背景:由于帕金森病(PD)的诊断基本上是临床的,ioflupane(123I)单光子发射计算机断层扫描(SPECT)或DaTSCAN作为诊断工具的有用性多年来一直存在争议.DaTSCAN的表现通常建议在临床诊断不确定的患者的随访中,尤其是那些怀疑有特发性震颤的人,药物诱发的帕金森病,或者血管性帕金森病.然而,除了PD和非典型帕金森病外,DaTSCAN还缺乏关于神经退行性帕金森病的发现。迄今为止,尚未描述有助于区分PD和最常见的非典型帕金森病的特定黑质纹状体多巴胺摄取模式.由于神经退行性帕金森病患者摄取模式异常的可能可视化,这一事实变得更加复杂。
目的:我们旨在总结目前关于DaTSCAN在罕见神经退行性帕金森病患者中的发现的文献。
方法:截至2023年10月15日,使用搜索词“DaTSCAN”对PubMed数据库进行了系统的英语或西班牙语研究筛选,\"ioflupane\",\"DaT-SPECT\",“123I-FP-CITSPECT”,“多巴胺转运蛋白成像”,和“[123I]FP-CITSPECT”。关于PD的重复出版物和研究,非典型帕金森病,肌张力障碍-帕金森病,特发性震颤,排除由非退行性原因引起的帕金森病。
结果:对获得的结果进行了回顾和总结,包括DaTSCAN在脆性X相关震颤/共济失调综合征中的发现,朊病毒病,亨廷顿病,脊髓小脑共济失调,遗传性痉挛性轻瘫,代谢紊乱,和其他疾病(抗IgLON5疾病,环染色体20综合征,舞蹈病-棘皮细胞增多症,和神经元类脂褐菌病)。
结论:这篇综述强调了在未来确定DaTSCAN的效用和成本效益的必要性,作为诊断和预测工具,在罕见的神经退行性疾病中具有帕金森病症状的患者中。
BACKGROUND: As the diagnosis of Parkinson\'s disease (PD) is fundamentally clinical, the usefulness of ioflupane (123I) single-photon emission computed tomography (SPECT) or DaTSCAN as a diagnostic tool has been a matter of debate for years. The performance of DaTSCAN is generally recommended in the follow-up of patients with a clinically uncertain diagnosis, especially in those with a suspected essential tremor, drug-induced parkinsonism, or vascular parkinsonism. However, there is a dearth of DaTSCAN findings regarding neurodegenerative parkinsonisms besides PD and atypical parkinsonisms. To date, a specific nigrostriatal dopamine uptake pattern that would help differentiate PD from the most frequent atypical parkinsonisms is yet to be described. This fact is further complicated by the possible visualization of abnormalities in the uptake pattern in patients with rarer neurodegenerative parkinsonisms.
OBJECTIVE: We aimed to summarize the current literature regarding DaTSCAN findings in patients with rare neurodegenerative parkinsonisms.
METHODS: The PubMed database was systematically screened for studies in English or Spanish up to October 15, 2023, using search terms \"DaTSCAN\", \"ioflupane\", \"DaT-SPECT\", \"123I-FP-CIT SPECT\", \"dopamine transporter imaging\", and \"[123I] FP-CIT SPECT\". Duplicated publications and studies regarding PD, atypical parkinsonisms, dystonia-parkinsonism, essential tremor, and parkinsonism due to non-degenerative causes were excluded.
RESULTS: The obtained results were reviewed and summarized, including DaTSCAN findings in fragile X-associated tremor/ataxia syndrome, prion diseases, Huntington\'s disease, spinocerebellar ataxia, hereditary spastic paraparesis, metabolic disorders, and other diseases (anti-IgLON5 disease, ring chromosome 20 syndrome, chorea-acanthocytosis, and neuronal ceroid lipofuscinosis).
CONCLUSIONS: This
review highlights the need to determine in the future the utility and cost-effectiveness of DaTSCAN, both as a diagnostic and a prognostic tool, in patients with parkinsonian symptoms in rare neurodegenerative diseases.