Is Parkinson’s Disease with History of Agent Orange Exposure Different from Idiopathic Parkinson’s Disease?
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Background and Purpose During Vietnam War, many Korean soldiers were dispatched to fight in the war where they were exposed toAgent Orange. Until now, there exist only limited evidence on existence of association between exposure to Agent Orange and Parkinson’sdisease (PD). To elucidate the effects of Agent Orange exposure on PD, we compared the clinical characteristics and radiolabeled 18F-FP-CITPET uptake between patients with Agent Orange exposure and patients with Agent Orange no-exposure. Methods We retrospectively evaluated 143 patients exposed to Agent Orange and 500 patients with no exposure to Agent Orange from ourmovement clinics database. The differences between clinical characteristics and pattern of 18F-FP-CIT PET uptake were investigated. Results Among Unified Parkinson’s Disease Rating Scale III motor subscales, tremor at rest, rigidity, finger taps, and rapid alternatingmovement was significantly higher in patients exposed to Agent Orange as compared to patients with no exposure to Agent Orange. The facialexpression score was significantly lower in patients exposed to Agent Orange as compared to patients with no exposure to Agent Orange. Compared to patients not exposed to Agent Orange, all basal ganglia areas (contra- and ipsilateral caudate nucleus, anterior putamen, andposterior putamen) showed a lower18F-FP-CIT uptake and higher asymmetry index of anterior and posterior putamen was found in patientsexposed to Agent Orange. The caudate/putamen ratio was significantly lower in patients exposed to Agent Orange as compared to patientswith no exposure to Agent Orange. Conclusions This study showed a different clinical profile and FP-CIT PET findings between patients exposed to Agent Orange as comparedto patients with no exposure to Agent Orange. This finding suggests the possibility of different pathophysiology of PD in patients exposedto Agent Orange from idiopathic PD.
Abstract
Background and Purpose During Vietnam War, many Korean soldiers were dispatched to fight in the war where they were exposed toAgent Orange. Until now, there exist only limited evidence on existence of association between exposure to Agent Orange and Parkinson’sdisease (PD). To elucidate the effects of Agent Orange exposure on PD, we compared the clinical characteristics and radiolabeled 18F-FP-CITPET uptake between patients with Agent Orange exposure and patients with Agent Orange no-exposure. Methods We retrospectively evaluated 143 patients exposed to Agent Orange and 500 patients with no exposure to Agent Orange from ourmovement clinics database. The differences between clinical characteristics and pattern of 18F-FP-CIT PET uptake were investigated. Results Among Unified Parkinson’s Disease Rating Scale III motor subscales, tremor at rest, rigidity, finger taps, and rapid alternatingmovement was significantly higher in patients exposed to Agent Orange as compared to patients with no exposure to Agent Orange. The facialexpression score was significantly lower in patients exposed to Agent Orange as compared to patients with no exposure to Agent Orange. Compared to patients not exposed to Agent Orange, all basal ganglia areas (contra- and ipsilateral caudate nucleus, anterior putamen, andposterior putamen) showed a lower18F-FP-CIT uptake and higher asymmetry index of anterior and posterior putamen was found in patientsexposed to Agent Orange. The caudate/putamen ratio was significantly lower in patients exposed to Agent Orange as compared to patientswith no exposure to Agent Orange. Conclusions This study showed a different clinical profile and FP-CIT PET findings between patients exposed to Agent Orange as comparedto patients with no exposure to Agent Orange. This finding suggests the possibility of different pathophysiology of PD in patients exposedto Agent Orange from idiopathic PD.
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