title: Dopamine transporter scanning in the evaluation of patients with suspected Parkinsonism: a case-based user's guide.
abstract: Given the wide range of manifestations of parkinsonism and its mimics, the diagnosis may remain elusive or be misattributed in some patients. Dopamine transporter (DAT) single photon emission computed tomography (SPECT) (DaTscan), an imaging technique that probes the integrity of the presynaptic nigrostriatal system, can be useful in the evaluation of clinically complex parkinsonian disorders in the appropriate context and when adequately interpreted. Pearls and pitfalls in the use of DaTscan for the differential diagnosis of parkinsonisms are reviewed using a case-based format. While the DaTscan is no replacement for a careful neurological examination in ascertaining the likelihood of Parkinson disease or other parkinsonisms in most clinical scenarios, it can be useful in the assessment of disorders where an abducting resting tremor, a prominent postural tremor, or incongruent features are not sufficiently clear on exam to distinguish neurodegenerative parkinsonism from dystonia, drug-induced parkinsonism and functional (psychogenic) parkinsonism, respectively.
authors.affiliation: a Department of Neurology, UC Neuroscience Institute , University of Cincinnati , Cincinnati , Ohio , USA.|b Gardner Family Center for Parkinson's Disease and Movement Disorders , Cincinnati , Ohio , USA.
authors.forename: Federico
authors.initials: F
authors.lastname: Rodriguez-Porcel
authors.affiliation: a Department of Neurology, UC Neuroscience Institute , University of Cincinnati , Cincinnati , Ohio , USA.|b Gardner Family Center for Parkinson's Disease and Movement Disorders , Cincinnati , Ohio , USA.
authors.forename: Sheheryar
authors.initials: S
authors.lastname: Jamali
authors.affiliation: a Department of Neurology, UC Neuroscience Institute , University of Cincinnati , Cincinnati , Ohio , USA.|b Gardner Family Center for Parkinson's Disease and Movement Disorders , Cincinnati , Ohio , USA.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Duker
authors.affiliation: a Department of Neurology, UC Neuroscience Institute , University of Cincinnati , Cincinnati , Ohio , USA.|b Gardner Family Center for Parkinson's Disease and Movement Disorders , Cincinnati , Ohio , USA.
authors.forename: Alberto J
authors.initials: AJ
authors.lastname: Espay
mesh_terms: D006801:Humans; D010300:Parkinson Disease / Q000000981:diagnostic imaging*; D015899:Tomography, Emission-Computed, Single-Photon / Q000592:standards*
keywords: DaTscan; Parkinson disease; SWEDD; drug-induced parkinsonism; parkinsonism; tremor