Impact of dopamine transporter SPECT using 123I-Ioflupane on diagnosis and management of patients with clinically uncertain parkinsonian syndromes

Authors

  • Ana M. Catafau MD,

    1. Institut de Recerca, Hospital de Sant Pau, Barcelona, Spain
    Current affiliation:
    1. Centre for Imaging in Psychiatry, Clinical Pharmacology Discovery Medicine, Psychiatry Centre of Excellence for Drug Discovery, GlaxoSmithKline
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  • Eduardo Tolosa MD

    Corresponding author
    1. Parkinson's Disease and Movement Disorders Unit, Neurology Service, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
    • Parkinson's Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic, c/ Villarroel, 170, 08036, Barcelona, Spain
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  • Members of The DaTSCAN CUPS Study Group are listed in Appendix.

Abstract

Imaging with 123I-Ioflupane single-photon emission computed tomography (SPECT) is a marker of nigrostriatal neuronal integrity, allowing differentiation of parkinsonism with loss of dopaminergic terminals (presynaptic Parkinson syndrome [PS]) from parkinsonism without nigrostriatal degeneration. This study assessed SPECT imaging in 118 patients with clinically uncertain parkinsonian syndromes (CUPS). In 36% of patients with presynaptic PS and 54% with nonpresynaptic PS, imaging results were not consistent with the initial diagnosis. After imaging, diagnosis was changed in 52% of patients. All patients with a final diagnosis of presynaptic PS had an abnormal image, whereas 94% of patients with nonpresynaptic PS had a normal scan. Imaging increased confidence in diagnosis, leading to changes in clinical management in 72% of patients. Consequently, visual assessment of 123I-Ioflupane SPECT may have a significant impact on the clinical management of CUPS patients. © 2004 Movement Disorder Society

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