Possible impact of dopamine SPECT on decision-making for drug treatment in Parkinsonian syndrome

J Neural Transm (Vienna). 2006 Sep;113(9):1177-90. doi: 10.1007/s00702-005-0401-6. Epub 2006 Feb 6.


Single-photon emission computed tomography (SPECT) markers allow measuring the integrity of the brain dopaminergic system in vivo. We used dopamine transporter (DAT) SPECT with [(123)I]FP-CIT and dopamine D(2)/D(3) receptor SPECT with [(123)I]IBZM to evaluate whether there is a reduction of DAT and/or D(2)/D(3) receptor SPECT in treated and untreated patients with Parkinsonian syndrome (PS). We found that almost a quarter of our patients treated with anti-Parkinsonian medication prior to SPECT imaging did not show evidence of a presynaptic dopaminergic deficit while 37% of untreated patients were diagnosed as having Parkinson's disease. 17% of treated patients had additional loss of D(2)/D(3) receptor binding capacity in concordance with the clinical follow-up diagnoses of multiple system atrophy, progressive nuclear palsy, and vascular Parkinsonism. Apart from 38% clinically uncertain cases, SPECT was in concordance with 75% of initial clinical diagnoses. 25% were reclassified as indicated by SPECT findings and confirmed by a 1.5-year clinical follow-up. We conclude that dopamine SPECT may support establishing or refuting the clinical diagnosis and, therefore, help to make the decision for or against dopaminomimetic treatment in cases with PS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antiparkinson Agents / therapeutic use*
  • Benzamides
  • Diagnosis, Differential
  • Dopamine / metabolism
  • Dopamine / physiology*
  • Dopamine Agents / therapeutic use
  • Dopamine Agonists / therapeutic use
  • Dopamine Plasma Membrane Transport Proteins / metabolism
  • Female
  • Humans
  • Levodopa / therapeutic use
  • Male
  • Middle Aged
  • Parkinsonian Disorders / diagnostic imaging*
  • Parkinsonian Disorders / drug therapy*
  • Parkinsonian Disorders / metabolism
  • Pyrrolidines
  • Radiopharmaceuticals
  • Retrospective Studies
  • Tomography, Emission-Computed, Single-Photon
  • Tropanes


  • Antiparkinson Agents
  • Benzamides
  • Dopamine Agents
  • Dopamine Agonists
  • Dopamine Plasma Membrane Transport Proteins
  • Pyrrolidines
  • Radiopharmaceuticals
  • Tropanes
  • 2-carbomethoxy-8-(3-fluoropropyl)-3-(4-iodophenyl)tropane
  • Levodopa
  • 3-iodo-2-hydroxy-6-methoxy-N-((1-ethyl-2-pyrrolidinyl)methyl)benzamide
  • Dopamine