title: The role of functional dopamine-transporter SPECT imaging in parkinsonian syndromes, part 1.
abstract: As we defeat infectious diseases and cancer, one of the greatest medical challenges facing us in the mid-21st century will be the increasing prevalence of degenerative disease. Those diseases, which affect movement and cognition, can be the most debilitating. Dysfunction of the extrapyramidal system results in increasing motor disability often manifest as tremor, bradykinesia, and rigidity. The common pathologic pathway of these diseases, collectively described as parkinsonian syndromes, such as Parkinson disease, multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, and dementia with Lewy bodies, is degeneration of the presynaptic dopaminergic pathways in the basal ganglia. Conventional MR imaging is insensitive, especially in early disease, so functional imaging has become the primary method used to differentiate a true parkinsonian syndrome from vascular parkinsonism, drug-induced changes, or essential tremor. Unusually for a modern functional imaging technique, the method most widely used in European clinics depends on SPECT and not PET. This SPECT technique (described in the first of 2 parts) commonly reports dopamine-transporter function, with decreasing striatal uptake demonstrating increasingly severe disease.
authors.affiliation: From the Department of Neuroradiology (T.C.B.), National Hospital for Neurology and Neurosurgery, London, UK tombooth@doctors.org.uk.
authors.forename: T C
authors.initials: TC
authors.lastname: Booth
authors.affiliation: Department of Nuclear Medicine (M.N., A.-M.Q.), Royal Free Hospital National Health Service Trust, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Nathan
authors.affiliation: Department of Imaging (A.D.W.), Imperial College Healthcare National Health Service Trust, London, UK.
authors.forename: A D
authors.initials: AD
authors.lastname: Waldman
authors.affiliation: Department of Nuclear Medicine (M.N., A.-M.Q.), Royal Free Hospital National Health Service Trust, London, UK.
authors.forename: A-M
authors.initials: AM
authors.lastname: Quigley
authors.affiliation: Department of Clinical Neurosciences (A.H.S.), Institute of Neurology, University College London, London, UK.
authors.forename: A H
authors.initials: AH
authors.lastname: Schapira
authors.affiliation: Department of Nuclear Medicine (J.B.), Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
authors.forename: J
authors.initials: J
authors.lastname: Buscombe
mesh_terms: D001479:Basal Ganglia / Q000378:metabolism / Q000473:pathology; D050483:Dopamine Plasma Membrane Transport Proteins / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D010300:Parkinson Disease / Q000175:diagnosis* / Q000503:physiopathology; D020734:Parkinsonian Disorders / Q000175:diagnosis* / Q000378:metabolism; D013378:Substantia Nigra / Q000473:pathology; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D050483:Dopamine Plasma Membrane Transport Proteins