The Impact of DaTscan in the Diagnosis of Parkinson Disease

Gayed, Isis; Joseph, Usha A.; Fanous, Mina; Wan, David; Schiess, Mya C.; Ondo, William G.; Won, Kyoung Sook

doi:10.1097/rlu.0000000000000766

Cited by 25 publications

(15 citation statements)

References 26 publications

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“…Gayed et al observed 64% of clinically uncertain patients with PD had abnormal DaT scan in their study. 12 In a meta-analysis, Brigo et al reported that the sensitivity and specificity of DaT scan in distinguishing DLB from non-DLB dementia reached nearly 80%, though our study supported the clinical diagnosis of the DLB in 54.5% of patients. 13 Van der Zande et al reported 7 patients with clinical diagnosis of probable LBD who had normal DaT scan at the outset.…”

Section: Discussioncontrasting

confidence: 63%

Analysis of the Effect of Dopamine Transporter Scan on the Diagnosis and Management in a Tertiary Neurology Center

Bhattacharjee

Paramanandam

Bhattacharya

2019

The Neurohospitalist

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Background and Purpose: The dopamine transporter scan or DaT scan is abnormal in presynaptic parkinsonism but normal in nondegenerative or postsynaptic parkinsonism. In this study, we tried to ascertain the impact of DaT scan on the diagnosis and clinical management and if the semiquantitative analysis of the DaT scans has any correlation with the clinical symptoms. Methods: The electronic and nonelectronic records of patients of Plymouth Hospital NHS Trust, United Kingdom, from 2011 to 2015 were studied to find the indication, outcome, and the impact of the scan on the management of patients. The DaT scan results were assessed visually and semiquantitatively by the Department of Nuclear Medicine. The available data were statistically analyzed with the help of Microsoft XL2010 and GraphPad software. Results: A total of 258 people had DaT scan. The scan results suggested an alternate diagnosis in 50.5% of clinically diagnosed patients with Parkinson disease. Similarly, DaT scan changed the diagnosis of 40% of patients with clinical diagnosis of vascular parkinsonism, 25% of clinically diagnosed drug-induced parkinsonism, and 54% of patients with possible Lewy body dementia. Visual assessment of the DaT scan revealed that more than 60% had grade 2 abnormalities. The distribution volume ratio, a semiquantitative tool for tracer uptake, was significantly less in the patients with akinetic-rigid subtype of Parkinson disease in comparison to a tremor predominant subtype. Conclusions: Dopamine transporter scan had a significant impact in diagnosis and management.

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Section: Discussioncontrasting

confidence: 63%

Analysis of the Effect of Dopamine Transporter Scan on the Diagnosis and Management in a Tertiary Neurology Center

Bhattacharjee

Paramanandam

Bhattacharya

2019

The Neurohospitalist

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“…The patients were diagnosed according to Gelb criteria for the diagnosis of PD [Gelb et al, ]. To support the clinical diagnosis, dopamine transporter single photon emission computerized tomography (DAT‐SPECT) has been also used [Gayed et al, ]. Then, normal appearance of the nigrostriatal pathway on DAT‐SPECT was used as exclusion criterion.…”

Section: Methodsmentioning

confidence: 99%

Characterizing structural neural networks in de novo Parkinson disease patients using diffusion tensor imaging

Nigro

Riccelli

Passamonti

et al. 2016

Human Brain Mapping

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Parkinson disease (PD) can be considered as a brain multisystemic disease arising from dysfunction in several neural networks. The principal aim of this study was to assess whether large-scale structural topological network changes are detectable in PD patients who have not been exposed yet to dopaminergic therapy (de novo patients). Twenty-one drug-naïve PD patients and thirty healthy controls underwent a 3T structural MRI. Next, Diffusion Tensor Imaging (DTI) and graph theoretic analyses to compute individual structural white-matter (WM) networks were combined. Centrality (degree, eigenvector centrality), segregation (clustering coefficient), and integration measures (efficiency, path length) were assessed in subject-specific structural networks. Moreover, Network-based statistic (NBS) was used to identify whether and which subnetworks were significantly different between PD and control participants. De novo PD patients showed decreased clustering coefficient and strength in specific brain regions such as putamen, pallidum, amygdala, and olfactory cortex compared with healthy controls. Moreover, NBS analyses demonstrated that two specific subnetworks of reduced connectivity characterized the WM structural organization of PD patients. In particular, several key pathways in the limbic system, basal ganglia, and sensorimotor circuits showed reduced patterns of communications when comparing PD patients to controls. This study shows that PD is characterized by a disruption in the structural connectivity of several motor and non-motor regions. These findings provide support to the presence of disconnectivity mechanisms in motor (basal ganglia) as well as in non-motor (e.g., limbic, olfactory) circuits at an early disease stage of PD. Hum Brain Mapp 37:4500-4510, 2016. © 2016 Wiley Periodicals, Inc.

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“…DaT-SPECT scan was approved by the European Medicines Agency and by the Food and Drug Administration for in vivo diagnosis for subjects suspected with PD [20]. Asymmetric rostral-caudal decrease in tracer uptake, maximally affecting the posterior dorsal striatum, has been identified in patients with early PD [15, 19, 21].…”

Section: Introductionmentioning

confidence: 99%

DaT-SPECT assessment depicts dopamine depletion among asymptomatic G2019S LRRK2 mutation carriers

et al. 2017

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Identification of early changes in Dopamine-Transporter (DaT) SPECT imaging expected in the prodromal phase of Parkinson’s disease (PD), are usually overlooked. Carriers of the G2019S LRRK2 mutation are known to be at high risk for developing PD, compared to non-carriers. In this work we aimed to study early changes in Dopamine uptake in non-manifesting PD carriers (NMC) of the G2019S LRRK2 mutation using quantitative DaT-SPECT analysis and to examine the potential for early prediction of PD. Eighty Ashkenazi-Jewish subjects were included in this study: eighteen patients with PD; thirty-one NMC and thirty-one non-manifesting non-carriers (NMNC). All subjects underwent a through clinical assessment including evaluation of motor, olfactory, affective and non-motor symptoms and DaT-SPECT imaging. A population based DaT-SPECT template was created based on the NMNC cohort, and data driven volumes-of-interest (VOIs) were defined. Comparisons between groups were performed based on VOIs and voxel-wise analysis. The striatum area of all three cohorts was segmented into four VOIs, corresponding to the right/left dorsal and ventral striatum. Significant differences in clinical measures were found between patients with PD and non-manifesting subjects with no differences between NMC and NMNC. Significantly lower uptake (p<0.001) was detected in the right and left dorsal striatum in the PD group (2.2±0.3, 2.3±0.4) compared to the NMC (4.2±0.6, 4.3±0.5) and NMNC (4.5±0.6, 4.6±0.6), and significantly (p = 0.05) lower uptake in the right dorsal striatum in the NMC group compared to NMNC. Converging results were obtained using voxel-wise analysis. Two NMC participants, who later phenoconverted into PD, demonstrated reduced uptake mainly in the dorsal striatum. No significant correlations were found between the DaT-SPECT uptake in the different VOIs and clinical and behavioral assessments in the non-manifesting groups. This study shows the clinical value of quantitative assessment of DaT-SPECT imaging and the potential for predicting PD by detection of dopamine depletion, already at the pre-symptomatic stage.Clinical registration numbers: NCT01089270 and NCT01089283.

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The Impact of DaTscan in the Diagnosis of Parkinson Disease

Abstract: Markedly abnormal DaTscan is confirmed as the diagnostic pattern for PD. This pattern helps confirm the diagnosis in patients with unclear clinical diagnosis. Good interobserver agreement is easily obtained in reading DaTscans.

Cited by 25 publications

References 26 publications

Analysis of the Effect of Dopamine Transporter Scan on the Diagnosis and Management in a Tertiary Neurology Center

Analysis of the Effect of Dopamine Transporter Scan on the Diagnosis and Management in a Tertiary Neurology Center

Characterizing structural neural networks in de novo Parkinson disease patients using diffusion tensor imaging

DaT-SPECT assessment depicts dopamine depletion among asymptomatic G2019S LRRK2 mutation carriers

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