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

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FIGURE 1.
¹²³I-FP-CIT SPECT images from 2 patients with recurrent falls. (A) 76-y-old woman with 4-y history of recurrent falls. Her neurologic examination was intact except for abnormal postural reflexes. DaT scan shows unilateral reduced striatal binding. (B) 70-y-old woman with falls during past year. On examination, she had mild symmetric tremor and bradykinesia, without rigidity. UPDRS score was 20. DaT scan shows normal striatal binding.
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FIGURE 2.
¹²³I-FP-CIT uptake in striatum, caudate, and putamen of control subjects, patients with recurrent falls and normal SPECT findings, and patients with recurrent falls and abnormal SPECT findings. Significant decrease in ligand uptake was noted in these areas on both sides only in patients with abnormal SPECT findings. ^*P < 0.001.

TABLE 1

Comparison of Patient Characteristics by SPECT Findings

Characteristic	Patients with normal SPECT findings (n = 15)	Patients with abnormal SPECT findings (n = 6)
Age, y, mean ± SD (range)	78.4 ± 5.6 (70–88)	78.6 ± 5.9 (71–89)
Duration of occurrence of falls, y	1–5	1–7
No. of falls per mo	1–4	1–4
Vascular risk factors^*
Present	15	5
Absent		1
MRI findings^*
Diffuse ischemic changes	7	4
Lacunar infarcts	4
Normal	2
Not determined	2	2
Parkinsonian symptoms^*
Present	11	4
Absent	4	2