Hafeez Mohib, Eoff Elizabeth, Wei Jeanne, Azhar Gohar
Donald W. Reynolds Department of Geriatrics, Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
Geriatrics (Basel). 2024 Oct 1;9(5):126. doi: 10.3390/geriatrics9050126.
This retrospective study focused on the role of Dopamine Transporter (DAT) scans in diagnosing Parkinson's Disease (PD) in older adults with cognitive impairment (CI). We retrospectively analyzed brain imaging of 6483 individuals aged 60 and above with CI. Among these, 297 underwent a DAT scan, with 189 testing positive and 89 starting dopamine therapy. In contrast, 173 patients exhibited PD-associated structural changes on CT or MRI without receiving DAT scans or treatment. Of these patients, 50 (29%) experienced falls. This points towards a potential missed diagnosis of PD, which can respond to therapy in the early stages. Our results suggest that providers may overlook subtle signs of parkinsonism in patients with CI, resulting in symptoms worsening and treatment delay. Since CI is often first brought to the attention of PCPs, our findings call for an increased effort to inform PCPs of the role of DAT scans in aiding the diagnosis of dopamine deficiency states. By understanding PD-related structural changes seen on brain imaging and using a DAT scan to confirm dopamine deficiency, treatment for PD or related states might be started earlier or a timely referral made to a specialist, reducing patient disability and improving their quality of life.
这项回顾性研究聚焦于多巴胺转运体（DAT）扫描在诊断患有认知障碍（CI）的老年人帕金森病（PD）中的作用。我们回顾性分析了6483名60岁及以上患有CI的个体的脑部影像。其中，297人接受了DAT扫描，189人检测呈阳性，89人开始接受多巴胺治疗。相比之下，173名患者在未接受DAT扫描或治疗的情况下，CT或MRI显示出与PD相关的结构变化。在这些患者中，50人（29%）出现过跌倒。这表明可能存在PD的漏诊情况，而PD在早期阶段对治疗有反应。我们的结果表明，医疗服务提供者可能会忽略CI患者帕金森症的细微迹象，导致症状恶化和治疗延误。由于CI通常首先引起初级保健医生（PCP）的注意，我们的研究结果呼吁加大力度，让PCP了解DAT扫描在辅助诊断多巴胺缺乏状态中的作用。通过了解脑部影像上显示的与PD相关的结构变化，并使用DAT扫描来确认多巴胺缺乏，可能会更早地开始对PD或相关状态进行治疗，或及时转诊给专科医生，从而减少患者残疾并提高他们的生活质量。
