Arquivos de Neuro-Psiquiatria (Sep 2012)

Dopamine transporter imaging in clinically unclear cases of parkinsonism and the importance of Scans Without Evidence of Dopaminergic Deficit (SWEDDs)

  • Marco A. T. Utiumi,
  • André C. Felício,
  • Conrado R. Borges,
  • Vera L. Braatz,
  • Sheyla A. S. Rezende,
  • Renato P. Munhoz,
  • Rodrigo A. Bressan,
  • Henrique B. Ferraz,
  • Hélio A. G. Teive

DOI
https://doi.org/10.1590/S0004-282X2012000900004
Journal volume & issue
Vol. 70, no. 9
pp. 667 – 673

Abstract

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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. OBJECTIVE: 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. CASES: We described four representative patients with clinically unclear parkinsonian syndromes who underwent [99mTc]-TRODAT-1 SPECT and reviewed the clinical implications. CONCLUSION: 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.

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