open access

Vol 53, No 2 (2019)
Research paper
Published online: 2019-03-11
Submitted: 2019-01-22
Accepted: 2019-01-22
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Should non-movement specialists refer patients for SPECT-DaTSCAN?

Agata Gajos, Janusz Dąbrowski, Małgorzata Bieńkiewicz, Anna  Płachcińska, Jacek Kuśmierek, Andrzej Bogucki
DOI: 10.5603/PJNNS.a2019.0011
·
Pubmed: 30855703
·
Neurol Neurochir Pol 2019;53(2):138-143.

open access

Vol 53, No 2 (2019)
Research paper
Published online: 2019-03-11
Submitted: 2019-01-22
Accepted: 2019-01-22

Abstract

Background. SPECT with radioligand DaTSCAN (SPECT-DaTSCAN) is a sensitive tool used for assessing the functional integrity of the presynaptic part of the nigrostriatal dopaminergic system. The procedure is useful whenever there is a need to distinguish between neurodegenerative parkinsonism and other parkinsonian syndromes in subjects with equivocal signs and symptoms. It can be assumed that the neurologist’s decision to perform SPECT-DaTSCAN depends on his or her experience and skill in the diagnosis of parkinsonian and tremor syndromes.

Aims. To assess the accuracy of referrals to SPECT-DATSCAN made by non-movement disorders specialists.

Material and methods. Sixty seven patients referred for SPECT-DaTSCAN by a general neurologist were studied. In all subjects, a movement disorder specialist performed the neurological examination, collected medical history, and analysed previous treatments and the results of diagnostic tests.

Results. Evaluation carried out by a movement disorder specialist did not confirm an indication for SPECT-DaTSCAN in 31 patients (46.3%). General neurologists needed support for clinical diagnosis with SPECT-DaTSCAN most frequently in subjects with parkinsonism even though they were presenting a full-blown disease manifestation and even though the patients met the diagnostic criteria for Parkinson’s disease or one of the atypical parkinsonian syndromes.

Conclusions. Our presented results probably reflect the limited experience of general neurologists in the evaluation of parkinsonian syndromes and tremor. The use of SPECT-DaTSCAN by non-movement disorders specialists is associated with a significant risk of overuse of this tool. To minimise this risk, the skills of general neurologists in diagnosing parkinsonian and tremor syndromes should be improved. Moreover, patients should be provided with access to movement disorders specialists.

Abstract

Background. SPECT with radioligand DaTSCAN (SPECT-DaTSCAN) is a sensitive tool used for assessing the functional integrity of the presynaptic part of the nigrostriatal dopaminergic system. The procedure is useful whenever there is a need to distinguish between neurodegenerative parkinsonism and other parkinsonian syndromes in subjects with equivocal signs and symptoms. It can be assumed that the neurologist’s decision to perform SPECT-DaTSCAN depends on his or her experience and skill in the diagnosis of parkinsonian and tremor syndromes.

Aims. To assess the accuracy of referrals to SPECT-DATSCAN made by non-movement disorders specialists.

Material and methods. Sixty seven patients referred for SPECT-DaTSCAN by a general neurologist were studied. In all subjects, a movement disorder specialist performed the neurological examination, collected medical history, and analysed previous treatments and the results of diagnostic tests.

Results. Evaluation carried out by a movement disorder specialist did not confirm an indication for SPECT-DaTSCAN in 31 patients (46.3%). General neurologists needed support for clinical diagnosis with SPECT-DaTSCAN most frequently in subjects with parkinsonism even though they were presenting a full-blown disease manifestation and even though the patients met the diagnostic criteria for Parkinson’s disease or one of the atypical parkinsonian syndromes.

Conclusions. Our presented results probably reflect the limited experience of general neurologists in the evaluation of parkinsonian syndromes and tremor. The use of SPECT-DaTSCAN by non-movement disorders specialists is associated with a significant risk of overuse of this tool. To minimise this risk, the skills of general neurologists in diagnosing parkinsonian and tremor syndromes should be improved. Moreover, patients should be provided with access to movement disorders specialists.

Get Citation

Keywords

SPECT-DaTSCAN, referrals, non-movement disorders specialists, movement disorders specialists

About this article
Title

Should non-movement specialists refer patients for SPECT-DaTSCAN?

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 53, No 2 (2019)

Pages

138-143

Published online

2019-03-11

DOI

10.5603/PJNNS.a2019.0011

Pubmed

30855703

Bibliographic record

Neurol Neurochir Pol 2019;53(2):138-143.

Keywords

SPECT-DaTSCAN
referrals
non-movement disorders specialists
movement disorders specialists

Authors

Agata Gajos
Janusz Dąbrowski
Małgorzata Bieńkiewicz
Anna  Płachcińska
Jacek Kuśmierek
Andrzej Bogucki

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