Experience with DaTscan at a tertiary referral center

•DaTscan imaging can aid in the diagnosis of clinically challenging parkinsonism.•We did retrospective chart review on all patients who had DaTscan.•We found that there was a management change in 63% of patients after DaTscan.•DaTscan imaging also increased the confidence in diagnosis.•DaTscan had significant impact on the clinical management in parkinsonism.

BackgroundThe accuracy of a clinical diagnosis of Parkinson's disease varies with the criteria employed and the population. Misdiagnosis of Parkinson's disease can lead to inappropriate long-term medication use and exposure to their potentially harmful side effects. Functional imaging of the dopamine transporter (DaT) defines integrity of the striatal dopaminergic system and provides a marker for presynaptic neuronal degeneration. DaT imaging is abnormal even in the earliest clinical presentations of parkinsonism associated with nigrostriatal degeneration and a normal scan suggests an alternative diagnosis such as essential tremor, dystonic tremor, drug-induced parkinsonism, or psychogenic parkinsonism.ObjectiveThe main objective of our study was to determine the impact of DaT imaging on the clinical diagnosis and management of patients with clinically uncertain parkinsonian syndromes, especially in patients with exposure to neuroleptics, in our tertiary movement disorders referral center.MethodsWe performed a retrospective chart review of all 65 patients who had DaTscans from August 2011 to December 2012.ResultsOur management changed in 63% of patients as a result of the DaTscan. Imaging also increased the confidence in diagnosis.ConclusionsWe conclude that DaTscan can have a significant impact on the clinical management of patients with clinically uncertain parkinsonian syndromes in a tertiary referral center.