency of the wave as prolonged of the N9, normal of the N13, normal of the N20 after the either median nerve stimulation.
The calculated central conduction time was
normal of the N13-N20 after the either median nerve stimulation.
normal of the N22-P40 after the either tibial nerve stimulation.
 
Conclusion:
These abnormal SSEP studies may suggest the peripheral sensory conduction defect in the bilateral upper limbs and please correlate the clinical features.
 
===========Page 3=============
PVEP:
Right Visual angle: P100=108
Left Visual angle: P100=102
 
Comment: Normal waveform and the peak latency of the P100 after the visual stimulation to the either eye.
 
Conclusion: These VEP studies were essentially normal.  Please correlate the clinical features.
 
===========Page 4=============
Right:
Threshold(dB):25 Stimulus(dB):85
I=1.50 II=_ III=3.75 IV=_ V=5.28 VI=_
I-III=2.25 III-V=1.53 I-V=3.78
 
Left:
Threshold(dB):25 Stimulus(dB):85
I=1.65 II=_ III=3.83 IV=_ V=5.4 VI=4
I-III=2.18 III-V=1.61 I-V=3.79
 
Comment: The latency of the all waves showed normal peak latency, interpeak intervals, and essentially normal amplitude following the click ear stimulation on the either side.
 
Conclusion: The BAEP studies were essentially normal.
 
===========Page 5=============
Summary:
A 60 y/o female;
Clinical Information: PD is likelt, R hand contracture deformity.
 
Magnetic Resonance Imaging of Brain WIthout Enhancement Show:
(Using Sagittal T1, Axial T2, T2 FLAIR; Sagittal T1 and Coronal in T2 sections Routine Brain Pulse Sequence Protocols) shows
1.  Minimal diffuse brain atrophy with minimal ventriculomegaly.
2.  Normal gray white matter differentiation without focal abnormality, no obvious infarction or hemorrhage or space taking lesion.
3.  The brain stem and posterior fossa structures are unremarkable.
4.  Pituitary fossa: no tumor.
5.  The mastoid air cells: sclerotic bilateral mastoid cavities.
6.  Paranasal sinuses are well aerated.
7.  Scalp and skull: no swelling, no hematoma or skull fracture.
 
IMP: Minimal diffuse brain atrophy with minimal ventriculomegaly.
 


#2 MComes RPH

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Posted 06 November 2013 - 02:28 PM

Let me print them out and look them over, then I will get back with you in a short while.
Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org

#3 MComes RPH

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Posted 19 November 2013 - 12:23 PM

Juggernaut ,

After looking at this information and consulting with Dr Pain, I believe he would be the best person to answer ALL of the questions you may have about the best.
So, if you would please post the same info under "Ask the Doctor" forum and Dr Pain is aware that of the post and is waiting for it to be posted.
Good luck and keep me posted.
Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org

#4 MComes RPH

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Posted 19 November 2013 - 12:26 PM

Sorry, I mean Dr Okun. is ready and waiting for the post. (Auto spelling- not a good thing). Sorry about that.
Best of health,
Mark R. Comes R.Ph.
"Ask The Pharmacist"
www.parkinson.org




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