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Background Aims Methods Results Conclusions Differentiating idiopathic Parkinson disease (iPD) from other causes of tremor and parkinsonism based on clinical grounds can be challenging, particularly early in the course of disease or in the case of atypical clinical presentations. 18F‐fluorodopa (F‐DOPA) is a positron emission tomography (PET) radioligand that can be used to demonstrate the presence and pattern of striatal presynaptic dopaminergic deficit and, thus, assist in the diagnosis of iPD and related disorders.To determine the clinical utility of F‐DOPA PET in an Australian movement disorder clinic setting.Retrospective cohort study of movement disorder clinic patients referred for F‐DOPA PET by four movement disorder neurologists over a 10‐year period to a single Australian nuclear medicine centre. Results of F‐DOPA PET scans were correlated with changes in provisional diagnosis and management in the short term following review of F‐DOPA PET results.A total of 105 F‐DOPA PET scan results and patient records were examined. In this cohort, provisional clinical diagnosis was altered in 37.9% of patients, and changes to clinical management were made in 48.4% of patients in the short term following review of F‐DOPA PET results. Changes in both diagnosis and management were more common following a normal F‐DOPA PET scan result (42.4% and 53.0% respectively) than a scan consistent with iPD (23.5% and 32.4% respectively).There was significant change in provisional clinical diagnosis and management in the short term following review of F‐DOPA PET results indicating significant clinical utility of F‐DOPA PET in the Australian movement disorder clinic setting. [ABSTRACT FROM AUTHOR]

Background and Purpose: There has been a concerted move in recent times to shift from an exclusionary to a positive diagnosis of functional movement disorders (FMDs). To date, most of the focus has been on defining positive physical signs. Here the focus was on the diagnostic specificity of specific symptoms and patient characteristics., Methods: For this prospective cohort study, newly referred patients in the Netherlands and Australia were recruited before their first neurology appointment. Participants completed questionnaires within 2 months prior to their visit at one of the six different clinics. Directly following the first consultation, physicians received a questionnaire about their diagnostic process. Patients were excluded if the diagnosis was not a movement disorder. Univariate and multivariate regression analyses were conducted to identify predictors of FMDs. Subsequently, a predictive model was constructed and assessed using the area under the receiver operating curve., Results: Between 1 March 2021 and 1 March 2023, 465 patients were eligible for inclusion, of whom 171 (37%) had an FMD and 294 (63%) a non-FMD. Distinguishing factors amongst these groups included age at onset, gender, history or family history of a functional and psychiatric disorder, sudden onset, specific triggers, fluctuation patterns throughout the day and over an extended period, pain, fatigue, depression, anxiety and dissociation. Using these, a predictive model was developed, yielding a discriminative accuracy of 88%., Conclusion: Specific symptoms and patient characteristics have high diagnostic discriminative value between FMDs and non-FMDs, providing an additional tool in positive diagnosis., (© 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)