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The diagnostic value of dopamine transporter imaging and olfactory testing in patients with parkinsonian syndromes
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Clinical Physiology in Linköping.
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV).ORCID iD: 0000-0002-2167-2450
Uppsala University, Sweden.
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2015 (English)In: Journal of Neurology, ISSN 0340-5354, E-ISSN 1432-1459, Vol. 262, no 9, 2154-2163 p.Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to compare the efficacy of olfactory testing and presynaptic dopamine imaging in diagnosing Parkinsons disease (PD) and atypical parkinsonian syndromes (APS); to evaluate if the combination of these two diagnostic tools can improve their diagnostic value. A prospective investigation of 24 PD patients, 16 APS patients and 15 patients with non-parkinsonian syndromes was performed during an 18-month period. Single photon emission computed tomography with the presynaptic radioligand I-123-FP-CIT (DaTSCAN (R)) and olfactory testing with the Brief 12-item Smell Identification Test (B-SIT) were performed in all patients. DaTSCAN was analysed semi-quantitatively, by calculating two different striatal uptake ratios, and visually according to a predefined ranking scale. B-SIT score was significantly lower for PD patients, but not significantly different between APS and non-parkinsonism. The visual assessment of DaTSCAN had higher sensitivity, specificity and diagnostic accuracy compared to olfactory testing. Most PD patients (75 %) had visually predominant dopamine depletion in putamen, while most APS patients (56 %) had visually severe dopamine depletion both in putamen and in caudate nucleus. The combination of DaTSCAN and B-SIT led to a higher rate of correctly classified patients. Olfactory testing can distinguish PD from non-parkinsonism, but not PD from APS or APS from non-parkinsonism. DaTSCAN is more efficient than olfactory testing and can be valuable in differentiating PD from APS. However, combining olfactory testing and DaTSCAN imaging has a higher predictive value than these two methods separately.

Place, publisher, year, edition, pages
Springer Berlin/Heidelberg, 2015. Vol. 262, no 9, 2154-2163 p.
Keyword [en]
Parkinsons disease; Atypical parkinsonism; Parkinsonian syndromes; Olfaction; I-123-FP-CIT SPECT
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-122669DOI: 10.1007/s00415-015-7830-4ISI: 000363035400018PubMedID: 26122543OAI: oai:DiVA.org:liu-122669DiVA: diva2:871691
Note

Funding Agencies|Ostergotland County Council (ALF); Swedish Parkinsons Foundation

Available from: 2015-11-16 Created: 2015-11-13 Last updated: 2017-06-19Bibliographically approved

Open Access in DiVA

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