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Tian M, Zuo C, Cahid Civelek A, Carrio I, Watanabe Y, Kang KW, Murakami K, Prior JO, Zhong Y, Dou X, Yu C, Jin C, Zhou R, Liu F, Li X, Lu J, Zhang H, Wang J. International consensus on clinical use of presynaptic dopaminergic positron emission tomography imaging in parkinsonism. Eur J Nucl Med Mol Imaging 2024; 51:434-442. [PMID: 37789188 DOI: 10.1007/s00259-023-06403-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/15/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE Presynaptic dopaminergic positron emission tomography (PET) imaging serves as an essential tool in diagnosing and differentiating patients with suspected parkinsonism, including idiopathic Parkinson's disease (PD) and other neurodegenerative and non-neurodegenerative diseases. The PET tracers most commonly used at the present time mainly target dopamine transporters (DAT), aromatic amino acid decarboxylase (AADC), and vesicular monoamine type 2 (VMAT2). However, established standards for the imaging procedure and interpretation of presynaptic dopaminergic PET imaging are still lacking. The goal of this international consensus is to help nuclear medicine practitioners procedurally perform presynaptic dopaminergic PET imaging. METHOD A multidisciplinary task group formed by experts from various countries discussed and approved the consensus for presynaptic dopaminergic PET imaging in parkinsonism, focusing on standardized recommendations, procedures, interpretation, and reporting. CONCLUSION This international consensus and practice guideline will help to promote the standardized use of presynaptic dopaminergic PET imaging in parkinsonism. It will become an international standard for this purpose in clinical practice.
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Affiliation(s)
- Mei Tian
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, 200235, China.
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China.
- Human Phenome Institute, Fudan University, Shanghai, 201203, China.
| | - Chuantao Zuo
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, 200235, China.
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China.
| | - A Cahid Civelek
- Department of Radiology and Radiological Science, Division of Nuclear Medicine and Molecular Imaging, Johns Hopkins Medicine, Baltimore, MD, 21287, USA.
| | - Ignasi Carrio
- Research Institute and Department of Nuclear Medicine, Hospital Sant Pau, Autonomous University of Barcelona, 08025, Barcelona, Spain
| | - Yasuyoshi Watanabe
- Laboratory for Pathophysiological and Health Science, RIKEN Center for Biosystems Dynamics Research, Kobe, Hyogo, 650-0047, Japan
| | - Keon Wook Kang
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, 03080, Korea
| | - Koji Murakami
- Department of Radiology, Juntendo University Hospital, Tokyo, 113-8431, Japan
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland
| | - Yan Zhong
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
| | - Xiaofeng Dou
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
| | - Congcong Yu
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
| | - Chentao Jin
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
| | - Rui Zhou
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China
| | - Fengtao Liu
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200235, China
| | - Xinyi Li
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200235, China
| | - Jiaying Lu
- Department of Nuclear Medicine and PET Center, Huashan Hospital, Fudan University, Shanghai, 200235, China
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Hong Zhang
- Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, China.
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, 310009, China.
- The College of Biomedical Engineering and Instrument Science of Zhejiang University, Hangzhou, 310007, China.
- Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, 310007, China.
| | - Jian Wang
- National Center for Neurological Disorders & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China.
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200235, China.
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Khan MA, Haider N, Singh T, Bandopadhyay R, Ghoneim MM, Alshehri S, Taha M, Ahmad J, Mishra A. Promising biomarkers and therapeutic targets for the management of Parkinson's disease: recent advancements and contemporary research. Metab Brain Dis 2023; 38:873-919. [PMID: 36807081 DOI: 10.1007/s11011-023-01180-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 02/04/2023] [Indexed: 02/23/2023]
Abstract
Parkinson's disease (PD) is one of the progressive neurological diseases which affect around 10 million population worldwide. The clinical manifestation of motor symptoms in PD patients appears later when most dopaminergic neurons have degenerated. Thus, for better management of PD, the development of accurate biomarkers for the early prognosis of PD is imperative. The present work will discuss the potential biomarkers from various attributes covering biochemical, microRNA, and neuroimaging aspects (α-synuclein, DJ-1, UCH-L1, β-glucocerebrosidase, BDNF, etc.) for diagnosis, recent development in PD management, and major limitations with current and conventional anti-Parkinson therapy. This manuscript summarizes potential biomarkers and therapeutic targets, based on available preclinical and clinical evidence, for better management of PD.
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Affiliation(s)
- Mohammad Ahmed Khan
- Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India
| | - Nafis Haider
- Prince Sultan Military College of Health Sciences, Dhahran, 34313, Saudi Arabia
| | - Tanveer Singh
- Department of Neuroscience and Experimental Therapeutics, College of Medicine, Texas A&M University Health Science Center, Bryan, TX, 77807, USA
| | - Ritam Bandopadhyay
- Department of Pharmacology, School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, 144411, Punjab, India
| | - Mohammed M Ghoneim
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, Ad Diriyah, 13713, Saudi Arabia
| | - Sultan Alshehri
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Murtada Taha
- Prince Sultan Military College of Health Sciences, Dhahran, 34313, Saudi Arabia
| | - Javed Ahmad
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran, 11001, Saudi Arabia
| | - Awanish Mishra
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER) - Guwahati, Sila Katamur (Halugurisuk), Kamrup, Changsari, Assam, 781101, India.
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Tsang K, Walker R. Dopamine transporter single photon emission computed tomography (DaT-SPECT) use in the diagnosis and clinical management of parkinsonism: an 8-year retrospective study. J Neurol 2023; 270:2550-2558. [PMID: 36795149 PMCID: PMC10129961 DOI: 10.1007/s00415-023-11563-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/06/2023] [Accepted: 01/08/2023] [Indexed: 02/17/2023]
Abstract
INTRODUCTION Parkinson's disease (PD) is a neurodegenerative movement disorder that is typically diagnosed clinically. DaT-SPECT scanning (DaT Scan) can be used when there is diagnostic difficulty differentiating from non-neurodegenerative Parkinsonism. This study assessed the effect of DaT Scan imaging on diagnosis and subsequent clinical management of these disorders. METHODS This single-trust retrospective study involved 455 patients who had undergone DaT scans for investigation for Parkinsonism, between 01/01/2014 and 31/12/2021. Data collected included patient demographics, date of clinical assessment, scan report, pre-scan and post-scan diagnosis, and clinical management. RESULTS The mean age at scan was 70.5 years and 57% were male. The percentage of patients who had an abnormal scan result was 40% (n = 184), whilst 53% (n = 239) had a normal scan result, and 7% (n = 32) had an equivocal scan. Pre-scan diagnosis was consistent with scan results in 71% of cases of neurodegenerative Parkinsonism, whereas this figure was 64% for cases of non-neurodegenerative Parkinsonism. For all DaT scans, the diagnosis was changed in 37% of patients (n = 168), whilst the clinical management was changed in 42% of patients (n = 190). Change in management involved 63% starting dopaminergic medication, 5% stopping dopaminergic medications, and 31% undergoing other changes in management. CONCLUSION DaT imaging is useful for confirming the correct diagnosis and clinical management for patients with clinically indeterminate Parkinsonism. Pre-scan diagnoses were generally consistent with scan results.
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Affiliation(s)
- Kaki Tsang
- North Tees and Hartlepool Trust, Stockton-upon-Tees, UK. .,Department of Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
| | - Richard Walker
- Department of Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,Northumbria Healthcare NHS Foundation Trust, Medicine, North Shields, Tyne and Wear, UK
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Wagle Shukla A. Diagnosis and Treatment of Essential Tremor. Continuum (Minneap Minn) 2022; 28:1333-1349. [DOI: 10.1212/con.0000000000001181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Arena JE, Urrutia L, Falasco G, de Leon MP, Vazquez S, Rossi M, Merello M. Correlation between 99mTc-TRODAT-1 SPECT and 18F-FDOPA PET in patients with Parkinson's disease: a pilot study. Radiol Bras 2021; 54:232-237. [PMID: 34393289 PMCID: PMC8354188 DOI: 10.1590/0100-3984.2020.0087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 08/04/2020] [Indexed: 11/28/2022] Open
Abstract
Objective To determine whether technetium-99m-labeled tropane derivative single-photon emission computed tomography (99mTc-TRODAT-1 SPECT) provides results comparable to those of the less widely available, less accessible tool fluorine-18-labeled fluorodopa positron-emission tomography (18F-FDOPA PET) in the setting of a movement disorders clinic. Materials and Methods In this prospective pilot study, eight subjects with a clinical diagnosis of Parkinson’s disease were randomly selected from among patients under treatment at a movement disorders clinic and submitted to 99mTc-TRODAT-1 SPECT and 18F-FDOPA PET. The results were read by two experienced observers, and a semiquantitative analysis was performed. Results The visual and semiquantitative analyses were concordant for all studies, showing that radiotracer uptake in the contralateral striatum on the most affected side was lower when 99mTc-TRODAT-1 SPECT was employed. The semiquantitative analysis demonstrated a significant correlation between 18F-FDOPA PET and 99mTc-TRODAT-1 SPECT (r = 0.73; p < 0.01). Conclusion It appears that 99mTc-TRODAT-1 SPECT is a valid option for the study of dopaminergic function in a clinical setting.
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Affiliation(s)
| | | | | | | | | | | | - Marcelo Merello
- Fleni, Buenos Aires, Argentina.,Pontificia Universidad Catolica Argentina, Buenos Aires, Argentina
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Bega D, Kuo PH, Chalkidou A, Grzeda MT, Macmillan T, Brand C, Sheikh ZH, Antonini A. Clinical utility of DaTscan in patients with suspected Parkinsonian syndrome: a systematic review and meta-analysis. NPJ Parkinsons Dis 2021; 7:43. [PMID: 34031400 PMCID: PMC8144619 DOI: 10.1038/s41531-021-00185-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 03/29/2021] [Indexed: 11/08/2022] Open
Abstract
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. Despite several systematic reviews having summarised the evidence on diagnostic accuracy, the impact of imaging results on clinical utility has not been systematically assessed. Our objective was to examine the available evidence on the clinical utility of DaTscan imaging in changing diagnosis and subsequent management of patients with suspected PS. We performed a systematic review of published studies of clinical utility from 2000 to 2019 without language restrictions. A meta-analysis of change in diagnosis and management rates reported from each study was performed using a random-effects model and logit transformation. Sub-group analysis, meta-regression and sensitivity analysis was performed to explore heterogeneity. Twenty studies met the inclusion criteria. Thirteen of these contributed to the meta-analyses including 950 and 779 patients with a reported change in management and change in diagnosis, respectively. The use of DaTscan imaging resulted in a change in management in 54% (95% CI: 47-61%) of patients. Change in diagnosis occurred in 31% (95% CI: 22-42%) of patients. The two pooled analyses were characterised by high levels of heterogeneity. 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. Regardless of time from symptom onset to scan results, these changes were consistent. Further research focusing on specific patient subgroups could provide additional evidence on the impact on clinical outcomes.
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Affiliation(s)
- Danny Bega
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Phillip H Kuo
- Departments of Medical Imaging Medicine, and Biomedical Engineering, University of Arizona, Tucson, AZ, USA
| | - Anastasia Chalkidou
- King's Technology Evaluation Centre, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
| | - Mariusz T Grzeda
- King's Technology Evaluation Centre, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Thomas Macmillan
- King's Technology Evaluation Centre, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | | | - Zulfiqar H Sheikh
- GE Healthcare, Pollards Wood, Nightingales Ln, Chalfont Saint Giles, UK
| | - Angelo Antonini
- Department of Neuroscience, University of Padua, Padua, Italy
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Isaacson JR, Brillman S, Chhabria N, Isaacson SH. Impact of DaTscan Imaging on Clinical Decision Making in Clinically Uncertain Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2021; 11:885-889. [PMID: 33554925 PMCID: PMC8150650 DOI: 10.3233/jpd-202506] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: The diagnosis of Parkinson’s disease (PD) is primarily clinical, but in cases of diagnostic uncertainty, evaluation of nigrostriatal dopaminergic degeneration (NSDD) by imaging of the dopamine transporter using DaTscan with single-photon emission computed tomography (SPECT) brain imaging may be helpful. Objective/Methods: In the current paper, we describe clinical scenarios for which DaTscan imaging was used in a prospective case series of 201 consecutive patients in whom a movement disorder specialist ordered DaTscan imaging to clarify NSDD. We describe the impact of DaTscan results on changing or confirming pre-DaTscan clinical diagnosis and on post-DaTscan treatment changes. Results/Conclusion: DaTscan imaging can be useful in several clinical scenarios to determine if NSDD is present. These include in patients with early subtle symptoms, suboptimal response to levodopa, prominent action tremor, drug-induced parkinsonism, and in patients with lower extremity or other less common parkinsonism clinical presentations. We also found DaTscan imaging to be useful to determine underlying NSDD in patients with PD diagnosis for 3-5 years but without apparent clinical progression or development of motor fluctuations. Overall, in 201 consecutive patients with clinically questionable NSDD, DaTscan was abnormal in 58.7% of patients, normal in 37.8%, and inconclusive in 3.5%. DaTscan imaging changed clinical diagnosis in 39.8% of patients and led to medication therapy changes in 70.1% of patients.
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Affiliation(s)
- Jonathan R Isaacson
- Parkinson's Disease and Movement Disorders Center of Boca Raton, Boca Raton, FL, USA
| | - Salima Brillman
- Parkinson's Disease and Movement Disorders Center of Boca Raton, Boca Raton, FL, USA
| | - Nisha Chhabria
- Parkinson's Disease and Movement Disorders Center of Boca Raton, Boca Raton, FL, USA
| | - Stuart H Isaacson
- Parkinson's Disease and Movement Disorders Center of Boca Raton, Boca Raton, FL, USA
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Ghoneim A, Pollard C, Tyagi A, Jampana R. Substantia nigra micro-haemorrhage causing ipsilateral unilateral Parkinsonism and abnormal dopamine transporter scan uptake. BJR Case Rep 2021; 7:20200118. [PMID: 33614119 PMCID: PMC7869125 DOI: 10.1259/bjrcr.20200118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/20/2020] [Accepted: 09/26/2020] [Indexed: 11/05/2022] Open
Abstract
Parkinsonism is a commonly seen movement disorder syndrome with neurodegenerative and non-neurodegenerative causes. Presynaptic dopamine transporter (DaT) single-photon emission computed tomography (SPECT) imaging is the most commonly used imaging technique in clinical practice to differentiate degenerative Parkinson's disease (PD) and PD plus syndromes from other causes such as essential tremor and drug-induced parkinsonism. This can help identify the patients who would benefit from medical therapy due to underlying pre-synaptic dopaminergic deficits. We report a case of unilateral parkinsonism caused by ipsilateral substantia nigra micro-haemorrhage resulting in disruption of the nigrostriatal pathway. This is an unusual case of a 55-year-old male patient who presented with unilateral Parkinsonism a decade after significant head trauma where MRI plays a critical and complementary role in diagnosing complete interruption of the nigrostriatal pathway due to cerebral micro-haemorrhage. The case also beautifully demonstrates the anatomy of the nigrostriatal pathway where a small lesion in the substantia nigra caused complete loss of radioligand uptake in the ipsilateral corpus striatum. Physicians should be aware of the importance of structural imaging in atypical movement disorder cases and, in particular, the routine use of susceptibility-weighted sequences (SWI).
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Affiliation(s)
- Aliaa Ghoneim
- Consultant Neuroradiology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Christopher Pollard
- Department of Neuroradiology, Consultant Neuroradiology, Institute of Neurological Sciences, Glasgow, UK
| | - Alok Tyagi
- Department of Neurology, Consultant Neurology, Institute of Neurological Sciences, Glasgow, UK
| | - Ravi Jampana
- Department of Neuroradiology, Consultant Neuroradiology, Institute of Neurological Sciences, Glasgow, UK
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Buchert R, Buhmann C, Apostolova I, Meyer PT, Gallinat J. Nuclear Imaging in the Diagnosis of Clinically Uncertain Parkinsonian Syndromes. DEUTSCHES ARZTEBLATT INTERNATIONAL 2020; 116:747-754. [PMID: 31774054 DOI: 10.3238/arztebl.2019.0747] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 03/01/2019] [Accepted: 08/08/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Parkinsonian syndromes are classified by etiology mainly on clinical grounds, that is, on the basis of the clinical manifestations and with the aid of conventional ancillary studies. In most cases, the clinical diagnosis is clear. In up to 30% of cases, however, the etiological classification remains uncertain after completion of the basic clinical diagnostic evaluation, and additional investigation with nuclear imaging may be indicated. In particular, cerebral single-photon emission computed tomography (SPECT) with dopamine transporter (DAT) ligands may be helpful. DAT-SPECT can be used to demonstrate or rule out nigrostriatal degeneration and thereby differentiate neurodegenerative parkinsonian syndromes from symptomatic parkinsonian syndromes and other differential diagnoses. Positron emission tomography (PET) with the glucose analogue [18F]fluorodeoxyglucose (FDG) can be used to identify disease-specific patterns of neuronal dysfunction/degeneration in order to differentiate the various neurodegenerative parkinsonian syndromes from one another. METHODS In this review, we summarize the current state of the evidence on DAT-SPECT and FDG-PET for the indications mentioned above on the basis of a selective review of the literature. RESULTS DAT-SPECT has been adequately validated as an in vivo marker for nigrostriatal degeneration. Studies using the clinical diagnosis of a movement disorders specialist over the course of the disease as a reference have shown that DAT- SPECT is 78-100% sensitive (median, 93%) and 70-100% specific (median, 89%) for the differentiation of neurodegenerative parkinsonian syndromes from symptomatic parkinsonism and other differential diagnoses in clinically unclear cases. DAT- SPECT scanning led to a change of diagnosis in 27-56% of patients (median, 43%) and to a change of treatment in 33-72% (median, 43%). FDG-PET enables the differentiation of atypical neurodegenerative parkinsonian syndromes from the idiopathic parkinsonian syndrome (i.e., Parkinson's disease proper) with high sensitivity and specificity (both approximately 90%), when the clinical diagnosis by a movement disorders specialist over the course of the disease is used as a reference. CONCLUSION DAT-SPECT has been well documented to be highly diagnostically accurate and to have a relevant influence on the diagnosis and treatment of patients with clinically uncertain parkinsonian or tremor syndrome. It has not yet been shown to improve patient-relevant endpoints such as mortality, morbidity, and health-related quality of life; proof of this will probably have to await the introduction of neuroprotective treatments. The current evidence for the high differential diagnostic accuracy of FDG-PET in neurodegenerative parkinsonian syndromes needs to be reinforced by prospective studies with neuropathological verification of the diagnosis.
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Affiliation(s)
- Ralph Buchert
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf; Department of Neurology, University Medical Center Hamburg-Eppendorf; Department of Nuclear Medicine, Medical Center-University of Freiburg; Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf
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Microelectrode arrays for monitoring neural activity in neural stem cells with modulation by glutamate in vitro. NANOTECHNOLOGY AND PRECISION ENGINEERING 2020. [DOI: 10.1016/j.npe.2020.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
PURPOSE OF REVIEW Tremor may be defined as an involuntary movement that is rhythmic (ie, regularly recurrent) and oscillatory (ie, rotating around a central plane) and may manifest in a variety of ways; accordingly, tremor has a rich clinical phenomenology. Consequently, the diagnosis of tremor disorders can be challenging, and misdiagnoses are common. The goal of this article is to provide the reader with straightforward approaches to the diagnosis and treatment of tremors. RECENT FINDINGS Focused ultrasound thalamotomy of the ventral intermediate nucleus of the thalamus is an emerging and promising therapy for the treatment of essential tremor. SUMMARY The evaluation should start with a detailed tremor history followed by a focused neurologic examination, which should attend to the many subtleties of tremor phenomenology. Among other things, the history and examination are used to establish whether the primary tremor is an action tremor (ie, postural, kinetic, or intention tremor) or a resting tremor. The clinician should then formulate two sets of diagnoses: disorders in which action tremor is the predominant tremor versus those in which resting tremor is the predominant tremor. Among the most common of the former type are essential tremor, enhanced physiologic tremor, drug-induced tremor, dystonic tremor, primary writing tremor, orthostatic tremor, and cerebellar tremor. Parkinson disease is the most common disorder of resting tremor. This article details the clinical features of each of these disorders, as well as those of additional tremor disorders.
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Xiao G, Song Y, Zhang Y, Xing Y, Zhao H, Xie J, Xu S, Gao F, Wang M, Xing G, Cai X. Microelectrode Arrays Modified with Nanocomposites for Monitoring Dopamine and Spike Firings under Deep Brain Stimulation in Rat Models of Parkinson's Disease. ACS Sens 2019; 4:1992-2000. [PMID: 31272150 DOI: 10.1021/acssensors.9b00182] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Little is known about the efficacy of deep brain stimulation (DBS) as an effective treatment for Parkinson's Disease (PD) because of the lack of multichannel neural electrical and chemical detection techniques at the cellular level. In this study, a 7-mm-long and 250-μm-wide microelectrode array (MEA) was fabricated to provide real-time monitoring of dopamine (DA) concentration and neural spike firings in the caudate putamen (CPU) of rats with PD. Platinumn nanoparticles and reduced graphene oxide nanocomposites (Pt/rGO) were modified onto the sensitive microelectrode sites. The detection limit (50 nM) and sensitivity (8.251 pA/μM) met the specific requirements for DA detection in vivo. A single neural spike was isolated due to the high signal-to-noise ratio of the MEA. DBS was applied in the affected side of the globus pallidus internal (GPi) in PD rats. After DBS, the concentration of DA in the bilateral CPU increased markedly. The mean increment of the ipsilateral DA was 7.33 μM (increasing from 0.54 μM to 7.87 μM), which was 2.2-fold higher than the increment in the contralateral side. The mean amplitude of neural spikes in the bilateral CPU decreased more than 10%, and was more obvious in the ipsilateral side where the spike amplitude changed from 169 μV to 134 μV. Spike firing rate decreased by 65% (ipsilateral side) and 51% (contralateral side). The power of the local field potential decreased to 940 μW (ipsilateral side) and 530 μW (contralateral side) in 0-30 Hz. Collectively, our data show that the GPi-DBS plays a significant regulatory role in the bilateral CPU in terms of DA concentration, spike firing, and power; furthermore, the ipsilateral variations of the dual mode signals were more significant than those in the contralateral side. These results provide new detection and stimulation technology for understanding the mechanisms underlying Parkinson's disease and should, therefore, represent a useful resource for the design of future treatments.
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Affiliation(s)
- Guihua Xiao
- State Key Laboratory of Transducer Technology, Institute of Electronics, Chinese Academy of Sciences, Beijing 100190, PR China
- University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Yilin Song
- State Key Laboratory of Transducer Technology, Institute of Electronics, Chinese Academy of Sciences, Beijing 100190, PR China
- University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Yu Zhang
- State Key Laboratory of Transducer Technology, Institute of Electronics, Chinese Academy of Sciences, Beijing 100190, PR China
- University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Yu Xing
- State Key Laboratory of Transducer Technology, Institute of Electronics, Chinese Academy of Sciences, Beijing 100190, PR China
- University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Hongyan Zhao
- Key Laboratory for Neuroscience, Ministry of Education and Ministry of Public Health Neuroscience Research, Institute and Department of Neurobiology, Peking University, Beijing 100191, PR China
| | - Jingyu Xie
- State Key Laboratory of Transducer Technology, Institute of Electronics, Chinese Academy of Sciences, Beijing 100190, PR China
- University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Shengwei Xu
- State Key Laboratory of Transducer Technology, Institute of Electronics, Chinese Academy of Sciences, Beijing 100190, PR China
- University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Fei Gao
- State Key Laboratory of Transducer Technology, Institute of Electronics, Chinese Academy of Sciences, Beijing 100190, PR China
- University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Mixia Wang
- State Key Laboratory of Transducer Technology, Institute of Electronics, Chinese Academy of Sciences, Beijing 100190, PR China
- University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Guogang Xing
- Key Laboratory for Neuroscience, Ministry of Education and Ministry of Public Health Neuroscience Research, Institute and Department of Neurobiology, Peking University, Beijing 100191, PR China
| | - Xinxia Cai
- State Key Laboratory of Transducer Technology, Institute of Electronics, Chinese Academy of Sciences, Beijing 100190, PR China
- University of Chinese Academy of Sciences, Beijing 100049, PR China
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Bhattacharjee S, Paramanandam V, Bhattacharya A. Analysis of the Effect of Dopamine Transporter Scan on the Diagnosis and Management in a Tertiary Neurology Center. Neurohospitalist 2019; 9:144-150. [PMID: 31244971 DOI: 10.1177/1941874419829293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background and Purpose The dopamine transporter scan or DaT scan is abnormal in presynaptic parkinsonism but normal in nondegenerative or postsynaptic parkinsonism. In this study, we tried to ascertain the impact of DaT scan on the diagnosis and clinical management and if the semiquantitative analysis of the DaT scans has any correlation with the clinical symptoms. Methods The electronic and nonelectronic records of patients of Plymouth Hospital NHS Trust, United Kingdom, from 2011 to 2015 were studied to find the indication, outcome, and the impact of the scan on the management of patients. The DaT scan results were assessed visually and semiquantitatively by the Department of Nuclear Medicine. The available data were statistically analyzed with the help of Microsoft XL2010 and GraphPad software. Results A total of 258 people had DaT scan. The scan results suggested an alternate diagnosis in 50.5% of clinically diagnosed patients with Parkinson disease. Similarly, DaT scan changed the diagnosis of 40% of patients with clinical diagnosis of vascular parkinsonism, 25% of clinically diagnosed drug-induced parkinsonism, and 54% of patients with possible Lewy body dementia. Visual assessment of the DaT scan revealed that more than 60% had grade 2 abnormalities. The distribution volume ratio, a semiquantitative tool for tracer uptake, was significantly less in the patients with akinetic-rigid subtype of Parkinson disease in comparison to a tremor predominant subtype. Conclusions Dopamine transporter scan had a significant impact in diagnosis and management.
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Affiliation(s)
- Shakya Bhattacharjee
- Neurology, Royal Cornwall Hospital, Truro, United Kingdom and Plymouth Hospital NHS Trust, Plymouth, UK
| | - Vijayashankar Paramanandam
- Toronto Western Hospital, Toronto, Ontario, Canada
- Neurology, Stanley Medical College, Chennai, Tamil Nadu, India
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Picascia M, Pozzi NG, Todisco M, Minafra B, Sinforiani E, Zangaglia R, Ceravolo R, Pacchetti C. Cognitive disorders in normal pressure hydrocephalus with initial parkinsonism in comparison with
de novo
Parkinson's disease. Eur J Neurol 2018; 26:74-79. [DOI: 10.1111/ene.13766] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 08/02/2018] [Indexed: 01/16/2023]
Affiliation(s)
- M. Picascia
- Parkinson's Disease and Movement Disorders Unit IRCCS Mondino Foundation PaviaItaly
| | - N. G. Pozzi
- Parkinson's Disease and Movement Disorders Unit IRCCS Mondino Foundation PaviaItaly
| | - M. Todisco
- Parkinson's Disease and Movement Disorders Unit IRCCS Mondino Foundation PaviaItaly
| | - B. Minafra
- Parkinson's Disease and Movement Disorders Unit IRCCS Mondino Foundation PaviaItaly
| | - E. Sinforiani
- Alzheimer's Disease Assessment Unit/Laboratory of Neuropsychology IRCCS Mondino Foundation PaviaItaly
| | - R. Zangaglia
- Parkinson's Disease and Movement Disorders Unit IRCCS Mondino Foundation PaviaItaly
| | - R. Ceravolo
- Neurology Unit Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - C. Pacchetti
- Parkinson's Disease and Movement Disorders Unit IRCCS Mondino Foundation PaviaItaly
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Lotankar S, Prabhavalkar KS, Bhatt LK. Biomarkers for Parkinson's Disease: Recent Advancement. Neurosci Bull 2017; 33:585-597. [PMID: 28936761 PMCID: PMC5636742 DOI: 10.1007/s12264-017-0183-5] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 07/03/2017] [Indexed: 12/12/2022] Open
Abstract
As a multi-factorial degenerative disease, Parkinson's disease (PD) leads to tremor, gait rigidity, and hypokinesia, thus hampering normal living. As this disease is usually detected in the later stages when neurons have degenerated completely, cure is on hold, ultimately leading to death due to the lack of early diagnostic techniques. Thus, biomarkers are required to detect the disease in the early stages when prevention is possible. Various biomarkers providing early diagnosis of the disease include those of imaging, cerebrospinal fluid, oxidative stress, neuroprotection, and inflammation. Also, biomarkers, alone or in combination, are used in the diagnosis and evolution of PD. This review encompasses various biomarkers available for PD and discusses recent advances in their development.
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Affiliation(s)
- Sharvari Lotankar
- Department of Pharmacology, SVKM's Dr Bhanuben Nanavati College of Pharmacy, Vile Parle (W), Mumbai, India
| | - Kedar S Prabhavalkar
- Department of Pharmacology, SVKM's Dr Bhanuben Nanavati College of Pharmacy, Vile Parle (W), Mumbai, India.
| | - Lokesh K Bhatt
- Department of Pharmacology, SVKM's Dr Bhanuben Nanavati College of Pharmacy, Vile Parle (W), Mumbai, India
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Oravivattanakul S, Benchaya L, Ahmed A, Itin I, Cooper S, Gostkowski M, Rudolph J, Appleby K, Sweeney P, Fernandez HH, Wu G. Reply to Comment on: Dopamine Transporter (DaT) Scan Utilization in a Movement Disorder Center. Mov Disord Clin Pract 2017; 4:155-156. [DOI: 10.1002/mdc3.12403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 05/19/2016] [Indexed: 11/12/2022] Open
Affiliation(s)
- Srivadee Oravivattanakul
- Center of Neurological Restoration; Department of Neurology; Cleveland Clinic; Cleveland Ohio USA
- Muhammad Ali Parkinson Center; Barrow Neurological Institute; St. Joseph's Hospital and Medical Center; Phoenix Arizona USA
| | - Lucas Benchaya
- Center of Neurological Restoration; Department of Neurology; Cleveland Clinic; Cleveland Ohio USA
| | - Anwar Ahmed
- Center of Neurological Restoration; Department of Neurology; Cleveland Clinic; Cleveland Ohio USA
| | - Ilia Itin
- Center of Neurological Restoration; Department of Neurology; Cleveland Clinic; Cleveland Ohio USA
| | - Scott Cooper
- Center of Neurological Restoration; Department of Neurology; Cleveland Clinic; Cleveland Ohio USA
| | - Michal Gostkowski
- Center of Neurological Restoration; Department of Neurology; Cleveland Clinic; Cleveland Ohio USA
| | - Joseph Rudolph
- Center of Neurological Restoration; Department of Neurology; Cleveland Clinic; Cleveland Ohio USA
| | - Kristin Appleby
- Center of Neurological Restoration; Department of Neurology; Cleveland Clinic; Cleveland Ohio USA
| | - Patrick Sweeney
- Center of Neurological Restoration; Department of Neurology; Cleveland Clinic; Cleveland Ohio USA
| | - Hubert H. Fernandez
- Center of Neurological Restoration; Department of Neurology; Cleveland Clinic; Cleveland Ohio USA
| | - Guiyun Wu
- Department of Nuclear Medicine; Cleveland Clinic; Cleveland Ohio USA
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Bhattacharjee S, Shankar V, Elkider M. Comment on: Dopamine Transporter (DaT) Scan Utilization in a Movement Disorder Center. Mov Disord Clin Pract 2017; 4:154. [DOI: 10.1002/mdc3.12369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 03/26/2016] [Indexed: 11/08/2022] Open
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