The role of DAT-SPECT in movement disorders
- 1Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, National Hospital for Neurology and Neurosurgery, London, UK
- 2Parkinson’s Disease and Movement Disorders Unit, Department of Neurology, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Suñer, Universitat de Barcelona, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
- Correspondence to Dr E Tolosa, Neurology Service, Institut Clínic de Neurociències, Hospital Clínic Universitari, Villarroel 170, Barcelona, Spain;
- Received 25 July 2008
- Revised 15 April 2009
- Accepted 5 May 2009
Dopamine transporter (DAT) imaging is a sensitive method to detect presynaptic dopamine neuronal dysfunction, which is a hallmark of neurodegenerative parkinsonism. DAT imaging can therefore assist the differentiation between conditions with and without presynaptic dopaminergic deficit. Diagnosis of Parkinson disease or tremor disorders can be achieved with high degrees of accuracy in cases with full expression of classical clinical features; however, diagnosis can be difficult, since there is a substantial clinical overlap especially in monosymptomatic tremor (dystonic tremor, essential tremor, Parkinson tremor). The use of DAT-SPECT can prove or excludes with high sensitivity nigrostriatal dysfunction in those cases and facilitates early and accurate diagnosis. Furthermore, a normal DAT-SPECT is helpful in supporting a diagnosis of drug-induced-, psychogenic- and vascular parkinsonism by excluding underlying true nigrostriatal dysfunction. This review addresses the value of DAT-SPECT and its impact on diagnostic accuracy in movement disorders presenting with tremor and/or parkinsonism.
Funding GK was supported by a grant from the Swiss Parkinson’s Disease Association. This work was supported by grant 2003 SRG00387 Generalitat de Catalunya, Spain and by the award “Distinción per la promoció de la Recerca Universitària Generalitat de Catalunya,” Spain, both to ET.
Competing interests None.
Provenance and Peer review Commissioned; externally peer reviewed.