Role of DAT‐SPECT in the diagnostic work up of Parkinsonism |
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| Authors: | Christoph Scherfler MD Johannes Schwarz MD PhD Angelo Antonini MD PhD Donald Grosset MD Francesc Valldeoriola MD PhD Kenneth Marek MD Wolfgang Oertel MD Eduardo Tolosa MD PhD Andrew J. Lees MD Werner Poewe MD |
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| Affiliation: | 1. Department of Neurology, Innsbruck Medical University, Innsbruck, Austria;2. Klinik und Poliklinik für Neurologie, Leipzig, Germany;3. Parkinson Institute, Istituti Clinici di Perfezionamento, Milano, Italy;4. Department of Neurology, Institute of Neurological Sciences, Southern General Hospital, Glasgow, United Kingdom;5. Parkinson's Disease and Movement Disorders Unit, Department of Neurology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Su?er, Universitat de Barcelona, Barcelona, Spain;6. Institute for Neurodegenerative Disorders, New Haven, Connecticut, USA;7. Klinik für Neurologie, Philipps‐Universit?t Marburg, Marburg, Germany;8. Reta Lila Weston Institute of Neurological Studies, Royal Free Hospital and University College Medical School, London, United Kingdom;9. Department of Neurology, Innsbruck Medical University, Innsbruck, AustriaDepartment of Neurology, Innsbruck Medical University, Anichstrasse 35, A‐6020 Innsbruck, Austria |
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| Abstract: | The diagnosis of idiopathic Parkinson's disease (PD) can be achieved with high degrees of accuracy in cases with full expression of classical clinical features. However, diagnostic uncertainty remains in early disease with subtle or ambiguous signs. Functional imaging has been suggested to increase the diagnostic yield in parkinsonian syndromes with uncertain clinical classification. Loss of striatal dopamine nerve terminal function, a hallmark of neurodegenerative Parkinsonism, is strongly related to decreases of dopamine transporter (DAT) density, which can be measured by single photon emission computed tomography (SPECT). The use of DAT‐SPECT facilitates the differential diagnosis in patients with isolated tremor symptoms not fulfilling PD or essential tremor criteria, drug‐induced, psychogenic and vascular Parkinsonism as well as dementia when associated with Parkinsonism. This review addresses the value of DAT‐SPECT in early differential diagnosis, and its potential as a screening tool for subjects at risk of developing PD as well as issues around the assessment of disease progression. © 2007 Movement Disorder Society |
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| Keywords: | dopamine transporter SPECT Parkinson's disease differential diagnosis |
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