The diagnosis of Parkinson's disease remains a challenge in patients who have abnormal symptoms or show a lack of response to medication
- the imaging technique, DaTscan, can be used to visualize dopamine degeneration in the nigro-striatum, which is associated with Parkinsonian Syndrome
The clinical diagnosis of classic Parkinson's disease (PD) is based on four cardinal features: bradykinesia, tremor, rigidity, or postural instability
- there is a subset of patients that are hard to diagnose due to unclear clinical presentation or lack of response to treatment
- there is a tendency to both under and over-diagnose PD, resulting in either a lack of treatment and delayed diagnosis or administering treatment and procedures that are unnecessary
- DaTscan, a dopamine transporter (DAT) single photon emission computerized tomography (SPECT) imaging technique is used to evaluate patients with suspected PS
- DaTscan is used for the detection of nigro-striatal dopaminergic neurodegeneration associated with PS and has shown to have a high specificity for PS
- uses 123I Ioflupane to bind to the DAT in the striatum and then SPECT visualizes the amount of transporter present
- these transporters normally function to reuptake dopamine from the synaptic cleft. The DAT plays a crucial role in the maintenance of the presynaptic neuron and is reduced 50-70% in patients with PD
- several studies show a high correlation between abnormal DaTscan and a final diagnosis of either PD or MSA (Multiple System Atrophy) via autopsy although the DaTscan cannot distinguish between the different PS disorders
Reference:
- Perju-Dumbrava LD, Kovacs GG, Pirker S, Jellinger K, Hoffmann M, Asenbaum S, Pirker W. Dopamine transporter imaging in autopsy-confirmed Parkinson's disease and multiple system atrophy. Mov Disord. 2012;27:65-71
- Poewe W, Scherfler C. Role of dopamine transporter imaging in investigation of parkinsonian syndromes in routine clinical practice. Mov Disord. 2003;18(Suppl 7):S16-S2.