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The object of the study in the science dictates to the researcher the method of the study, and every
step in the scientific observation and comprehension of the object determines the next step. We
guess that proceeding from measurement of biogenic amines in dystonic patients to their PET study
was not random. Analyzing the former investigations done in the area, we revealed that the most
competent pioneer in this exploration, Dr. Thomas Chase, had done the same passage from
chromatography to PET. Therefore, the inner scientific logic unites two parts of our chapter together,
biochemical conception of dystonia is achieved when biochemical study of plasma and urine is
accomplished by direct biochemical study of the patient’s brain.
At our first reports we have communicated of enhanced serotonin exchange in dystonia. Later we
applied to that data more sophisticated methods of statistical analysis, such as decision tree and
discriminate analysis, and these advanced methods allowed us to elaborate new powerful diagnostic
tests for diagnosis of dystonia [1,2]. We are telling of these new methods and their results in the first
part of our chapter.
In 2010 we published results of PET study with 18 – FDG of brain of patients with dystonia and
essential tremor (ET). The results have been presented in semi quantitative form of percentage of
change of glucose metabolism, without comparison with the healthy control. The calculation has been
done by means of software package SPM2 in software environment MATLAB v. 6.1, installated to the
personal computer (OS Windows 2000). Initially, on the base of above mentioned tools of
investigation, we reported, that we had revealed decrease of glucose metabolism in different brain
areas in all patients, and that the study failed to detect any difference between the group with the
dystonia and the ET group. Later the Advantage Workstation of the same tomograph, used for the
study, was equipped by software package Cortex ID that allows to analyze PET visualization of the
brain in comparison with the scans of control group. This program in the equation of Z score
calculates the results of such comparison. Recount of the former data by means of Z score equation
has confirmed hypometabolism in both groups of dystonia and ET, but in contrast to the former
results, revealed difference between these 2 groups of patients in certain areas of the brain [3]. These
two nosologic forms overlap in clinical features and are difficult to differentiate. In the second part of
our chapter we are telling, that PET picture could provide the clue to differential diagnosis in cope with
biochemical difference in dopamine (DA) exchange revealed by us in this group of patients before.