Article type: Literature Review
Article title: Neuroimaging techniques in differentiating Parkinson's disease from drug-induced parkinsonism: A comprehensive review
Journal: Clinics and Practice
Year: 2023
Authors: Jamir Pitton Rissardo and Ana Letícia Fornari Caprara
E-mail: jamirrissardo@gmail.com
ABSTRACT
Background: Neuroimaging can provide significant benefits in evaluating patients with movement disorders associated with drugs. This literature review describes neuroimaging techniques performed to distinguish Parkinson’s disease from drug-induced parkinsonism. The dopaminergic radiotracers already reported to assess patients with drug-induced parkinsonism are [123I]-FP-CIT, [123I]-β-CIT, [99mTc]-TRODAT-1, [18F]-DOPA, [18F]-AV-133, and [18F]-FP-CIT. The most studied one and the one with the highest number of publications is [123I]-FP-CIT. Fludeoxyglucose (18F) revealed a specific pattern that could predict individuals susceptible to developing drug-induced parkinsonism. Another scintigraphy method is [123I]-MIBG cardiac imaging, in which a relationship between abnormal cardiac imaging and normal dopamine transporter imaging was associated with a progression to degenerative disease in individuals with drug-induced parkinsonism. Structural brain magnetic resonance imaging can be used to assess the striatal region. A transcranial ultrasound is a non-invasive method with significant benefits regarding costs and availability. Optic coherence tomography only showed abnormalities in the late phase of Parkinson’s disease, so no benefit in distinguishing early-phase Parkinson’s disease and drug-induced parkinsonism was found. Most methods demonstrated a high specificity in differentiating degenerative from non-degenerative conditions, but the sensitivity widely varied in the studies. An algorithm was designed based on clinical manifestations, neuroimaging, and drug dose adjustment to assist in the management of patients with drug-induced parkinsonism.
Keywords: dopamine transporter; DAT; dopaminergic imaging; DIP; PET; SPECT; SWEED; SWIDD;neurotransmitter; drug-induced movement disorder
Full text available at:
DOI
10.3390/clinpract13060128
Citation
Rissardo JP, Caprara ALF. Neuroimaging Techniques in Differentiating Parkinson's Disease from Drug-Induced Parkinsonism: A Comprehensive Review. Clin Pract 2023;13:1427-1448.
Figure 1. Neuroimaging characteristics. Abbreviations: CT, computed tomography; fMRI, functional magnetic resonance imaging; MRI, magnetic resonance imaging; MRS, magnetic resonance spectroscopy; PET, positron emission tomography; and SPECT, single-photon emission computed tomography.
Figure 2. Dopamine transporter radiotracer mechanism. Abbreviations: DAT, dopamine transporter; and SPECT, single-photon emission computed tomography.
Figure 3. Algorithm of drug-induced parkinsonism (DIP) management with dopamine transporter (DAT) imaging.
Table 1. Properties of selected radionuclides.
Table 2. Dopamine transporter uptake SPECT appearance classification.
Table 3. Recommendations regarding the influence of different agents in dopamine transporter imaging.
Table 4. Radiotracers and drug-induced parkinsonism.
Table 5. FreeText and MeSH search terms in the US National Library of Medicine.
Table 6. Labeled indications for [123I]-FP-CIT.
Table 7. [123I]-FP-CIT studies of individuals with drug-induced parkinsonism.
Table 8. Labeled indications for [18F]-DOPA.
Table 9. Comparison among different neuroimaging techniques for the differentiation between PD and DIP.