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¹²³I-FP-CIT SPECT Imaging of Dopamine Transporters in Patients with Recurrent Sudden Falls: Are Such Falls a Distinct Entity?

¹ Department of Neurology, Rabin Medical Center, Petah Tiqwa, Israel; ² Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; and ³ Department of Nuclear Medicine, Edith Wolfson Medical Center, Holon, Israel

Correspondence: For correspondence or reprints contact: Ruth Djaldetti, MD, Rabin Medical Center, 4 Kaplan St., Petah Tiqwa 49100, Israel. E-mail: yhaimi{at}bezeqint.net

Recurrent falls in older people are commonly associated with abnormalities that involve several parts of the central nervous system, especially with basal ganglion pathology. The aim of the present study was to evaluate the integrity of striatal dopamine transporters (DaTs) by use of ¹²³I-N-3-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl)tropane (¹²³I-FP-CIT) SPECT of striatal DaTs in patients with recurrent sudden falls. Methods: Twenty-one patients without a definite neurologic diagnosis for recurrent sudden falls were enrolled in a cross-sectional study. SPECT with a DaT ligand was performed 180 min after injection of 185 MBq of ¹²³I-FP-CIT with a dual-head -camera. Results: DaT SPECT findings were normal in 15 of 21 patients (71%). Of those, 73% had abnormal MRI findings suggestive of atherosclerotic lesions. Eleven patients with normal DaT SPECT findings had mild parkinsonian symptoms. There was no correlation of the SPECT results with patient age, duration of occurrence of falls, or frequency of falls, and there was no significant difference in the relative distributions of SPECT findings between patients with and patients without parkinsonian symptoms or vascular risk factors. Conclusion: Recurrent sudden falls are, in most cases, not attributable to the degeneration of the nigrostriatal system.

Key Words: recurrent falls; SPECT; dopamine transporters; parkinsonism