Peduncular 'Rubral' Tremor and Dopaminergic Denervation

Publisher Website
Google Scholar
Abstract
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