Impact of dopamine transporter SPECT using 123I-Ioflupane on diagnosis and management of patients with clinically uncertain parkinsonian syndromes. J Neurol Sci. and A.C. screened the articles for eligibility and tabulated relevant information. DaTscan is a radioactive drug that is injected into your bloodstream to highlight areas of your brain so that images can be taken with a special camera (called a single-photon emission computed tomography [SPECT] camera). https://doi.org/10.1038/s41531-021-00185-8, DOI: https://doi.org/10.1038/s41531-021-00185-8. The relationship between cerebral vascular disease and parkinsonism: The VADO study, Parkinsonism & Related Disorders, 18, 775–780, https://doi.org/10.1016/j.parkreldis.2012.03.017 (2012). 2018 Dec;32(12):1351-1361. doi: 10.1177/0269881118796814. has acted as a consultant, speaker and grant recipient for GE Healthcare and is an employee of Konica-Minolta. Unable to load your collection due to an error, Unable to load your delegates due to an error. Both false positive DAT scan results (1.4%) and false negative (4.8%) are uncommon. • The risks of overdose relate predominantly to increased radiation exposure, with the long-term risks for neoplasia. Clinically, Alzheimer's disease (AD) is by far the most common cause of dementia. 17, 38–43 (2017). Rest tremor for example, is seen in virtually no other illness. Cite this article. In case of overdosage of radioactivity, frequent urination and defecation should be encouraged to minimize radiation exposure to the patient. J Neurol Sci. All proportions were subject to logit transformation to facilitate data analyses under the assumption of normal distribution. You will likely be asked to lie quietly on your back for about 20 minutes during the SPECT scan. Tremor (so called "pill-rolling," occurring at rest), Postural instability (stooped posture with shuffling gait and risk of falls), DaTscans are unable to distinguish Parkinson’s disease from other neurodegenerative parkinsonian disorders or other diagnoses that impact dopamine levels, such as. In abnormal scans, the striatum will appear darker, indicating the loss of dopamine neurons, a signature of Parkinson’s disease. What happens after my appointment? All data included in this manuscript have been sourced by publicly available information and are provided in the main manuscript and the supplementary data. -, Stevens T, Livingston G, Kitchen G, Manela M, Walker Z, Katona C. Islington study of dementia subtypes in the community. 19–21). government site. J. Neurol. Read our, PET Scan for Cancer: What You Need to Know. Disord. Used clinical examination with or without structural imaging to establish the pre-SPECT diagnosis. The purpose of this systematic review and meta-analysis is to examine the available evidence on the clinical utility of DaTscan image results in changing diagnoses and subsequent management of patients. I want a test to prove whether I do or do not have Parkinson’s disease!”, small handwriting, that decreases in size as the writing continues. Med. Mirpour, S., Turkbey, E. B., Marashdeh, W., El Khouli, R. & Subramaniam, R. M. Impact of DAT-SPECT on management of patients suspected of Parkinsonism. In these cases, DaT SPECT will be used to confirm the diagnosis and result in less change in management. The impact of DaTscan on the diagnosis and management of movement disorders: A retrospective study. The enrolled subjects (n=273) underwent a complete clinical evaluation to establish a baseline clinical diagnosis and were randomly assigned to undergo either SPECT imaging with DaTscan (n=135) or We would also like to acknowledge funding from GE Healthcare. 2004 Jun;61(6):919-25. doi: 10.1001/archneur.61.6.919. Oravivattanakul, S. et al. 2016 Jan;43(1):184-192. doi: 10.1007/s00259-015-3146-y. McKeith IG, Burn DJ, Ballard CG, et al. volume 7, Article number: 43 (2021) 262, 909–915 (2015). Assoc. Watch webinars, download our latest publications, and read articles — all filterable by the topic you would like to learn more about. Prior to DaTscan administration, please read the full Prescribing Information for additional Important Safety Information. Thirteen of these contributed to the meta-analyses including 950 and 779 patients with a reported change in management and change in diagnosis, respectively. Change in diagnosis occurred in 31% (95% CI: 22-42%) of patients. Ughreja, K. et al. Using a random-effects model, DaT imaging resulted in a change of diagnosis in 31% (95% CI: 22–42%) of patients (Fig. Keep in mind that like in any medical test, DaTscans can result in false positives and false negatives. Epub 2014 Dec 10. It also is not used currently as a clinical test to screen for the disease before motor symptoms are evident. In addition, the definition of ‘change in diagnosis’6 also included cases where the pre-scan diagnoses were less definitive and firmly established post-scan. Table 2 lists the change in management and diagnosis extracted from each study. Read more to learn about DaTscan, cases in which it may be prescribed, and the process for undergoing a SPECT scan to diagnose Parkinson's disease. ڨԐ���]�")�y��2�J�����?p$�5�H�ʢ��k.�Ku,��9&*A X�\Uw�_k#]:Q�}2�[S�D1�k��)08�N�b�u�61XK�D�+�I��8��΂I3,��"��U:0'uasR� Isaacson SH, Fisher S, Gupta F, Hermanowicz N, Kremens DE, Lew MF, Marek K, Pahwa R, Russell DS, Seibyl J. In 2011, the Food and Drug Administration (FDA) approved an imaging test to help diagnose PD. Brigo, F., Matinella, A., Erro, R. & Tinazzi, M. [(1)(2)(3)I]FP-CIT SPECT (DaTSCAN) may be a useful tool to differentiate between Parkinson’s disease and vascular or drug-induced parkinsonisms: a meta-analysis. Currently, the threshold for the proportion of cases that constitute a ‘clinically important’ change in management varies depending on multiple factors, including but not limited to, underlying conditions and available treatment management options. Therefore, in many cases, DaTscan results may improve diagnostic confidence rather than suggest a different medical condition. When results on the same dataset were reported in several publications, only the most recent or complete publication was included in the analysis, in order to avoid overlapping cohorts. to assist in the evaluation of adult patients with suspected parkinsonian syndromes." [4] Only a clinician can make a diagnosis. sharing sensitive information, make sure you’re on a federal Vor der Gutachterkommission Westfalen-Lippe kam der Sachverständige zu dem Ergebnis: Die DATScan-Untersuchungen (Hirn-Szintigraphien) vom 23.01.2008 und 21.05.2013 seien fehlerhaft bewertet worden. 27, 4–15 (2013). Preparation and Administration Assess pregnancy status before administering DATSCAN to a female of reproductive potential [see Use in Specific Populations (8.1)]. Kupsch, A. et al. DaTscan radiopharmaceutical for binding to dopamine transporters had to be discontinued for at least 5 half-lives prior to DaTscan administration. Medikamentenliste ®mit Relevanz für DaTSCAN (123I-FP CIT) Verantwortlich Medizin: Eveline Donnemiller Verantwortlich Radiopharmazie: Verantwortlich TAs: Angelika Huter . It may help distinguish the diagnosis of essential tremor from Parkinson's syndromes, like Parkinson’s disease or Parkinson’s disease dementia. 27, 933–937 (2006). The most common side effects associated with the use of DaTscan include the following: The potential side effects from DaTscan tend to be minimal and are relieved shortly after the test concludes. For example, in the differential diagnosis of PD vs. DIP change in management is primarily related to drug changes and may occur in higher frequency than other subgroups. The majority of the studies did not report intra- and inter-observer variation. A randomized, double-blind, placebo-controlled, crossover study to evaluate the human abuse liability of solriamfetol, a selective dopamine and norepinephrine reuptake inhibitor. Results were compared, and discrepancies between the two reviewers were resolved in a meeting. Studies that combined DaT SPECT with other imaging tests to establish the diagnosis. Case studies and small case series (<10 patients). Neurosci. Nucl. The authors also reported that shorter disease duration, absence of tremor or motor fluctuation, poor cognition, comorbidities, and absence of levodopa treatment were associated with lower diagnostic confidence at baseline34. Further exploratory subgroup analyses were performed based on the region where the study was performed (0.51, 95% CI: 0.41–0.62 North America vs. 0.57, 95% CI: 0.47–0.66 Europe), study design (0.62, 95% CI: 0.49–0.74 prospective vs. 0.54, 95% CI: 0.47–0.62 retrospective), patient age (0.56, 95% CI: 0.42–0.69 < 64 years vs. 0.58, 95% CI: 0.50–0.67 > 64 years), female to male ratio (0.55, 95% CI: 0.48–0.62 < 1 vs. 0.68, 95% CI: 0.55–0.79 > 1), follow-up time (0.54, 95% CI: 0.44–0.64 < 16 months vs. 0.45, 95% CI: 0.32–0.57 > 16 months) and time since onset of symptoms (0.57, 95% CI: 0.41–0.71 < 3.84 years vs. 0.59, 95% CI: 0.43–0.74 > 3.84 years). The use of DaTscan imaging resulted in a change in management in 54% (95% CI: 47–61%) of patients. National Library of Medicine Roussotte FF, Gutman BA, Hibar DP, Madsen SK, Narr KL, Thompson PM; Alzheimer's Disease Neuroimaging Initiative (ADNI). Change in diagnosis was reported by 13 studies6,7,8,9,10,13,16,17,20,21,22,23,24 including 779 patients. Disclaimer. Optimum presentation of the reconstructed images for visual interpretation is transaxial slices parallel to the anterior commissure-posterior commissure (AC-PC) line. 1998;351:1032–1033. 21, 1369–e1390 (2014). 2015 Dec 15;359(1-2):161-71. doi: 10.1016/j.jns.2015.11.004. Bethesda, MD 20894, Web Policies and C.B. Neurol. Potential impact of amyloid imaging on diagnosis and intended management in patients with progressive cognitive decline. Am J Neurodegener Dis. The rate of disease progression in clinical studies varies due to patient selection in treatment trials, medication use, and duration of follow‐up. Verywell Health's content is for informational and educational purposes only. Some of the variables considered important for clinical utility, such as diagnostic uncertainty, were inconsistently reported in the primary studies, limiting a comprehensive evaluation of their impact on heterogeneity. Clin. Contrast Media & Molecular Imaging Agents, Confidence inside the vial and far beyond, Supply chain precision from dose to delivery, a patient is scanned every 3.5 min worldwide, in the US are currently living with Parkinson’s disease, one of the world’s fastest growing neurological disorders8. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. With the exception of two RCTs7,16 the rest of the studies were reporting single centre real-world experiences utilising both retrospective and prospective designs. 2000;356:2031–2036. The proportion of patients who started a new drug treatment following the scan results, reported in 10 studies, was 26% (95% CI: 21–32%), who had their drug treatment stopped (12 studies) was 14% (95% CI: 10–20%), and who had a change in dose (3 studies) was 6% (95% CI: 2–19%). ���(�$" Past medical history included bipolar disorder (on lithium, haloperidol, valproate). J. Neural Transm. Die Arzneimittelinformation-AMI im Intranet der Tilak dient zur Überprüfung und . Efficacy of rivastigmine in dementia with Lewy bodies: a randomised, double-blind, placebo-controlled international study. eCollection 2021. However, some people may have mixed tremor features making the diagnosis more difficult. Introduction To Meta-analysis 77–86, https://doi.org/10.1002/9780470743386.ch13 (Wiley, 2009). Crotty, G. F., O’Corragain, O., Bogue, C., Crotty, J. Images of DaTscan (ioflupane [123I] SPECT) have been used as an adjunct to clinical diagnosis to facilitate the differential diagnosis of neurodegenerative (ND) Parkinsonian Syndrome (PS) vs. non-dopamine deficiency aetiologies of Parkinsonism. Based on the pre-existing diagnosis, change in management and diagnosis varied between 33% and 70% and 35%–56%, respectively. Mol. Apart from Garcia et al.11, none of the other studies had any significant effect on the change in management results (Supplementary Fig. Neurology 82, 1791–1797 (2014). DaTSCAN . The mean time of symptom duration in a systematic review and meta-analysis of diagnostic accuracy studies including patients with unclear Parkinsonism5 varied between 2 and 5.6 years with the longest duration observed in patients with a final diagnosis of DIP. Accurate differentiation of parkinsonism and essential tremor using visual assessment of [123I]-FP-CIT SPECT imaging: the [123I]-FP-CIT study group. Google Scholar. Similarly, for the change in diagnosis, with the exception of Marek et al.16, none of the other studies had any significant effect on the change in diagnosis (Supplementary Fig. Using a random-effects model 54% (95% CI: 47–61%) of patients had a change in management following the scan (Fig. with a DaTscan image is unknown. Dopamine transporter imaging for the diagnosis of dementia with Lewy bodies. While this assessment serves as an alternative diagnostic test for those with atypical symptoms, the use of DaTscan unfortunately comes with several limitations: Despite limitations, several studies are uncovering potential roles and benefits for using this test. DaTscan may be useful in distinguishing PD from certain conditions, but not from others, so talk with your neurologist about whether DaTscan would be useful in your specific situation. Arch Neurol. Mov. Change in diagnosis occurred in 31% (95% CI: 22-42%) of patients. 19, 1175–1182 (2004). Get the most important science stories of the day, free in your inbox. Seifert KD, Wiener JI. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. DaTscans are not currently used as preliminary tests to screen for Parkinson’s disease, and can only be used after classic motor symptoms are already present. Hum Psychopharmacol. Neurology 86, 566–576 (2016). Med. This result provides more confidence to our analyses as retrospective studies have a higher propensity for bias, missing data and a tendency to overestimate the effect. While the exam to some may seem very basic and thus a PD diagnosis subjective or questionable, neurologists are well-trained to assess and diagnose (in most cases) with confidence. Overall, there was a small majority of male patients (56.4% of the total population). Unlike other imaging tests, DaTscan with SPECT imaging assesses the function of the brain, rather than its anatomy or structure. Our systematic review and meta-analysis show that imaging with DaTscan was associated with a change in management in approximately half the patients tested and the diagnosis was modified in one third. Ir. The latter was also a factor contributing to higher change in management. Sampling variability (standard errors) of all proportions was assessed and their 95% confidence intervals were reported. However, our subgroup analysis based on study type did not show any influence on the results (0.62, 95% CI: 0.49–0.74 vs. 0.54, 95% CI: 0.47–0.62). Used under trademark license. Antonini, A. et al. This was mostly observed for the change in management outcome. Borenstein, M., Hedges, L., Higgins, J. P. T. & Rothstein, H. R. Fixed-Effect Versus Random-Effects Models. It explains how the Committee for Medicinal Products for Human Use (CHMP) assessed the medicine to reach its opinion in favour of granting a marketing authorisation and its recommendations on the The scan can be misread, leading to an incorrect diagnosis. Lancet. The use of DaTscan imaging resulted in a change in management in 54% (95% CI: 47-61%) of patients. By Brandon Peters, MD 2013;2(1):29–34. Dopamine transporter (DaT) scan utilization in a Movement Disorder Center. Federal government websites often end in .gov or .mil. Neurodegener. Current research continues to investigate the use of DaTscan and SPECT scans as secondary screening methods for people at risk for developing Parkinson’s disease and as a method of monitoring disease progression and striatal dopaminergic dysfunction in patients being treated for Parkinson’s disease. It is important to note that conventional MRI imaging will appear normal in PD and is therefore not helpful in confirming the diagnosis. Sadasivan, S. & Friedman, J. H. Experience with DaTscan at a tertiary referral center. The DaTscan once started takes approximately 30-45 minutes. J. Neurol. The above reflects the limitations of retrospective data collection and analysis. 9X�z�Q�'ͤ�fU9X�ʌ�Yݍ���P�j)D�Mp�&���S+_ Q�� 1i�(�NF��`�fA6-�Z��F6� F��������Դ"�1������A��%۴D��)�r0'MD�`��] �2�B�O��N�\�� bZ�2 �[E0 A.C., T.M., D.B., P.K. In the Flow and Timing domain, with the exception of 4 studies, the rest of the studies lacked clarity in the time interval between clinical diagnosis and DaTscan. J. Med. received funding for this analysis from GE Healthcare and are employees of Kings College London. Federal government websites often end in .gov or .mil. Google Scholar. J. Nucl. However, the absence of publication bias and the analysis of 20 different studies with a total of 3185 patients strengthen our results. The results of meta-analyses for change in management and diagnosis were subjected to sub-group analysis by regional variation, the proportion of patients with diagnoses deemed clinically uncertain and time since onset of symptoms (a categorical variable was created for each sub-group). In those cases, a DaTscan can be very useful. This is to show how a body system is functioning. Similarly, for ET vs. PD, a relatively high change in management is to be expected as the two groups are treated differently. Huma Sheikh, MD, is a board-certified neurologist, specializing in migraine and stroke, and affiliated with Mount Sinai of New York. Combined 123I-FP-CIT and 123I-IBZM SPECT for the diagnosis of parkinsonian syndromes: study on 72 patients. The DaTscan may be of benefit in situations like these when symptoms overlap. Hesse, S. et al. њ�W�βΊ�PUB�U�ia�jTa�#� PD tremors occur at rest and are accompanied by slowness and stiffness of the limb, whereas ET tremors occur with action and are not accompanied by slowness and stiffness of the limb. PMC the finding is easily explained by the concept of functional reserve: the system must cross a threshold before syntoms appear. DaTscan is a test that can help in the diagnosis of PD, although in most situations a clinical exam done by a neurologist offers the same information. There were no restrictions for inclusion based on the clinical setting. It has been also reported that the median annual progression rates of motor impairment and disability, are subject to considerable individual variability33. A random-effect model (with restricted maximum-likelihood estimation) was used as it allows for more realistic assumptions of the true between studies heterogeneity35. ALS vs. Parkinson's: What Are the Differences? DaTSCAN is a brain scan to diagnose Parkinson's disease. (2018). führen zu falsch-negativen oder falsch-positiven Befunden und sind daher abzusetzen. cMRI of the 3 cases (T 2 , coronal plane, including hippocampal area). Change in management can impact patients’ outcomes in a number of ways including affecting their quality of life by avoiding unnecessary medications and their side-effects and by providing people with clearer expectations related to prognosis. and A.A. contributed to the risk of bias assessment. Causes and Risk Factors of Parkinson's Disease, Coping With and Treating Essential Tremor, The impact of DaTscan on the diagnosis and management of movement disorders: A retrospective study, Role of DAT-SPECT in the diagnostic work up of parkinsonism, The role of DAT-SPECT in movement disorders. Nevertheless, some elements of the standard in-office neurologic exam are very characteristic, such as. Please enable it to take advantage of the complete set of features! Summary effect sizes were estimated as weighted means of observed effect sizes of individual studies. In neurogenerative disorders, it is often difficult to capture the long-term effect of diagnostic tests in clinical outcomes. Other atypical parkinsonian conditions, such as vascular parkinsonism however, can have abnormalities on MRI, so the test may be done to rule out other diagnoses. Elderly patients frequently suffer from concomitant cognitive deficits and the presence of cerebrovascular brain pathology potentially limits the benefit from levodopa treatment regardless of the imaging results. The risk of bias assessment was used independently of the quantitative meta-analysis. Typically, medications used as dopaminergic therapies can continue to be used. 2017 Mar;17(3):219-225. doi: 10.1080/14737175.2017.1256205. DATSCAN is indicated as an adjunct to other diagnostic evaluations for striatal dopamine transporter visualization using single photon emission computed tomography (SPECT) brain imaging in adult patients with: Important Safety Information About DaTscan™ (ioflupane I 123 injection). The https:// ensures that you are connecting to the Rizzo, G. et al. Following the DaTsan, your healthcare provider may ask you to continue to increase your intake of liquids to frequently empty your bladder for the first 48 hours post-scan in order to flush out and release any remaining tracer. DaTscan is not a test used for monitoring PD progression. 8600 Rockville Pike Arch. A copy of the amended QUADAS-2 checklist is provided in Supplementary data (Sect. Nucl. Keywords: The test is not currently used to indicate disease progression or to provide additional information that would clarify the anticipated response to dopaminergic therapies. Epub 2012 Jul 22. I) This document is a summary of the European public assessment report (EPAR) for DaTSCAN. Before Ⓒ 2023 Dotdash Media, Inc. — All rights reserved. The combination of an elderly population with potentially cognitive impairment and no benefit from levodopa reduce treatment options in these patients and therefore, determine an overall low rate of change in management. However, DaTscan and SPECT specifically visualize to what capacity dopamine is being utilized in the brain. These medications--such as carbidopa-levodopa, ropinirole, pramipexole, or rotigotine--treat the loss of dopamine. A DaTscan may be helpful in complex cases. The logit transformations and their 95% confidence intervals were converted back to proportions to provide an estimate of the pooled change in management and diagnosis and their heterogeneity. Careers. Reconstructed pixel size should be between 3.5 and 4.5 mm with slices 1 pixel thick. DaTscan is administered through an injection, so there is a theoretical risk of a more serious infection, or even an allergic reaction, at the site of injection. Grundman, M. et al. Dopamine Transporter Scan, also known as DaTscan, is a new, non-invasive imaging test for patients that can help physicians diagnose Parkinson's disease and Dementia. With the exception of one study6, the rate of change in management was higher than a change in diagnosis. Read about what we fund and explore opportunities for funding. -, Perry RH, Irving D, Blessed G, Fairbairn A, Perry EK. All studies included a reference standard (clinical diagnosis) albeit with a variety of methods reported. 1310 0 obj <>stream However, following injection of the DaT agent approximately 3-6 hours are required before the agent has achieved appropriate concentration in the brain. PO Box 61420 The three studies that reported diagnostic confidence results12,21,24, all indicated that post-imaging confidence in the prediction of degenerative parkinsonism decreased in cases of a normal scan but remained high or increased when results were abnormal suggesting that DaT imaging was mainly utilised to confirm the presence of PD. The funnel plot analysis showed distribution asymmetry potentially indicating the presence of publication bias (Supplementary Fig. A replication study, systematic review and meta-analysis of automated image-based diagnosis in parkinsonism, Differential diagnosis of parkinsonism: a head-to-head comparison of FDG PET and MIBG scintigraphy, Safinamide in the treatment pathway of Parkinson’s Disease: a European Delphi Consensus, A nationwide study of the incidence, prevalence and mortality of Parkinson’s disease in the Norwegian population, A systematic review of brain morphometry related to deep brain stimulation outcome in Parkinson’s disease, Clinical factors and dopamine transporter availability for the prediction of outcomes after globus pallidus deep brain stimulation in Parkinson’s disease, Factors associated with mortality in early stages of parkinsonism, A meta-analysis of the diagnostic utility of biomarkers in cerebrospinal fluid in Parkinson’s disease, Change in the incidence of Parkinson’s disease in a large UK primary care database, https://doi.org/10.1016/j.parkreldis.2012.03.017, https://doi.org/10.1002/9780470743386.ch13, http://creativecommons.org/licenses/by/4.0/, Stereotactical normalization with multiple templates representative of normal and Parkinson-typical reduction of striatal uptake improves the discriminative power of automatic semi-quantitative analysis in dopamine transporter SPECT, A systematic review of the potential effects of medications and drugs of abuse on dopamine transporter imaging using [123I]I-FP-CIT SPECT in routine practice, Dopamine transporter single photon emission computed tomography (DaT-SPECT) use in the diagnosis and clinical management of parkinsonism: an 8-year retrospective study, Multiple-pinhole collimators improve intra- and between-rater agreement and the certainty of the visual interpretation in dopamine transporter SPECT, Mining imaging and clinical data with machine learning approaches for the diagnosis and early detection of Parkinson’s disease. You should always talk to your personal healthcare providers for specific medical and health-related instructions and guidelines. The two pooled analyses were characterised by high levels of heterogeneity. -, McKeith I, Del Ser T, Spano P, et al. apda@apdaparkinson.org. Studies including patients with higher mean age and higher female to male ratio resulted in a larger change in diagnosis. Change in diagnosis was defined as any change in the patient’s assigned or suspected diagnosis following disclosure of the results of the imaging scan. Accessibility Every medical test (for any disease) has a false positive and a false negative rate. Clin. We attempted to account for this variation by using random-effects modelling, sub-group, and leave-one-out sensitivity analysis. The DaTscan will then be injected into your bloodstream. Northwestern University Feinberg School of Medicine, Chicago, IL, USA, Departments of Medical Imaging Medicine, and Biomedical Engineering, University of Arizona, Tucson, AZ, USA, King’s Technology Evaluation Centre, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK, Anastasia Chalkidou, Mariusz T. Grzeda & Thomas Macmillan, GE Healthcare, Pollards Wood, Nightingales Ln, Chalfont Saint Giles, UK, Department of Neuroscience, University of Padua, Padua, Italy, You can also search for this author in Control. Because of these limitations, the search continues for additional measurable indicators, known as biomarkers, to help diagnosis and manage PD. 2021 Jun 21;13:672956. doi: 10.3389/fnagi.2021.672956. Using a random-effects model, all 13 studies were sequentially excluded. performed the literature search. Br J Psychiatry. government site. Neuropharmacology. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Any observed heterogeneity was explored using pre-specified sub-group and meta-regression analysis. The assessment of the methodological quality revealed potential sources of bias in the reviewed studies. 15, 81–86 (2015). (123I) beta-CIT and single-photon emission computed tomographic imaging vs clinical evaluation in Parkinsonian syndrome: unmasking an early diagnosis. and transmitted securely. Alzheimers Dement. Clinical routine use of dopamine transporter imaging in 516 consecutive patients. Yomtoob, J., Koloms, K. & Bega, D. DAT-SPECT imaging in cases of drug-induced parkinsonism in a specialty movement disorders practice. In patients with a diagnosis of Parkinson’s disease, or parkinsonism (referring more generally to a condition that causes symptoms that affect movement the way Parkinson's can), this area of the brain will show “dark.” This indicates the loss of dopamine-containing nerve cells within the brain, a hallmark of the disease. DaTscan used during SPECT scanning may be a good alternative to help alleviate this confusion. In contrast, the tremor associated with Parkinson’s disease tends to be slower, may appear like someone is rolling a pill in their cupped hand, and notably occurs at rest. Disord. and JavaScript. Learn More. False-Positive DaTscan Features With Methylphenidate and Phentermine Therapy Mayo Clin Proc. Plotkin, M. et al. Graebner, A. K. et al. Change in management was defined as any changes that the study authors recorded as changes in treatment or further investigations, such as drug changes (start of a new drug, discontinue existing medication or change in dose), referral for counselling or physical therapy following the disclosure of DaT imaging results. 17). The level of heterogeneity was assessed using the between-study variance (τ-squared statistic), Q statistics, and I-squared statistics. Carter LP, Henningfield JE, Wang YG, Lu Y, Kelsh D, Vince B, Sellers E. J Psychopharmacol. You can find out more about our use, change your default settings, and withdraw your consent at any time with effect for the future by visiting Cookies Settings, which can also be found in the footer of the site.
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