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NEUROLOGY 1995;45:472-477
© 1995 American Academy of Neurology

Peduncular 'Rubral' Tremor and Dopaminergic Denervation

A PET Study

P. Remy, MD, A. de Recondo, MD, G. Defer, MD, C. Loc'h, BS, P. Amarenco, MD, V. Plante-Bordeneuve, MD, M.-H. Dao-Castellana, MD, B. Bendriem, PhD, C. Crouzel, PhD, M. Clanet, MD, P. Rondot, MD and Y. Samson, MD

Article abstract-Lesions causing so-called rubral tremors frequently involve the substantia nigra or the nigrostriatal fibers, suggesting dopaminergic denervation as possibly contributory. We examined this hypothesis using PET and (Fluorine-18)-fluorodopa in six patients with a contralateral tremor following a peduncular lesion. The denervation revealed by PET was even more marked than in severe parkinsonian patients. All patients showed partial to complete improvement with levodopa therapy. PET evaluation of D2-receptors with (Bromine-76)bromolisuride showed no asymmetry of the D2 binding despite the important asymmetry of Fluorine-18-fluorodopa uptake. Our results indicate an important involvement of the nigral dopaminergic system in peduncular tremors that appears to be independent of postsynaptic dopamine receptors.

NEUROLOGY 1995;45: 472-477




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