Dopamine transporter imaging in clinically unclear cases of parkinsonism and the importance of scans without evidence of dopaminergic deficit (SWEDDs)

The clinical diagnosis of Parkinson's disease (PD) is susceptible to misdiagnosis, especially in the earlier stages of the disease. Recently, in vivo imaging techniques assessing the presynaptic dopamine transporter (DAT) have emerged as a useful tool in PD diagnosis, improving its accuracy. It...

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Bibliographic Details
Published in:	Arquivos de neuro-psiquiatria Vol. 70; no. 9; pp. 667 - 673
Main Authors:	Utiumi, Marco A T, Felício, André C, Borges, Conrado R, Braatz, Vera L, Rezende, Sheyla A S, Munhoz, Renato P, Bressan, Rodrigo A, Ferraz, Henrique B, Teive, Hélio A G
Format:	Journal Article
Language:	English
Published:	Brazil Academia Brasileira de Neurologia - ABNEURO 01-09-2012 Academia Brasileira de Neurologia (ABNEURO)
Subjects:	Adult Basal ganglia Brain Central nervous system diseases Computed tomography Data processing Diagnosis, Differential Differential diagnosis doença de Parkinson Dopamine Plasma Membrane Transport Proteins - metabolism Dopamine transporter exames sem evidência de déficit dopaminérgico Female Humans Magnetic Resonance Imaging Middle Aged Movement disorders Neurodegenerative diseases Neuroimaging NEUROSCIENCES Organotechnetium Compounds Parkinson's disease Parkinsonian Disorders - diagnostic imaging PSYCHIATRY Radiopharmaceuticals Single photon emission computed tomography Tc-99m-trodat-1 tomografia computadorizada de emissão de fóton único Tomography, Emission-Computed, Single-Photon - economics transportador de dopamina tremor Tropanes emission-computed Tc-99m-trodat-1 transportador de dopamina dopamine transporter exames sem evidência de déficit dopaminérgico doença de Parkinson single-photon tomography Parkinson disease scans without evidence of dopaminergic deficit tomografia computadorizada de emissão de fóton único Tc-99mtrodat- 1
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Summary:	The clinical diagnosis of Parkinson's disease (PD) is susceptible to misdiagnosis, especially in the earlier stages of the disease. Recently, in vivo imaging techniques assessing the presynaptic dopamine transporter (DAT) have emerged as a useful tool in PD diagnosis, improving its accuracy. It was to illustrate the clinical usefulness of a brain single-photon emission computed tomography (SPECT) DAT ligand, and highlight relevant aspects of scans without evidence of dopaminergic deficit (SWEDDs) in this context. We described four representative patients with clinically unclear parkinsonian syndromes who underwent [(99m)Tc]-TRODAT-1 SPECT and reviewed the clinical implications. DAT-SPECT is an important, cost-effective, technique for the differential diagnosis of parkinsonian syndromes. Additionally, SWEDD cases present clinical and paraclinical peculiarities that may retrospectively identify them as essential/dystonic tremor. The lack of histopathological data limits further conclusions.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	0004-282X 1678-4227 1678-4227 0004-282X
DOI:	10.1590/s0004-282x2012000900004