Affiliation:
1. Department of Neurology La Princesa University Hospital Madrid Spain
2. Department of R&D HT Médica Madrid Spain
3. Department of Radiology HT Médica, San Juan de Dios Hospital Córdoba Spain
4. Faculty of Medicine Autonomous University of Madrid Madrid Spain
Abstract
AbstractBackgroundAs the diagnosis of Parkinson's disease (PD) is fundamentally clinical, the usefulness of ioflupane (123I) single‐photon emission computed tomography (SPECT) or DaTSCAN as a diagnostic tool has been a matter of debate for years. The performance of DaTSCAN is generally recommended in the follow‐up of patients with a clinically uncertain diagnosis, especially in those with a suspected essential tremor, drug‐induced parkinsonism, or vascular parkinsonism. However, there is a dearth of DaTSCAN findings regarding neurodegenerative parkinsonisms besides PD and atypical parkinsonisms. To date, a specific nigrostriatal dopamine uptake pattern that would help differentiate PD from the most frequent atypical parkinsonisms is yet to be described. This fact is further complicated by the possible visualization of abnormalities in the uptake pattern in patients with rarer neurodegenerative parkinsonisms.ObjectivesWe aimed to summarize the current literature regarding DaTSCAN findings in patients with rare neurodegenerative parkinsonisms.MethodsThe PubMed database was systematically screened for studies in English or Spanish up to October 15, 2023, using search terms “DaTSCAN”, “ioflupane”, “DaT‐SPECT”, “123I‐FP‐CIT SPECT”, “dopamine transporter imaging”, and “[123I] FP‐CIT SPECT”. Duplicated publications and studies regarding PD, atypical parkinsonisms, dystonia‐parkinsonism, essential tremor, and parkinsonism due to non‐degenerative causes were excluded.ResultsThe obtained results were reviewed and summarized, including DaTSCAN findings in fragile X‐associated tremor/ataxia syndrome, prion diseases, Huntington's disease, spinocerebellar ataxia, hereditary spastic paraparesis, metabolic disorders, and other diseases (anti‐IgLON5 disease, ring chromosome 20 syndrome, chorea‐acanthocytosis, and neuronal ceroid lipofuscinosis).ConclusionsThis review highlights the need to determine in the future the utility and cost‐effectiveness of DaTSCAN, both as a diagnostic and a prognostic tool, in patients with parkinsonian symptoms in rare neurodegenerative diseases.