Regional and global metabolic rates for glucose (rCMRGlc and GMR) were estimated 
using [18F]fluorodeoxyglucose and positron emission tomography in 3 patients 
with Filipino X-linked dystonia-parkinsonism (lubag). In all 3 patients a 
selective reduction in normalized striatal glucose metabolism (rCMRGlc/GMR) was 
observed compared with 15 normal volunteer subjects. Presynaptic nigrostriatal 
function was assessed in these patients using [18F]fluorodopa and positron 
emission tomography. Striatal rate constants for [18F]flurodopa uptake were 
found to be in the normal range in all 3 patients with lubag. These findings 
suggest that the extrapyramidal manifestations of lubag are metabolically 
localized to the striatum and that clinical parkinsonism in these patients may 
be secondary to extranigral factors.