The diagnostic accuracy of dopamine transporter SPECT imaging to detect nigrostriatal cell loss in patients with Parkinson's disease or clinically uncertain parkinsonism: a systematic review

Sven R Suwijn, Caroline Jm van Boheemen, Rob J de Haan, Gerrit Tissingh, Jan Booij, Rob Ma de Bie, Sven R Suwijn, Caroline Jm van Boheemen, Rob J de Haan, Gerrit Tissingh, Jan Booij, Rob Ma de Bie

Abstract

In specialized movement disorder centers, Parkinson's disease (PD) is wrongly diagnosed in 6 to 25% of cases. To improve the accuracy of the clinical diagnosis, it is necessary to have a reliable and practical reference standard. Dopamine transporter single-photon emission computed tomography (DAT SPECT) imaging might have the potential (high diagnostic accuracy and practical to use) to act as reference standard in detecting nigrostriatal cell loss in patients with (early stage) parkinsonism. We performed a systematic review to evaluate if DAT SPECT imaging can be used as such. Relevant studies were searched in the MEDLINE and EMBASE databases. Studies were selected when they met the following criteria: (1) all patients were adults with a clinical diagnosis of PD or clinically uncertain parkinsonism and (2) the study reported original data. In addition, studies needed to fulfill one of the two following criteria: (1) patients underwent at least one DAT SPECT and had a neuropathological confirmed diagnosis and (2) patients underwent at least two DAT SPECT scans, performed at least 2 years apart. The search identified 1,649 articles. Eight studies fulfilled our selection criteria and were included in this review. There was only one study including patients with diagnostic uncertainty. Sensitivity and specificity of DAT SPECT imaging to detect nigrostriatal cell loss were 98%. The other studies included patients with a diagnosis of PD in whom there was no uncertainty. In these studies, sensitivity was 100%. Our systematic review indicates that DAT SPECT imaging seems to be accurate to detect nigrostriatal cell loss in patients with parkinsonism.

Keywords: Clinical diagnosis; Diagnostic accuracy; Dopamine transporter; Nigrostriatal cell loss; Parkinsonism; Parkinson’s disease; Single-photon emission computed tomography.

Figures

Figure 1
Figure 1
Flowchart of eligible studies.

References

    1. de Rijk MC, Tzourio C, Breteler MM, Dartigues JF, Amaducci L, Lopez-Pouza S, et al. Prevalence of parkinsonism and Parkinson’s disease in Europe: the EUROPARKINSON Collaborative Study. European Community Concerted Action on the Epidemiology of Parkinson's disease. J Neurol Neurosurg Psychiatry. 1997;62:10–5. doi: 10.1136/jnnp.62.1.10.
    1. de Lau LM, Breteler MM. Epidemiology of Parkinson’s disease. Lancet Neurol. 2006;5:525–35. doi: 10.1016/S1474-4422(06)70471-9.
    1. Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992;55:181–4. doi: 10.1136/jnnp.55.3.181.
    1. Hughes AJ, Daniel SE, Lees AJ. Improved accuracy of clinical diagnosis of Lewy body Parkinson’s disease. Neurology. 2001;57:1497–9. doi: 10.1212/WNL.57.8.1497.
    1. Jankovic J. Diagnosis and treatment of psychogenic parkinsonism. J Neurol Neurosurg Psychiatry. 2011;82:1300–3. doi: 10.1136/jnnp-2011-300876.
    1. Shin DH, Lee PH, Bang OY, Joo IS, Huh K. Clinical implications of cardiac-MIBG SPECT in the differentiation of Parkinsonian Syndromes. J Clin Neurol. 2006;2:51–7. doi: 10.3988/jcn.2006.2.1.51.
    1. Jankovic J, Rajput AH, McDermott MP, Perl DP. The evolution of diagnosis in early Parkinson disease. Parkinson Study Group Arch Neurol. 2000;57:369–72. doi: 10.1001/archneur.57.3.369.
    1. Tolosa E, Wenning G, Poewe W. The diagnosis of Parkinson’s disease. Lancet Neurol. 2006;5:75–86. doi: 10.1016/S1474-4422(05)70285-4.
    1. Ravina B, Marek K, Eberly S, Oakes D, Kurlan R, Ascherio A, et al. Dopamine transporter imaging is associated with long-term outcomes in Parkinson’s disease. Mov Disord. 2012;27:1392–7. doi: 10.1002/mds.25157.
    1. Litvan I, MacIntyre A, Goetz CG, Wenning GK, Jellinger K, Verny M, et al. Accuracy of the clinical diagnoses of Lewy body disease, Parkinson disease, and dementia with Lewy bodies: a clinicopathologic study. Arch Neurol. 1998;55:969–78. doi: 10.1001/archneur.55.7.969.
    1. Hughes AJ, Daniel SE, Ben-Shlomo Y, Lees AJ. The accuracy of diagnosis of parkinsonian syndromes in a specialist movement disorder service. Brain. 2002;125:861–70. doi: 10.1093/brain/awf080.
    1. Meara J, Bhowmick BK, Hobson P. Accuracy of diagnosis in patients with presumed Parkinson’s disease. Age Ageing. 1999;28:99–102. doi: 10.1093/ageing/28.2.99.
    1. Mian OS, Schneider SA, Schwingenschuh P, Bhatia KP, Day BL. Gait in SWEDDs patients: comparison with Parkinson’s disease patients and healthy controls. Mov Disord. 2011;26:1266–73. doi: 10.1002/mds.23684.
    1. Kim JS, Oh YS, Kim YI, Yang DW, Chung YA, You IR, et al. Combined use of [123I]-metaiodobenzylguanidine (MIBG) scintigraphy and dopamine transporter (DAT) positron emission tomography (PET) predicts prognosis in drug-induced Parkinsonism (DIP): a 2-year follow-up study. Arch Gerontol Geriatr. 2012;56:124–8. doi: 10.1016/j.archger.2012.05.001.
    1. Whone AL, Watts RL, Stoessl AJ, Davis M, Reske S, Nahmias C, et al. Slower progression of Parkinson’s disease with ropinirole versus levodopa: the REAL-PET study. Ann Neurol. 2003;54:93–101. doi: 10.1002/ana.10609.
    1. Morrish PK, Sawle GV, Brooks DJ. Clinical and [18 F] dopa PET findings in early Parkinson’s disease. J Neurol Neurosurg Psychiatry. 1995;59:597–600. doi: 10.1136/jnnp.59.6.597.
    1. De la Fuente-Fernandez R. Role of DaTSCAN and clinical diagnosis in Parkinson disease. Neurology. 2012;78:696–701. doi: 10.1212/WNL.0b013e318248e520.
    1. Vlaar AM, van Kroonenburgh MJ, Kessels AG, Weber WE. Meta-analysis of the literature on diagnostic accuracy of SPECT in parkinsonian syndromes. BMC Neurol. 2007;7:27. doi: 10.1186/1471-2377-7-27.
    1. Benamer TS, Patterson J, Grosset DG, Booij J, de Bruin K, van Royen E. 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. doi: 10.1002/1531-8257(200005)15:3<503::AID-MDS1013>;2-V.
    1. Chouker M, Tatsch K, Linke R, Pogarell O, Hahn K, Schwarz J. Striatal dopamine transporter binding in early to moderately advanced Parkinson’s disease: monitoring of disease progression over 2 years. Nucl Med Commun. 2001;22:721–5. doi: 10.1097/00006231-200106000-00017.
    1. Fahn S, Oakes D, Shoulson I, Kieburtz K, Rudolph A, Lang A, et al. Levodopa and the progression of Parkinson’s disease. N Engl J Med. 2004;351:2498–508. doi: 10.1056/NEJMoa033447.
    1. Marek K, Innis R, van Dyck C, Fussell B, Early M, Eberly S, et al. [123I]beta-CIT SPECT imaging assessment of the rate of Parkinson’s disease progression. Neurology. 2001;57:2089–94. doi: 10.1212/WNL.57.11.2089.
    1. Pirker W, Djamshidian S, Asenbaum S, Gerschlager W, Tribl G, Hoffmann M, et al. Progression of dopaminergic degeneration in Parkinson’s disease and atypical parkinsonism: a longitudinal beta-CIT SPECT study. Mov Disord. 2002;17:45–53. doi: 10.1002/mds.1265.
    1. Staffen W, Mair A, Unterrainer J, Trinka E, Ladurner G. Measuring the progression of idiopathic Parkinson’s disease with [123I] beta-CIT SPECT. J Neural Transm. 2000;107:543–52. doi: 10.1007/s007020070077.
    1. Berendse HW, Booij J, Francot CM, Bergmans PL, Hijman R, Stoof JC, et al. Subclinical dopaminergic dysfunction in asymptomatic Parkinson’s disease patients’ relatives with a decreased sense of smell. Ann Neurol. 2001;50:34–41. doi: 10.1002/ana.1049.
    1. Iranzo A, Lomena F, Stockner H, Valldeoriola F, Vilaseca I, Salamero M, et al. Decreased striatal dopamine transporter uptake and substantia nigra hyperechogenicity as risk markers of synucleinopathy in patients with idiopathic rapid-eye-movement sleep behaviour disorder: a prospective study [corrected] Lancet Neurol. 2010;9:1070–7. doi: 10.1016/S1474-4422(10)70216-7.
    1. Sommer U, Hummel T, Cormann K, Mueller A, Frasnelli J, Kropp J, et al. Detection of presymptomatic Parkinson’s disease: combining smell tests, transcranial sonography, and SPECT. Mov Disord. 2004;19:1196–202. doi: 10.1002/mds.20141.
    1. Stiasny-Kolster K, Doerr Y, Moller JC, Hoffken H, Behr TM, Oertel WH, et al. Combination of ‘idiopathic’ REM sleep behaviour disorder and olfactory dysfunction as possible indicator for alpha-synucleinopathy demonstrated by dopamine transporter FP-CIT-SPECT. Brain. 2005;128:126–37. doi: 10.1093/brain/awh322.
    1. Cilia R, Rossi C, Frosini D, Volterrani D, Siri C, Pagni C, et al. Dopamine transporter SPECT imaging in Corticobasal Syndrome. PLoS One. 2011;6:e18301. doi: 10.1371/journal.pone.0018301.
    1. Scherfler C, Schwarz J, Antonini A, Grosset D, Valldeoriola F, Marek K, et al. Role of DAT-SPECT in the diagnostic work up of parkinsonism. Mov Disord. 2007;22:1229–38. doi: 10.1002/mds.21505.
    1. Vlaar AM, de Nijs T, Kessels AG, Vreeling FW, Winogrodzka A, Mess WH, et al. Diagnostic value of [123I]-ioflupane and [123I]-iodobenzamide SPECT scans in 248 patients with parkinsonian syndromes. Eur Neurol. 2008;59:258–66. doi: 10.1159/000115640.
    1. Becker G, Seufert J, Bogdahn U, Reichmann H, Reiners K. Degeneration of substantia nigra in chronic Parkinson’s disease visualized by transcranial color-coded real-time sonography. Neurology. 1995;45:182–4. doi: 10.1212/WNL.45.1.182.
    1. Berg D, Godau J, Walter U. Transcranial sonography in movement disorders. Lancet Neurol. 2008;7:1044–55. doi: 10.1016/S1474-4422(08)70239-4.
    1. Stockner H, Schwingenschuh P, Djamshidian A, Silveira-Moriyama L, Katschnig P, Seppi K, et al. Is transcranial sonography useful to distinguish scans without evidence of dopaminergic deficit patients from Parkinson’s disease? Mov Disord. 2012;27:1182–5. doi: 10.1002/mds.25102.
    1. Gaenslen A, Unmuth B, Godau J, Liepelt I, Di Santo A, Schweitzer KJ, et al. The specificity and sensitivity of transcranial ultrasound in the differential diagnosis of Parkinson’s disease: a prospective blinded study. Lancet Neurol. 2008;7:417–24. doi: 10.1016/S1474-4422(08)70067-X.
    1. Izawa MO, Miwa H, Kajimoto Y, Kondo T. Combination of transcranial sonography, olfactory testing, and MIBG myocardial scintigraphy as a diagnostic indicator for Parkinson’s disease. Eur J Neurol. 2012;19:411–6. doi: 10.1111/j.1468-1331.2011.03533.x.
    1. Vlaar AM, Bouwmans A, Mess WH, Tromp SC, Weber WE. Transcranial duplex in the differential diagnosis of parkinsonian syndromes: a systematic review. J Neurol. 2009;256:530–8. doi: 10.1007/s00415-009-0143-8.
    1. Stockner H, Sojer M, Seppi KK, Mueller J, Wenning GK, Schmidauer C, et al. Midbrain sonography in patients with essential tremor. Mov Disord. 2007;22:414–7. doi: 10.1002/mds.21344.
    1. Morrish PK, Rakshi JS, Bailey DL, Sawle GV, Brooks DJ. Measuring the rate of progression and estimating the preclinical period of Parkinson’s disease with [18 F]dopa PET. J Neurol Neurosurg Psychiatry. 1998;64:314–9. doi: 10.1136/jnnp.64.3.314.
    1. Whiting PF, Rutjes AW, Westwood ME, Mallet S, Deeks JJ, Reitsma JB, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155:529–36. doi: 10.7326/0003-4819-155-8-201110180-00009.
    1. Catafau AM, Vander BT TE, DaTSCAN Clinically Uncertain Parkinsonian Syndromes Study Group Impact of dopamine transporter SPECT using 123I-Ioflupane on diagnosis and management of patients with clinically uncertain parkinsonian syndromes. Mov Disord. 2004;19:1175–82. doi: 10.1002/mds.20112.
    1. Parkinson Study Group Dopamine transporter brain imaging to assess the effects of pramipexole vs levodopa on Parkinson disease progression. JAMA. 2002;287:1653–61. doi: 10.1001/jama.287.13.1653.
    1. Parkinson Study Group Mixed lineage kinase inhibitor CEP-1347 fails to delay disability in early Parkinson disease. Neurology. 2007;69:1480–90. doi: 10.1212/01.wnl.0000277648.63931.c0.
    1. Bender A, Koch W, Elstner M, Schombacher Y, Bender J, Moeschl M, et al. Creatine supplementation in Parkinson disease: a placebo-controlled randomized pilot trial. Neurology. 2006;67:1262–4. doi: 10.1212/01.wnl.0000238518.34389.12.
    1. Eggers C, Pedrosa DJ, Kahraman D, Maier F, Lewis CJ, Fink GR, et al. Parkinson subtypes progress differently in clinical course and imaging pattern. PLoS One. 2012;7:e46813. doi: 10.1371/journal.pone.0046813.
    1. Perju-Dumbrava LD, Kovacs GG, Pirker S, Jellinger K, Hoffmann M, Asenbaum S, et al. Dopamine transporter imaging in autopsy-confirmed Parkinson’s disease and multiple system atrophy. Mov Disord. 2012;27:65–71. doi: 10.1002/mds.24000.
    1. Colloby SJ, McParland S, O'Brien JT, Attems J. Neuropathological correlates of dopaminergic imaging in Alzheimer’s disease and Lewy body dementias. Brain. 2012;135:2798–808. doi: 10.1093/brain/aws211.
    1. Isaias IU, Marotta G, Hirano S, Canesi M, Benti R, Righini A, et al. Imaging essential tremor. Mov Disord. 2010;25:679–86. doi: 10.1002/mds.22870.
    1. Marshall VL, Reininger CB, Marquardt M, Patterson J, Hadley DM, Oertel WH, et al. Parkinson’s disease is overdiagnosed clinically at baseline in diagnostically uncertain cases: a 3-year European multicenter study with repeat [123I]FP-CIT SPECT. Mov Disord. 2009;24:500–8. doi: 10.1002/mds.22108.
    1. Bajaj 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. doi: 10.1136/jnnp-2012-304436.
    1. Kagi G, Bhatia KP, Tolosa E. The role of DAT-SPECT in movement disorders. J Neurol Neurosurg Psychiatry. 2010;81:5–12. doi: 10.1136/jnnp.2008.157370.
    1. Bajaj NP, Gontu V, Birchall J, Patterson J, Grosset DG, Lees AJ. Accuracy of clinical diagnosis in tremulous parkinsonian patients: a blinded video study. J Neurol Neurosurg Psychiatry. 2010;81:1223–8. doi: 10.1136/jnnp.2009.193391.
    1. Tolosa E, Borght TV, Moreno E. Accuracy of DaTSCAN ([123I]-Ioflupane) SPECT in diagnosis of patients with clinically uncertain parkinsonism: 2-year follow-up of an open-label study. Mov Disord. 2007;22:2346–51. doi: 10.1002/mds.21710.
    1. Ziebell M, Andersen BB, Thomsen G, Pinborg LH, Karlsborg M, Hasselbach SG, et al. Predictive value of dopamine transporter SPECT imaging with [123I]PE2I in patients with subtle parkinsonian symptoms. Eur J Nucl Med Mol Imaging. 2012;39:242–50. doi: 10.1007/s00259-011-1976-9.
    1. Jennings D, Siderowf A, Stern M, Seibyl J, Eberly S, Oakes D, et al. Imaging prodromal Parkinson disease. Neurology. 2014;83:1739–46. doi: 10.1212/WNL.0000000000000960.
    1. Bajaj N, Hauser RA, Seibyl J, Kupsch A, Plotkin M, Chen C, et al. Association between Hoehn and Yahr, Mini-Mental State Examination, age, and clinical syndrome predominance and diagnostic effectiveness of ioflupane I 123 injection (DaTSCAN™) in subjects with clinically uncertain parkinsonian syndromes. Alzheimer’s ResTherapy. 2014;6:67.
    1. Stephenson R, Siderowf A, Stern MB. Premotor Parkinson’s disease: clinical features and detection strategies. Mov Disord. 2009;24:S665–70. doi: 10.1002/mds.22403.
    1. Lang AE. A critical appraisal of the premotor symptoms of Parkinson’s disease: potential usefulness in early diagnosis and design of neuroprotective trials. Mov Disord. 2011;26:775–83. doi: 10.1002/mds.23609.
    1. Siderowf A, Lang AE. Premotor Parkinson’s disease: concepts and definitions. Mov Disord. 2012;27:608–16. doi: 10.1002/mds.24954.
    1. Mahlknecht P, Poewe W. Is there a need to redefine Parkinson’s disease? J Neural Transm. 2013;9:S9–17. doi: 10.1007/s00702-013-1038-5.
    1. Langston JW. Predicting Parkinson’s disease. Neurology. 1990;40:S4.
    1. Hornykiewicz O, Kish SJ. Biochemical pathophysiology of Parkinson’s disease. Adv Neurol. 1987;45:19–34.

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