Dement Neurocogn Disord.  2016 Sep;15(3):75-81. 10.12779/dnd.2016.15.3.75.

Is Parkinson's Disease with History of Agent Orange Exposure Different from Idiopathic Parkinson's Disease?

• Yang Y
• Cheon M
• Kwak YT

• KMID: 2442849
• DOI: http://doi.org/10.12779/dnd.2016.15.3.75

Abstract

BACKGROUND AND PURPOSE
During Vietnam War, many Korean soldiers were dispatched to fight in the war where they were exposed to Agent Orange. Until now, there exist only limited evidence on existence of association between exposure to Agent Orange and Parkinson's disease (PD). To elucidate the effects of Agent Orange exposure on PD, we compared the clinical characteristics and radiolabeled 18F-FP-CIT PET 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 our movement 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 alternating movement was significantly higher in patients exposed to Agent Orange as compared to patients with no exposure to Agent Orange. The facial expression 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, and posterior putamen) showed a lower18F-FP-CIT uptake and higher asymmetry index of anterior and posterior putamen was found in patients exposed to Agent Orange. The caudate/putamen ratio was significantly lower in patients exposed to Agent Orange as compared to patients with 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 compared to patients with no exposure to Agent Orange. This finding suggests the possibility of different pathophysiology of PD in patients exposed to Agent Orange from idiopathic PD.

Keyword

Agent Orange; 18F-FP-CIT PET; Parkinson's disease

MeSH Terms

Basal Ganglia
Caudate Nucleus
Citrus sinensis*
Facial Expression
Fingers
Humans
Military Personnel
Parkinson Disease*
Putamen
Retrospective Studies
Tremor
Vietnam

Figure

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  Fig. 1 Images of N-(3-fluoropropyl)-2β-carboxymethoxy-3β-(4-iodophenyl) nortropane positron emission tomography (FP-CIT PET) uptake at the level of striatum in patients with Hoehn-Yahr stage I Parkinson's disease. Patients with exposure to Agent Orange (A) display bilateral lower striatal uptake as compared with patients with no exposure to Agent Orange (B).

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