title: Experience with DaTscan at a tertiary referral center.
abstract: BACKGROUND
  The accuracy of a clinical diagnosis of Parkinson's disease varies with the criteria employed and the population. Misdiagnosis of Parkinson's disease can lead to inappropriate long-term medication use and exposure to their potentially harmful side effects. Functional imaging of the dopamine transporter (DaT) defines integrity of the striatal dopaminergic system and provides a marker for presynaptic neuronal degeneration. DaT imaging is abnormal even in the earliest clinical presentations of parkinsonism associated with nigrostriatal degeneration and a normal scan suggests an alternative diagnosis such as essential tremor, dystonic tremor, drug-induced parkinsonism, or psychogenic parkinsonism.
  
  
  OBJECTIVE
  The main objective of our study was to determine the impact of DaT imaging on the clinical diagnosis and management of patients with clinically uncertain parkinsonian syndromes, especially in patients with exposure to neuroleptics, in our tertiary movement disorders referral center.
  
  
  METHODS
  We performed a retrospective chart review of all 65 patients who had DaTscans from August 2011 to December 2012.
  
  
  RESULTS
  Our management changed in 63% of patients as a result of the DaTscan. Imaging also increased the confidence in diagnosis.
  
  
  CONCLUSIONS
  We conclude that DaTscan can have a significant impact on the clinical management of patients with clinically uncertain parkinsonian syndromes in a tertiary referral center.
authors.affiliation: Department of Neurology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, USA.
authors.forename: Suja
authors.initials: S
authors.lastname: Sadasivan
authors.affiliation: Movement Disorders Program, Butler Hospital, Division of Movement Disorders, Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA. Electronic address: joseph_friedman@brown.edu.
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Friedman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000627:therapeutic use; D001921:Brain / Q000000981:diagnostic imaging* / Q000187:drug effects; D050483:Dopamine Plasma Membrane Transport Proteins / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy; D012189:Retrospective Studies; D012737:Sex Factors; D015899:Tomography, Emission-Computed, Single-Photon; D055815:Young Adult
chemical_list: D000978:Antiparkinson Agents; D050483:Dopamine Plasma Membrane Transport Proteins
keywords: Atypical parkinsonism; DaTscan; Dopamine transporter imaging; Drug induced parkinsonism; Neurodegenerative parkinsonism; Parkinson's disease