Center of Excellence of Neurodegenerative Disease (CoEN), AP-HP, Pitié-Salpêtrière Hospital, Paris, France.
Clinical Investigation Centre (CIC) Neuroscience, Brain Institute, Pitié-Salpêtrière Hospital, Paris, France.
Sci Rep. 2024 Oct 23;14(1):25088. doi: 10.1038/s41598-024-73777-y.
I-FP-CIT SPECT enables the detection of presynaptic dopaminergic denervation. It allows to differentiate degenerative parkinsonian syndromes from secondary parkinsonian syndromes or essential tremor, and patients with suspected dementia with Lewy bodies from those with other dementia subtypes. The aim of our study was to evaluate the appropriateness of I-FP-CIT SPECT prescriptions, identify prescriber profiles and analyze changes in prescriptions over a decade in the Neurology department of Avicenne University hospital. This retrospective study included all patients who underwent I-FP-CIT SPECT between February 2009 and May 2019 (n = 723). Clinical and paraclinical data were compared between three groups based on the relevance of I-FP-CIT SPECT prescription: "inappropriate", "uncertain" and "relevant". We showed that inappropriate indications accounted for 37.5% of I-FP-CIT SPECT requests. Hospital neurologists and neurologists with mixed practice accounted for 74.1% of I-FP-CIT SPECT requests, hospital movement disorders specialists being more likely to prescribe appropriately (67.1%) than hospital non-movement disorders specialists (33.3%). Following the replacement of the neuro-oncology team with a team including movement disorders specialists, the percentage of relevant SPECT 123I-FP-CIT prescriptions rose from 37.5% to 81.0%. These observations suggest that seeking the expertise of a movement disorders specialist would be more relevant than the systematic prescription of I-FP-CIT SPECT.
I-FP-CIT SPECT 能够检测到突触前多巴胺能神经纤维丧失。它可以区分退行性帕金森综合征与继发性帕金森综合征或特发性震颤，以及疑似路易体痴呆的患者与其他痴呆亚型的患者。我们的研究目的是评估 I-FP-CIT SPECT 处方的适宜性，确定开处方医生的特征，并分析神经内科在十年间 I-FP-CIT SPECT 处方的变化。这项回顾性研究纳入了 2009 年 2 月至 2019 年 5 月间进行 I-FP-CIT SPECT 的所有患者（n=723）。根据 I-FP-CIT SPECT 处方的相关性，将临床和辅助检查数据分为三组：“不适当”、“不确定”和“适当”。我们发现，不适当的适应症占 I-FP-CIT SPECT 请求的 37.5%。医院神经内科医生和混合执业的神经内科医生占 I-FP-CIT SPECT 请求的 74.1%，医院运动障碍专家更有可能开适当的处方（67.1%），而不是医院非运动障碍专家（33.3%）。在更换神经肿瘤团队为包括运动障碍专家的团队后，123I-FP-CIT SPECT 相关的处方比例从 37.5%上升到 81.0%。这些观察结果表明，寻求运动障碍专家的专业意见比系统地开 I-FP-CIT SPECT 更有意义。
