[Differential diagnosis of parkinsonism using dopamine transporters brain SPECT]

Parkinsonism is a group of neurological disorders characterized by extrapiramidal signs. Often, the differential diagnosis between parkinsonism, essential tremor and drug-induced parkinsonism is difficult. The aim of the study was to evaluate the utility of (123I)-FP-CIT SPECT in patients with movement disorders.

52 patients were referred from the neurology department to characterize those with parkinsonism. Patients were clinically evaluated and those with Parkinson's disease were assessed using the rating scale Hoehn & Yahr and the UPDRS motor score. Subsequently, a (123I)-FP-CIT SPECT was performed with a qualitative analysis.

All patients with essential tremor and drug-induced parkinsonism had a normal SPECT. All patients with parkinsonism displayed SPECT defects, except for four who had a normal SPECT result. Two of them were categorized as vascular parkinsonisms, one patient had a Shy-Drager's syndrome and the another one had probably a Parkinson's disease. The sensitivity and specificity were 90.47% (38/42; CI95%, 81.59%-99.35%) and 100% (10/10; CI95%, 69.15%-100%), respectively.

(123I)-FP-CIT SPECT is an effective tool to study the integrity of the dopaminergic nigrostriatal system. Moreover, it permits to characterize the different types of parkinsonism.