Dopamine transporter imaging for the diagnosis of multiple system atrophy cerebellar type.
Parkinsonism & Related Disorders. 2019-02-01; :
DOI: 10.1016/j.parkreldis.2019.02.006
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Vergnet S(1), Hives F(2), Foubert-Samier A(3), Payoux P(4), Fernandez P(5), Meyer M(5), Dupouy J(6), Brefel-Courbon C(6), Ory-Magne F(6), Rascol O(7), Tison F(8), Pavy-Le Traon A(9), Meissner WG(10).
Author information:
(1)Service de Neurologie, CRMR Atrophie Multisystématisée, CHU Bordeaux, 33000, Bordeaux, France.
(2)Service de Médecine Nucléaire, CHU Toulouse Purpan, 31059, Toulouse cedex, France.
(3)Service de Neurologie, CRMR Atrophie Multisystématisée, CHU Bordeaux, 33000, Bordeaux, France; INSERM U 897, Public Health and Development Institute (ISPED), Bordeaux University, Bordeaux, France.
(4)Service de Médecine Nucléaire, CHU Toulouse Purpan, 31059, Toulouse cedex, France; ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France.
(5)Service de Médecine Nucléaire, Pellegrin, CHU de Bordeaux, Bordeaux, France; INCIA, UMR CNRS 5287, 33000, Bordeaux, France; Univ. de Bordeaux, 33000, Bordeaux, France.
(6)Service de Neurologie et de Pharmacologie, CHU de Toulouse, INSERM U1214, Toulouse University, Toulouse, France.
(7)Université de Toulouse 3, CHU de Toulouse, INSERM, Centre de reference AMS, Service de Neurologie et de Pharmacologie Clinique, Centre d’Investigation Clinique CIC1436, Réseau NS-Park/FCRIN et Centre of excellence for
neurodegenerative disorders (COEN) de Toulouse, Toulouse, France; Service de Neurologie, CRMR Atrophie Multisystématisée, CHU Toulouse 31059 Toulouse Cedex 9 – INSERM U 1048 Institut des Maladies Métaboliques et Cardiovasculaires, 31432, Toulouse Cedex 4, France.
(8)Service de Neurologie, CRMR Atrophie Multisystématisée, CHU Bordeaux, 33000, Bordeaux, France; Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, 33000, Bordeaux, France; CNRS, Institut des Maladies
Neurodégénératives, UMR 5293, 33000, Bordeaux, France.
(9)Service de Neurologie, CRMR Atrophie Multisystématisée, CHU Toulouse 31059 Toulouse Cedex 9 – INSERM U 1048 Institut des Maladies Métaboliques et Cardiovasculaires, 31432, Toulouse Cedex 4, France.
(10)Service de Neurologie, CRMR Atrophie Multisystématisée, CHU Bordeaux, 33000, Bordeaux, France; Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, 33000, Bordeaux, France; CNRS, Institut des Maladies
Neurodégénératives, UMR 5293, 33000, Bordeaux, France; Dept. of Medicine, University of Otago, Christchurch, and New Zealand Brain Research Institute, Christchurch, New Zealand. Electronic address: .
INTRODUCTION: The added value of dopamine transporter SPECT (DAT-SPECT) for the diagnosis of « possible » multiple system atrophy of the cerebellar type (MSA-C) remains unknown.
METHODS: We reviewed retrospectively the charts of 128 consecutive patients with a clinical diagnosis of MSA-C who were seen between 2007 and 2016 at the French Reference Center for MSA. The main objective was to evaluate the proportion of patients for whom the diagnosis of « possible » MSA-C was made because of a positive DAT-SPECT.
RESULTS: Seventy-eight MSA-C patients had at least one DAT-SPECT. Fifty-nine of them were considered for the final analysis. In these, 22 had « possible » MSA-C and 23 « probable » MSA-C before DAT-SPECT, while 14 did not reach diagnosis criteria at that time. In those with « possible » MSA-C, DAT-SPECT was positive in 64%. In patients with « probable » MSA-C, 83% showed nigrostriatal denervation. Six out of 14 (43%) received a diagnosis of « possible » MSA-C because of positive DAT-SPECT. These patients had mean disease duration of 2.3 years at the time of DAT-SPECT compared to 3.5 years of the entire cohort of MSA-C patients with DAT-SPECT. Of the eight remaining, one had positive DAT-SPECT but also pons atrophy on magnetic resonance imaging, and seven progressed to « probable » MSA based on clinical features.
CONCLUSION: Our results suggest that DAT-SPECT significantly contributes to the diagnosis of « possible » MSA-C (43% of patients not reaching consensus diagnosis criteria before DAT-SPECT). DAT-SPECT seems especially useful in patients with shorter disease duration, while a negative result does not exclude a diagnosis of MSA.
Copyright © 2019 Elsevier Ltd. All rights reserved.
DOI: 10.1016/j.parkreldis.2019.02.006
PMID: 30745212