Abstract
Objective: Describe real-life value of DaTscan in a Movement Disorder Center for improving diagnosis and management.
Background: DaTscan uses a radiopharmaceutical marker of the striatal dopamine transporter to unmask striatonigral degeneration for diagnosis of neurodegenerative parkinsonism syndromes. It has been available since 2011. Initially approved to eliminate cases of essential tremor, its use has evolved to clarify other mimics of neurodegenerative parkinsonism syndromes.
Design/Methods: A single center retrospective chart review at University of Nebraska Medical Center (UNMC) Movement Disorders Clinic including five Movement Disorders Specialists (MDS) from 2013–2019.
Results: Our 190 patients had a slight male predominance (n=115, 60.5%) and average age of 67.6 years (range 33–94). Mean Unified Parkinson Disease Rating Scale (UPDRS) Motor Score was 28.76 (range 3–75, median 28). Most patients had resting tremor (n=105, 55.26%). Mean duration of symptoms before DaTscan was 6.28 years (range 0–43, median 4).
The most common reasons for DaTscan was drug-induced parkinsonism (n=38, 20%). Others included nonspecific parkinsonism (n=37,19.47%), vascular parkinsonism (n=13,6.8%), essential tremor (n=19,10%) and dystonia(n=19,10%).
About half of the patients with DaTscans showed a positive scan (n=99, 52.1%) indicative of neurodegenerative Parkinsonism syndrome. Only one patient had an equivocal result and all others were normal. DaTscan led to treatment change in most patients (n=118, 62.1%).
Conclusions: DaTscan was of proven value for correctly managing drug-induced parkinsonism, vascular parkinsonism, and rare situations including dopa-responsive dystonia, and patients with comorbid brain diseases or injury. In our practice DaTscan was positive in half of the cases, and guided management in most of them.
Disclosure: Dr. Nandanwar has nothing to disclose. Dr. Doss has nothing to disclose. Dr. Doss has nothing to disclose. Dr. Crespo has nothing to disclose. Dr. Cameron has nothing to disclose. Dr. Torres-Russotto has received personal compensation for serving as an employee of University of Nebraska Medical Center. Dr. Torres-Russotto has received personal compensation for serving as an employee of Movement Disorders Consulting, Inc. The institution of Dr. Torres-Russotto has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Acadia. The institution of Dr. Torres-Russotto has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Acorda. The institution of Dr. Torres-Russotto has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Allergan. Dr. Torres-Russotto has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. The institution of Dr. Torres-Russotto has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sunovion. Dr. Torres-Russotto has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Acorda. Dr. Torres-Russotto has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Adamas. Dr. Torres-Russotto has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for IPSEN. Dr. Torres-Russotto has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Kyowa Kirin. Dr. Torres-Russotto has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Teva. The institution of Dr. Torres-Russotto has received research support from Revance. Dr. Bertoni has nothing to disclose. Dr. Bhatti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Bhatti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Bhatti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Accorda. Dr. Bhatti has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. Dr. Bhatti has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Adamas. Dr. Bhatti has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Accadia. Dr. Bhatti has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for PharmEvo Pakistan. Dr. Bhatti has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Allergan Pakistan.
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