Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, National Hospital for Neurology and Neurosurgery, London, UK.
J Neurol Neurosurg Psychiatry. 2010 Jan;81(1):5-12. doi: 10.1136/jnnp.2008.157370.
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.
多巴胺转运体（DAT）成像技术是一种检测突触前多巴胺能神经元功能障碍的敏感方法，而突触前多巴胺能神经元功能障碍是神经退行性帕金森病的标志。因此，DAT 成像可以辅助区分存在和不存在突触前多巴胺能缺陷的情况。在具有充分表现的经典临床特征的情况下，DAT-SPECT 可以高度准确地诊断帕金森病或震颤障碍；然而，由于存在大量的临床重叠，特别是在单症状震颤（肌张力障碍性震颤、特发性震颤、帕金森震颤）中，诊断可能很困难。DAT-SPECT 的使用可以在这些情况下高度敏感地证明或排除黑质纹状体功能障碍，并有助于早期和准确的诊断。此外，正常的 DAT-SPECT 有助于通过排除潜在的真正黑质纹状体功能障碍来支持药物诱导、心因性和血管性帕金森病的诊断。本综述探讨了 DAT-SPECT 在以震颤和/或帕金森病为表现的运动障碍中的价值及其对诊断准确性的影响。
