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Molecular imaging studies in Parkinson disease: reducing diagnostic uncertainty.
- Source :
-
The neurologist [Neurologist] 2009 Jan; Vol. 15 (1), pp. 6-16. - Publication Year :
- 2009
-
Abstract
- Background: The diagnosis of Parkinson disease (PD) is based on clinical criteria but misdiagnosis is as high as 25% of cases as confirmed by anatomic-pathologic studies. Since the introduction of in vivo molecular imaging techniques using Single-Photon Emission Computed Tomography and Positron Emission Tomography, the diagnosis of PD became more reliable by assessing dopaminergic and even nondopaminergic systems.<br />Review Summary: The purpose of this article is to critically review the current data on molecular neuroimaging focusing on the nigrostriatal circuitry and providing useful information on the role of these new imaging techniques in the management of clinically unclear cases of PD.<br />Conclusions: Patients with essential tremor, psychogenic Parkinsonism or drug-induced Parkinsonism can be differentiated from PD in doubtful situations using molecular imaging techniques evaluating striatal dopamine transporters (DAT). However, in patients with vascular Parkinsonism, atypical Parkinsonism and Parkinsonism associated with dementia DAT scans have less diagnostic usefulness. Scans with non-DAT tracers (ie, D2 dopamine receptors) are necessary together with long-term clinical follow-up, and rescans to improve diagnostic accuracy.
- Subjects :
- Brain diagnostic imaging
Brain metabolism
Corpus Striatum diagnostic imaging
Corpus Striatum metabolism
Dementia diagnosis
Dementia diagnostic imaging
Diagnosis, Differential
Dopa Decarboxylase metabolism
Dopamine Plasma Membrane Transport Proteins metabolism
Essential Tremor diagnosis
Essential Tremor diagnostic imaging
Humans
Parkinson Disease metabolism
Parkinsonian Disorders chemically induced
Parkinsonian Disorders diagnosis
Parkinsonian Disorders diagnostic imaging
Positron-Emission Tomography
Radioisotopes
Receptors, Dopamine D2 metabolism
Tomography, Emission-Computed, Single-Photon
Vesicular Monoamine Transport Proteins metabolism
Parkinson Disease diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1074-7931
- Volume :
- 15
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- The neurologist
- Publication Type :
- Academic Journal
- Accession number :
- 19131852
- Full Text :
- https://doi.org/10.1097/NRL.0b013e318183fdd8