Neuroimagen funcional en el diagnóstico de pacientes con síndrome parkinsoniano: actualización y recomendaciones para el uso clínico

Arbizu, Javier; Luquin, M. R.; Abella, J.; Fuente‐Fernández, Raúl de la; Fernández‐Torrón, Roberto; García-Solís, David; Garrastachu, Puy; Jiménez-Hoyuela, J.M.; Llaneza, M.; Lomeña, Francisco; Lorenzo-Bosquet, Carles; Martı́, Marı́a José; Martínez-Castrillo, Juan Carlos; Mir, Pablo; Mitjavila, Mercedes; Ruíz‐Martínez, Javier; Vela, Lydia

doi:10.1016/j.remn.2014.02.001

Cited by 14 publications

(7 citation statements)

References 51 publications

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“…Brain 18 F-fluorodeoxyglucose positron emission tomography ( 18 FDG-PET) has been extensively used in the differential diagnosis of parkinsonian disorders (Arbizu et al, 2014). In patients with PD, brain 18 FDG-PET is normal or shows an increase in uptake in the putamen nucleus whereas in patients with MSA specific hypometabolic patterns have been described.…”

Section: Brain and Cardiac Neuroimagingmentioning

confidence: 99%

“…Multiple tracers are available, including 18 F-Dopa (dopamine storage capacity), 11 C-dihydrotetrabenazine (DTBZ, vesicular monoamine transporter function) for PET, and 123 I-β-CIT and 123 I-FPCIT (dopamine transporter binding) for SPECT (Arbizu et al, 2014; Brooks et al, 2009). Because pre-synaptic dopaminergic metabolism is impaired in all basal ganglia disorders, presynaptic dopaminergic markers cannot distinguish between parkinsonian syndromes, although they may be useful to distinguish MSA-C from other adult-onset cerebellar ataxias (Gebus et al, 2017).…”

Section: Brain and Cardiac Neuroimagingmentioning

confidence: 99%

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Diagnosis of multiple system atrophy

Palma

Norcliffe‐Kaufmann

Kaufmann

2018

Autonomic Neuroscience

120

114

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Multiple system atrophy (MSA) may be difficult to distinguish clinically from other disorders, particularly in the early stages of the disease. An autonomic-only presentation can be indistinguishable from pure autonomic failure. Patients presenting with parkinsonism may be misdiagnosed as having Parkinson disease. Patients presenting with the cerebellar phenotype of MSA can mimic other adult-onset ataxias due to alcohol, chemotherapeutic agents, lead, lithium, and toluene, or vitamin E deficiency, as well as paraneoplastic, autoimmune, or genetic ataxias. A careful medical history and meticulous neurological examination remain the cornerstone for the accurate diagnosis of MSA. Ancillary investigations are helpful to support the diagnosis, rule out potential mimics, and define therapeutic strategies. This review summarizes diagnostic investigations useful in the differential diagnosis of patients with suspected MSA. Currently used techniques include structural and functional brain imaging, cardiac sympathetic imaging, cardiovascular autonomic testing, olfactory testing, sleep study, urological evaluation, and dysphagia and cognitive assessments. Despite advances in the diagnostic tools for MSA in recent years and the availability of consensus criteria for clinical diagnosis, the diagnostic accuracy of MSA remains sub-optimal. As other diagnostic tools emerge, including skin biopsy, retinal biomarkers, blood and cerebrospinal fluid biomarkers, and advanced genetic testing, a more accurate and earlier recognition of MSA should be possible, even in the prodromal stages. This has important implications as misdiagnosis can result in inappropriate treatment, patient and family distress, and erroneous eligibility for clinical trials of disease-modifying drugs.

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Section: Brain and Cardiac Neuroimagingmentioning

confidence: 99%

Section: Brain and Cardiac Neuroimagingmentioning

confidence: 99%

Diagnosis of multiple system atrophy

Palma

Norcliffe‐Kaufmann

Kaufmann

2018

Autonomic Neuroscience

120

114

View full text Add to dashboard Cite

show abstract

“…Pre- and postsynaptic dopaminergic neuronal function, as assessed with nuclear imaging techniques, has been widely documented in parkinsonian conditions. Multiple tracers are available, including PET tracers such as 18 F-dopa (dopamine storage capacity) and 11 C-dihydrotetrabenazine (DTBZ, vesicular monoamine transporter function), or SPECT tracers such as 123 I-β-CIT and 123 I-FP-CIT [ 59 , 60 ]. 123 I-FP-CIT SPECT imaging has demonstrated increased accuracy in differentiating SNCApathies, especially DLB, from AD in which DAT is preserved [ 58 , 61 ].…”

Section: The Alpha-synucleinopathies (Sncapathies)mentioning

confidence: 99%

Positron Emission Tomography (PET) and Neuroimaging in the Personalized Approach to Neurodegenerative Causes of Dementia

Ricci

Cimini

Chiaravalloti

et al. 2020

IJMS

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Generally, dementia should be considered an acquired syndrome, with multiple possible causes, rather than a specific disease in itself. The leading causes of dementia are neurodegenerative and non-neurodegenerative alterations. Nevertheless, the neurodegenerative group of diseases that lead to cognitive impairment and dementia includes multiple possibilities or mixed pathologies with personalized treatment management for each cause, even if Alzheimer’s disease is the most common pathology. Therefore, an accurate differential diagnosis is mandatory in order to select the most appropriate therapy approach. The role of personalized assessment in the treatment of dementia is rapidly growing. Neuroimaging is an essential tool for differential diagnosis of multiple causes of dementia and allows a personalized diagnostic and therapeutic protocol based on risk factors that may improve treatment management, especially in early diagnosis during the prodromal stage. The utility of structural and functional imaging could be increased by standardization of acquisition and analysis methods and by the development of algorithms for automated assessment. The aim of this review is to focus on the most commonly used tracers for differential diagnosis in the dementia field. Particularly, we aim to explore 18F Fluorodeoxyglucose (FDG) and amyloid positron emission tomography (PET) imaging in Alzheimer’s disease and in other neurodegenerative causes of dementia.

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“…The main limitation of our study is the sample size, mostly affecting the subgroup of Non-AD patients. Also, our sample did not include patients with other forms of cognitive impairment at baseline diagnosis, like non-amnestic MCI, vascular dementia, atypical parkinsonism or Parkinson's dementia, in which 18 F-FDG or amyloid PET have proved useful for clinical characterization (45,46). Another limitation is the lack of availability of tau biomarkers that are currently under development in our center.…”

Section: Discussionmentioning

confidence: 99%

Clinical Impact of PET With 18F-FDG and 11C-PIB in Patients With Dementia in a Developing Country

et al. 2021

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Introduction: The objective of this study was to evaluate the clinical impact PET with 18F-FDG and 11C-PIB in patients with dementia in a developing country.Methodology: Retrospective study of the patients referred for the evaluation of dementia to the only PET center in Uruguay. A total of 248 patients were identified, from which 70 patients were included based on the availability of medical history and clinical follow-up. Main outcomes included change in diagnosis, diagnostic dilemma and AD treatment. We evaluated the association of clinical outcomes with PET concordance with baseline diagnosis, diagnostic dilemma, level of education, AD pathology/Non-AD pathology (AD/Non-AD), baseline diagnosis and 11C-PIB PET result.Results: Baseline clinical diagnosis was concordant with 18F-FDG and 11C-PIB PET results in 64.7 and 77.1% of the patients, respectively. Change in diagnosis after PET was identified in 30.0% of the patients and was associated with discordant 18F-FDG (p = 0.002) and 11C-PIB (p < 0.001) PET results, previous diagnostic dilemma (p = 0.005), low education (p = 0.027), Non-AD baseline diagnosis (p = 0.027), and negative 11C-PIB PET result (p < 0.001). Only the last variable remained significant in the multivariate analysis (adjusted p = 0.038). Diagnostic dilemma decreased after PET from 15.7 to 7.1% (p = 0.11) and was associated with Non-AD diagnosis (p = 0.002) and negative 11C-PIB PET result (p = 0.003). Change in AD treatment after PET occurred in 45.7% of the patients.Conclusion:18F-FDG and 11C-PIB PET had a significant clinical impact in terms of change in diagnosis and treatment in patients with dementia in a developing country, similar to that reported in high-income countries.

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Neuroimagen funcional en el diagnóstico de pacientes con síndrome parkinsoniano: actualización y recomendaciones para el uso clínico

Cited by 14 publications

References 51 publications

Diagnosis of multiple system atrophy

Diagnosis of multiple system atrophy

Positron Emission Tomography (PET) and Neuroimaging in the Personalized Approach to Neurodegenerative Causes of Dementia

Clinical Impact of PET With 18F-FDG and 11C-PIB in Patients With Dementia in a Developing Country

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