The diagnostic accuracy of dopamine transporter SPECT imaging to detect nigrostriatal cell loss in patients with Parkinson's disease or clinically uncertain parkinsonism: a systematic review

reposted from

The diagnostic accuracy of dopamine transporter SPECT imaging to detect nigrostriatal cell loss in patients with Parkinson's disease or clinically uncertain parkinsonism: a systematic review Posted: 09 Apr 2015 09:56 AM PDT DAT SPECT is often useful in the clinic but is not 'bullet proof' by any means... I couldn't access the full article here but the diagnostic accuracy depends on who you are comparing the patients to - if it is healthy unaffected people then accuracy will be high... unfortunately lots of the things that mimic PD also give abnormal DAT SPECT scans Here the authors are comparing DAT SPECT with pathological findings... An example of normal and abnormal DAT SPECT scan Normal - 'inverted comma' appearance, Abnormal - 'full stop' appearance EJNMMI Res. 2015 Mar 17;5:12. doi: 10.1186/s13550-015-0087-1. eCollection 2015. Suwijn SR, van Boheemen CJ, de Haan RJ, Tissingh G, Booij J, de Bie RM. In specialized movement disorder centers, Parkinson's disease (PD) is wrongly diagnosed in 6 to 25% of cases. To improve the accuracy of the clinical diagnosis, it is necessary to have a reliable and practical reference standard. Dopamine transporter single-photon emission computed tomography (DAT SPECT) imaging might have the potential (high diagnostic accuracy and practical to use) to act as reference standard in detecting nigrostriatal cell loss in patients with (early stage) parkinsonism. We performed a systematic review to evaluate if DAT SPECT imaging can be used as such. Relevant studies were searched in the MEDLINE and EMBASE databases. Studies were selected when they met the following criteria: (1) all patients were adults with a clinical diagnosis of PD or clinically uncertain parkinsonism and (2) the study reported original data. In addition, studies needed to fulfill one of the two following criteria: (1) patients underwent at least one DAT SPECT and had a neuropathological confirmed diagnosis and (2) patients underwent at least two DAT SPECT scans, performed at least 2 years apart. The search identified 1,649 articles. Eight studies fulfilled our selection criteria and were included in this review. There was only one study including patients with diagnostic uncertainty. Sensitivity and specificity of DAT SPECT imaging to detect nigrostriatal cell loss were 98%. The other studies included patients with a diagnosis of PD in whom there was no uncertainty. In these studies, sensitivity was 100%. Our systematic review indicates that DAT SPECT imaging seems to be accurate to detect nigrostriatal cell loss in patients with parkinsonism.

reposted from

PUBLIC RELEASE DATE:

11-Feb-2014

[ Print | E-mail ]  Share

 [ Close Window ] 

Contact: Ron Najman
ron.najman@downstate.edu
718-270-2696
SUNY Downstate Medical Center 

Excess weight linked to brain changes that may relate to memory, emotions, and appetite

Being overweight appears related to reduced levels of a molecule that reflects brain cell health in the hippocampus, a part of the brain involved in memory, learning, and emotions, and likely also involved in appetite control, according to a study performed by researchers at SUNY Downstate Medical Center and other institutions. The results of the study were published in Neuroimage: Clinical.

Jeremy D. Coplan, MD, professor of psychiatry at SUNY Downstate, led a multicenter team that visualized the molecule, N-acetyl-aspartate (NAA), using magnetic resonance spectroscopy, a non-invasive magnetic resonance imaging (MRI) application. NAA is associated with brain cell health. Overweight study participants exhibited lower levels of NAA in the hippocampus than normal weight subjects. The effect was independent of age, sex, and psychiatric diagnoses.

The importance of the hippocampus – a seahorse-shaped organ deep within the brain – to the formation and preservation of memory and to emotional control is well known, Dr. Coplan notes, but its role in appetite control is less established.

"The relevance of the finding is that being overweight is associated with specific changes in a part of the brain that is crucial to memory formation and emotions, and probably to appetite," said Dr. Coplan. The study is believed to be the first human research documenting the association of NAA with body weight.

"Whether low NAA is a consequence of being overweight, causes being overweight, or a combination of both remains to be determined," Dr. Coplan added. "Future studies are planned to focus on whether weight loss leads to an increase in NAA."

"We also found that high worry also produced low levels of NAA in the hippocampus, but was not associated with a high body mass index (BMI)," Dr. Coplan said. Dr. Coplan and his team looked at persons with a BMI equal to or greater than 25. Normal weight is defined as a BMI of 18.5-24.9, overweight between 25 and 29.9, and obesity at a BMI of 30 or greater.

###

Dr. Coplan's article, "Reduced Hippocampal N-acetyl-aspartate (NAA) as a Biomarker for Overweight," is available online at:

http://www.sciencedirect.com/science/article/pii/S2213158213001733.

SUNY Downstate Medical Center, founded in 1860, was the first medical school in the United States to bring teaching out of the lecture hall and to the patient's bedside. A center of innovation and excellence in research and clinical service delivery, SUNY Downstate Medical Center comprises a College of Medicine, Colleges of Nursing and Health Related Professions, a School of Graduate Studies, a School of Public Health, University Hospital of Brooklyn, and an Advanced Biotechnology Park and Biotechnology Incubator.

SUNY Downstate ranks seventh nationally in the number of alumni who are on the faculty of American medical schools. More physicians practicing in New York City have graduated from SUNY Downstate than from any other medical school.

---

[ Print | E-mail  Share ] [ Close Window ] 

 

AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.

HOME   DISCLAIMER   PRIVACY POLICY   TERMS & CONDITIONS   CONTACT US   TOP Copyright ©2014 by AAAS, the science society.