Objective: Correlate the clinical parkinsonism and TRODAT.

Background: 99mTc-TRODAT-1 SPECT is well documented method for dopamine transporter survey. Clinical use was usually for Parkinsonism in Taiwan. However, the clinical staging of Parkinson disease(PD) was not correlated to image staging sometimes. This study was focus on the correlation of clinical staging between TRODAT and parkinsonism.

Method: Reviewed the medical records, there were 54 patients who had been arranged TRODAT study in clinical visit of one neurologist during 2017/01/01 to 2018/08/31. Fiver patients didn’t go to the examination and total 49 patients received the examination. Core symptom, diagnosis, H&Y stage and the results of TRODAT were reviewed.

Results: The diagnosis for the patients included: Parkinson disease: 31 patients(57.4%), vascular parkinsonism: 10 patients (18.5%),  essential tremor: 4 patients(7.4%), psychiatric disease: 4 patients(7.4%), cerebellar ataxia: 3 patients (5.6%) and dementia: 2 patients(3.7%). The core symptom of patients were tremor(44.4%), bradykinesia(29.6%) and gait difficulty(25.9%). In patients with tremor predominant, final diagnosis was PD(66.7%), essential tremor(16%), functional disorder(8.3%), cerebrovascular disease(4.2%) and dementia(4.2%). About the results of TRODAT, significant lower level of uptake was noted in PD than non-PD patients. In non-PD patients, the uptake of TRODAT decline as aging but the tendency was not presented in PD patients. However, H&Y stage was not correlate with TRODAT classification in PD patients.

Conclusion: The diagnosis of Parkinson disease was still depended on clinical symptoms and sign, with assessment of laboratory test and image study. TRODAT could help the diagnosis of PD from essential tremor and secondary parkinsonism. It might be poor correlation between the result of TRODAT and the clinical stage of PD. In non-PD patients, the TRODATE results correlated to age but PD patients didn’t.

References: [99mTc]TRODAT-1 SPECT imaging correlates with odor identification in early Parkinson disease A. Siderowf, A. Newberg, K. L. Chou, M. Lloyd, A. Colcher, H. I. Hurtig, M. B. Stern, R. L. Doty, P. D. Mozley, N. Wintering, J. E. Duda, D. Weintraub, P. J. Moberg Neurology May 24, 2005; 64 (10) Differential Diagnosis of Parkinson’s Disease and Vascular Parkinsonism by 99mTc-TRODAT-1 Kai-Yuan Tzen, Chin-Song Lu, Tzu-Chen Yen, Shiaw-Pyng Wey, and Gann Ting THE JOURNAL OF NUCLEAR MEDICINE • Vol. 42 • No. 3 • March 2001

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-correlation-between-99mtc-trodat-1-spect-and-parkinsonism/