The clinical features of parkinsonism in carbon monoxide (CO) intoxication have been associated with striatal-related neuronal networks. As parkinsonian and neuropsychiatric features are both related to presynaptic dopaminergic integrity, the aim of this study was to explore the clinical significance of ^99mTcTRODAT-1 in grading neurobehavioral scores and parkinsonian severity in CO intoxication.

We enrolled 64 patients with CO intoxication, including 29 with parkinsonism (parkinsonism[+] group) and 35 without (parkinsonism[−] group). All of the patients received ^99mTcTRODAT-1 neuroimaging evaluations, comprehensive neurobehavioral tests and assessments of the severity of parkinsonism using Unified Parkinson's Disease Rating Scale (UPDRS)-part III motor score. Univariate and multivariate regression analyses were used to test the predictive factors and scores for a diagnosis of parkinsonism and its severity.

The parkinsonism(+) group had significantly lower cognitive scores and higher neuropsychiatric total scores compared with the parkinsonism(−) group, both of which were independently related to the severity of parkinsonism. ^99mTcTRODAT-1 regional caudate signals were correlated with tremors at rest, action or postural tremors of the hands, bradykinesia and hypokinesia, and visuospatial, verbal fluency, abstract thinking and digit backwards scores. Scores of the neurobehavioral tests and UPDRS items were highly correlated (p < 0.01).

Our results validated the initial hypothesis in that neurobehavioral deficits and parkinsonian symptoms were highly related. This association was independent of demographic factors and initial carboxyhemoglobin level. Within the presynaptic dopaminergic circuit, the clinical role of the caudate in mediating the clinical symptoms in CO intoxication may outweigh the putamen.

一氧化碳（CO）中毒的帕金森氏症的临床特征与纹状体相关的神经元网络有关。由于帕金森氏症和神经精神病学特征均与突触前多巴胺能完整性有关，因此，本研究的目的是探讨^99mTc TRODAT-1在CO中毒中对神经行为评分和帕金森病严重程度进行分级的临床意义。

我们招募了64例CO中毒患者，包括29例帕金森病（帕金森病[+]组）和35例非帕金森病（-帕金森病[−]组）。所有患者均接受了^99mTc TRODAT-1神经影像学评估，综合神经行为学测试以及使用帕金森病统一疾病分级量表（UPDRS）-第三部分运动评分对帕金森病严重程度的评估。单因素和多元回归分析用于检验预测因素和评分，以诊断帕金森氏症及其严重程度。

与帕金森氏症（-）组相比，帕金森氏症（+）组的认知得分和神经精神病学总得分均明显较低，这两者均与帕金森氏症的严重程度独立相关。^99mTc TRODAT-1区域尾状信号与静息震颤，手部动作或姿势震颤，运动迟缓和运动减退以及视觉空间，言语流畅，抽象思维和手指向后得分相关。神经行为测试得分与UPDRS项目得分高度相关（p <0.01）。

我们的结果证实了最初的假设，即神经行为缺陷和帕金森病症状高度相关。这种联系独立于人口统计学因素和最初的羧基血红蛋白水平。在突触前的多巴胺能回路中，尾状体在介导CO中毒的临床症状中的临床作用可能超过壳核。