J Puñal Riobóo1, L Varela Lema, A Serena Puig, A Ruano-Ravina. 1. Agencia de Evaluación de Tecnologías Sanitarias de Galicia (avalia-t). Consellería de Sanidade. Xunta de Galicia. Santiago de Compostela. A Coruña. España.
Abstract
BACKGROUND: Parkinson disease (PD) is the second most frequent neurodegenerative disease, affecting the 1-2 % of the population over 65. Around 20-24 % of diagnosed patients are estimated to be misdiagnosed. The aim of this paper is to assess the efficacy of DaTSCAN in the diagnosis of early PD and to determine the efficacy of 123I-FP in the differential diagnosis of vascular parkinsonism, drug-induced parkinsonism, essential tremor, Lewy body dementia (LBD) and Alzheimer disease (AD). METHODS: Systematic review. Two independent investigators reviewed and selected the papers according to predefined selection criteria. The quality of the original studies was assessed using one specifically designed scale. RESULTS: Eleven original articles were included. No randomized clinical trials were found. Three papers assessed the effect of DaTSCAN in medication of patients and found that 17 to 69 % of the patients treatment changed after SPECT. Six studies assessed the change in the diagnosis for patients with parkinsonian syndromes after SPECT. Four of them showed that 123I-FP could be useful for the differential diagnosis between PD and non-degenerative disorders. One observed that ioflupane could help differentiate between PD and AD and between this last disease and LBD. The other investigation group showed that DaTSCAN could help in the differential diagnosis between PD and parkinsonian syndromes such as multisystem atrophy (MSA) and progressive supranuclear palsy (PSP). CONCLUSIONS: The scientific evidence available indicates that 123I-FP can be useful to differentiate PD from essential tremor and vascular and drug-induced parkinsonism, and also to differentiate AD from LBD.
BACKGROUND:Parkinson disease (PD) is the second most frequent neurodegenerative disease, affecting the 1-2 % of the population over 65. Around 20-24 % of diagnosed patients are estimated to be misdiagnosed. The aim of this paper is to assess the efficacy of DaTSCAN in the diagnosis of early PD and to determine the efficacy of 123I-FP in the differential diagnosis of vascular parkinsonism, drug-induced parkinsonism, essential tremor, Lewy body dementia (LBD) and Alzheimer disease (AD). METHODS: Systematic review. Two independent investigators reviewed and selected the papers according to predefined selection criteria. The quality of the original studies was assessed using one specifically designed scale. RESULTS: Eleven original articles were included. No randomized clinical trials were found. Three papers assessed the effect of DaTSCAN in medication of patients and found that 17 to 69 % of the patients treatment changed after SPECT. Six studies assessed the change in the diagnosis for patients with parkinsonian syndromes after SPECT. Four of them showed that 123I-FP could be useful for the differential diagnosis between PD and non-degenerative disorders. One observed that ioflupane could help differentiate between PD and AD and between this last disease and LBD. The other investigation group showed that DaTSCAN could help in the differential diagnosis between PD and parkinsonian syndromes such as multisystem atrophy (MSA) and progressive supranuclear palsy (PSP). CONCLUSIONS: The scientific evidence available indicates that 123I-FP can be useful to differentiate PD from essential tremor and vascular and drug-induced parkinsonism, and also to differentiate AD from LBD.