Department of Neurology, La Princesa University Hospital, Madrid, Spain.
Department of R&D, HT Médica, Madrid, Spain.
Mov Disord Clin Pract. 2024 Jun;11(6):613-625. doi: 10.1002/mdc3.14055. Epub 2024 May 1.
As the diagnosis of Parkinson's disease (PD) is fundamentally clinical, the usefulness of ioflupane (I) 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.
We aimed to summarize the current literature regarding DaTSCAN findings in patients with rare neurodegenerative parkinsonisms.
The 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.
The 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).
This 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.
由于帕金森病（PD）的诊断主要基于临床症状，因此碘氟苯（I）单光子发射计算机断层扫描（SPECT）或 DaTSCAN 作为诊断工具的效用多年来一直存在争议。DaTSCAN 的性能通常在临床诊断不确定的患者随访中得到推荐，特别是在那些疑似特发性震颤、药物诱导性帕金森病或血管性帕金森病的患者中。然而，除了 PD 和非典型帕金森病之外，DaTSCAN 对神经退行性帕金森病的研究结果还很少。迄今为止，尚未描述一种能够帮助将 PD 与最常见的非典型帕金森病区分开来的特定黑质纹状体多巴胺摄取模式。这一事实因罕见神经退行性帕金森病患者中摄取模式异常的可能可视化而变得更加复杂。
我们旨在总结目前关于罕见神经退行性帕金森病患者 DaTSCAN 研究结果的文献。
系统地在 PubMed 数据库中搜索英文或西班牙语文献，截至 2023 年 10 月 15 日，使用的检索词包括“DaTSCAN”、“ioflupane”、“DaT-SPECT”、“123I-FP-CIT SPECT”、“多巴胺转运体成像”和“[123I] FP-CIT SPECT”。排除了 PD、非典型帕金森病、肌张力障碍-帕金森病、特发性震颤和非退行性原因引起的帕金森病、以及与其他疾病（脆性 X 相关震颤/共济失调综合征、朊病毒病、亨廷顿病、脊髓小脑共济失调、遗传性痉挛性截瘫、代谢紊乱和其他疾病（抗 IgLON5 病、环状染色体 20 综合征、舞蹈病-棘红细胞增多症和神经元蜡样脂褐质沉积症）相关的帕金森病）相关的重复发表和研究。
对获得的结果进行了综述和总结，包括脆性 X 相关震颤/共济失调综合征、朊病毒病、亨廷顿病、脊髓小脑共济失调、遗传性痉挛性截瘫、代谢紊乱和其他疾病（抗 IgLON5 病、环状染色体 20 综合征、舞蹈病-棘红细胞增多症和神经元蜡样脂褐质沉积症）中 DaTSCAN 的发现。
本综述强调了未来需要确定 DaTSCAN 作为诊断和预后工具在罕见神经退行性疾病中帕金森病患者中的效用和成本效益。
