Indian Journal of Nuclear Medicine

LETTER TO EDITOR
Year
: 2016  |  Volume : 31  |  Issue : 3  |  Page : 249--250

Dopamine transporter single-photon emission computed tomography brain scan: A reliable way to distinguish between degenerative and drug-induced parkinsonism


Shakya Bhattacharjee1, Paramananda Vijaya Shankar2, Mohammed Elkider3,  
1 MRCP, Neurology, Plymouth Hospital NHS Trust, Devon, UK
2 DM, Neurology, Stanley Medical College, Chennai, Tamil Nadu, India
3 MRCP, Neurology, Cork University Hospital, Cork, Ireland

Correspondence Address:
Shakya Bhattacharjee
Flat 96, 21, Plymbridge Lane, Plymouth, PL68AX
UK




How to cite this article:
Bhattacharjee S, Shankar PV, Elkider M. Dopamine transporter single-photon emission computed tomography brain scan: A reliable way to distinguish between degenerative and drug-induced parkinsonism .Indian J Nucl Med 2016;31:249-250


How to cite this URL:
Bhattacharjee S, Shankar PV, Elkider M. Dopamine transporter single-photon emission computed tomography brain scan: A reliable way to distinguish between degenerative and drug-induced parkinsonism . Indian J Nucl Med [serial online] 2016 [cited 2021 Apr 19 ];31:249-250
Available from: https://www.ijnm.in/text.asp?2016/31/3/249/183620


Full Text



Sir,

A 54-year-old man on valproate because of bipolar affective disorders developed extra-pyramidal symptoms suggestive of drug-induced parkinsonism. His symptoms persisted despite stopping valproate. He had a dopamine transporter (DaT) scan and single-photon emission computed tomography (SPECT) scan. The DaT scan showed abnormality (Grade 1) [Table 1] in the right putaminal tracer uptake suggestive of degenerative parkinsonism instead of drug-induced parkinsonism [Figure 1]a and [Figure 1]b.[1],[2]{Figure 1}{Table 1}

DaT is the presynaptic transmembrane protein of the dopaminergic synapses. It transports dopamine back to the presynaptic neurons from the synaptic cleft.123 I-ioflupane is a molecular imaging agent used in DaT imaging to demonstrate the location and concentration of DaTs in the synapses. Tc99m-TRODAT and F-18 FDOPA positron emission tomography scan can also assess the DaT activity and the integrity of the presynaptic nigrostriatal function.[3]

DaT SPECT brain scan is helpful to distinguish between pre- (degenerative) and post-synaptic (such as drug-induced or vascular parkinsonism) parkinsonism.[4] DaT imaging is usually normal in postsynaptic parkinsonism, but abnormal in the presynaptic variety.[1] The degenerative presynaptic parkinsonism includes sub-types such as idiopathic Parkinson's disease, progressive supranuclear palsy, multiple system atrophy, Lewy body dementia, and corticobasal degeneration. Though this SPECT scan can distinguish between pre- and post-synaptic parkinsonism, it cannot distinguish among the sub-types of degenerative parkinsonism mentioned above.[1],[4]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Bajaj N, Hauser RA, Grachev ID. Clinical utility of dopamine transporter single photon emission CT (DaT-SPECT) with (123I) ioflupane in diagnosis of parkinsonian syndromes. J Neurol Neurosurg Psychiatry 2013;84:1288-95.
2Benamer TS, Patterson J, Grosset DG, Booij J, de Bruin K, van Royen E, et al. Accurate differentiation of parkinsonism and essential tremor using visual assessment of [123I]-FP-CIT SPECT imaging: The [123I]-FP-CIT study group. Mov Disord 2000;15:503-10.
3Berti V, Pupi A, Mosconi L. PET/CT in diagnosis of movement disorders. Ann N Y Acad Sci 2011;1228:93-108.
4Djang DS, Janssen MJ, Bohnen N, Booij J, Henderson TA, Herholz K, et al. SNM practice guideline for dopamine transporter imaging with 123I-ioflupane SPECT 1.0. J Nucl Med 2012;53:154-63.